Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EXC SHOULDER TUM DEEP 5 CM/>

Facility

$11,141.64

Service Code	HCPCS 23073
Hospital Charge Code	16000443
Hospital Revenue Code	360
Min. Negotiated Rate	$316.42
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,896.83
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,671.25
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$352.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$316.42

EXC SHOULDER TUM DEEP 5 CM/>

Facility

$11,141.64

Service Code	HCPCS 23073
Hospital Charge Code	16000443
Hospital Revenue Code	360
Min. Negotiated Rate	$1,671.25
Max. Negotiated Rate	$1,671.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,671.25

EXC SHOULDER TUM DEEP< 5 CM B

Facility

$15,933.34

Service Code	HCPCS 23076
Hospital Charge Code	16000812
Hospital Revenue Code	360
Min. Negotiated Rate	$452.51
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,142.67
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,390.00
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$503.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$452.51

EXC SHOULDER TUM DEEP< 5 CM B

Facility

$15,933.34

Service Code	HCPCS 23076
Hospital Charge Code	16000812
Hospital Revenue Code	360
Min. Negotiated Rate	$2,390.00
Max. Negotiated Rate	$2,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,390.00

EXC SKIN ABD

Facility

$42,601.70

Service Code	HCPCS 15830
Hospital Charge Code	16000353
Hospital Revenue Code	360
Min. Negotiated Rate	$6,390.26
Max. Negotiated Rate	$6,390.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26

EXC SKIN ABD

Facility

$42,601.70

Service Code	HCPCS 15830
Hospital Charge Code	16000353
Hospital Revenue Code	360
Min. Negotiated Rate	$1,209.89
Max. Negotiated Rate	$28,616.22
Rate for Payer: Aetna Commercial	$21,457.24
Rate for Payer: Aetna Medicare Advantage	$25,559.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,616.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,616.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,888.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,616.22
Rate for Payer: Cigna Commercial	$15,812.86
Rate for Payer: Cigna Medicare Advantage	$7,888.69
Rate for Payer: Clover Medicare Advantage	$7,494.26
Rate for Payer: EmblemHealth Commercial	$23,666.07
Rate for Payer: Humana Medicare Advantage	$8,125.35
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,888.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,076.44
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,346.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,888.69
Rate for Payer: Wellcare Medicare Advantage	$7,888.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,209.89

EXC SKIN ABD ADD-ON

Facility

$42,601.70

Service Code	HCPCS 15847
Hospital Charge Code	16000438
Hospital Revenue Code	360
Min. Negotiated Rate	$1,209.89
Max. Negotiated Rate	$21,300.85
Rate for Payer: Aetna Commercial	$16,188.65
Rate for Payer: Aetna Medicare Advantage	$12,780.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,863.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,863.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,863.43
Rate for Payer: Cigna Commercial	$21,300.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,076.44
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$1,346.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1,209.89

EXC SKIN ABD ADD-ON

Facility

$42,601.70

Service Code	HCPCS 15847
Hospital Charge Code	16000438
Hospital Revenue Code	360
Min. Negotiated Rate	$6,390.26
Max. Negotiated Rate	$6,390.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26

EXC SKN HDRDNT ING SMPL/NTRM

Facility

$16,852.60

Service Code	HCPCS 11462
Hospital Charge Code	1600000500
Hospital Revenue Code	360
Min. Negotiated Rate	$2,527.89
Max. Negotiated Rate	$2,527.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,527.89

EXC SKN HDRDNT ING SMPL/NTRM

Facility

$16,852.60

Service Code	HCPCS 11462
Hospital Charge Code	1600000500
Hospital Revenue Code	360
Min. Negotiated Rate	$478.61
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,381.68
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,527.89
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$532.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$478.61

EXC S/N/H/F/G MAL+MRG 3.1-4

Facility

$6,322.68

Service Code	HCPCS 11624
Hospital Charge Code	16000777
Hospital Revenue Code	360
Min. Negotiated Rate	$948.40
Max. Negotiated Rate	$948.40
Rate for Payer: Qualcare PPO/HMO/WC	$948.40

EXC S/N/H/F/G MAL+MRG 3.1-4

Facility

$6,322.68

Service Code	HCPCS 11624
Hospital Charge Code	16000777
Hospital Revenue Code	360
Min. Negotiated Rate	$179.56
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,643.90
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$948.40
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$199.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$179.56

EXC S/N/H/F/G MAL+MRG > 4 CM

Facility

$11,452.64

Service Code	HCPCS 11626
Hospital Charge Code	16000493
Hospital Revenue Code	360
Min. Negotiated Rate	$325.25
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,977.69
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$361.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$325.25

EXC S/N/H/F/G MAL+MRG > 4 CM

Facility

$11,452.64

Service Code	HCPCS 11626
Hospital Charge Code	16000493
Hospital Revenue Code	360
Min. Negotiated Rate	$1,717.90
Max. Negotiated Rate	$1,717.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90

EXCSN OF LNGL FRNM (FRENECTOMY

Facility

$6,474.80

Service Code	HCPCS 41115
Hospital Charge Code	16000583
Hospital Revenue Code	360
Min. Negotiated Rate	$971.22
Max. Negotiated Rate	$971.22
Rate for Payer: Qualcare PPO/HMO/WC	$971.22

EXCSN OF LNGL FRNM (FRENECTOMY

Facility

$6,474.80

Service Code	HCPCS 41115
Hospital Charge Code	16000583
Hospital Revenue Code	360
Min. Negotiated Rate	$183.88
Max. Negotiated Rate	$6,686.64
Rate for Payer: Aetna Commercial	$5,013.83
Rate for Payer: Aetna Medicare Advantage	$5,972.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,686.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,686.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,843.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,686.64
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: Cigna Medicare Advantage	$1,843.32
Rate for Payer: Clover Medicare Advantage	$1,751.15
Rate for Payer: EmblemHealth Commercial	$5,529.96
Rate for Payer: Humana Medicare Advantage	$1,898.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,843.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.45
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.22
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$204.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,843.32
Rate for Payer: Wellcare Medicare Advantage	$1,843.32
Rate for Payer: Wellpoint Medicaid Managed Care	$183.88

EXC ST LESION EXT AUDITRY CNL

Facility

$13,615.50

Service Code	HCPCS 69145
Hospital Charge Code	16000528
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC ST LESION EXT AUDITRY CNL

Facility

$13,615.50

Service Code	HCPCS 69145
Hospital Charge Code	16000528
Hospital Revenue Code	360
Min. Negotiated Rate	$386.68
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,540.03
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$430.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$386.68

EXC SYNOVIUAL CYST POPLTEAL SP

Facility

$105,850.92

Service Code	HCPCS 27345
Hospital Charge Code	16000880
Hospital Revenue Code	360
Min. Negotiated Rate	$3,006.17
Max. Negotiated Rate	$27,521.24
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27,521.24
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,877.64
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$3,344.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3,006.17

EXC SYNOVIUAL CYST POPLTEAL SP

Facility

$105,850.92

Service Code	HCPCS 27345
Hospital Charge Code	16000880
Hospital Revenue Code	360
Min. Negotiated Rate	$15,877.64
Max. Negotiated Rate	$15,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$15,877.64

EXC TARSAL/METATRAS CYST/TUMOR

Facility

$21,064.35

Service Code	HCPCS 28104
Hospital Charge Code	16000282
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.65
Max. Negotiated Rate	$3,159.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.65

EXC TARSAL/METATRAS CYST/TUMOR

Facility

$21,064.35

Service Code	HCPCS 28104
Hospital Charge Code	16000282
Hospital Revenue Code	360
Min. Negotiated Rate	$598.23
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,476.73
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.65
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$665.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$598.23

EXC THIGH/KNEE LES SC 3 CM/>

Facility

$16,680.90

Service Code	HCPCS 27337
Hospital Charge Code	16000238
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.14
Max. Negotiated Rate	$2,502.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14

EXC THIGH/KNEE LES SC 3 CM/>

Facility

$16,680.90

Service Code	HCPCS 27337
Hospital Charge Code	16000238
Hospital Revenue Code	360
Min. Negotiated Rate	$473.74
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,337.03
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$527.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$473.74

EXC THIGH/KNEE LES SC < 3CM

Facility

$20,625.50

Service Code	HCPCS 27327
Hospital Charge Code	16000413
Hospital Revenue Code	360
Min. Negotiated Rate	$585.76
Max. Negotiated Rate	$8,192.00
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,362.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$585.76

Know your out-of-pocket cost for care.

All Charges