Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EXTENSION TUBE FR EPIDURAL INJ

Facility

$182.00

Hospital Charge Code	270325400
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

EXTENSION TUBING

Facility

$39.75

Hospital Charge Code	270654298
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.96

EXTENSION TUBING

Facility

$39.75

Hospital Charge Code	270654298
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$19.88
Rate for Payer: Aetna Commercial	$15.11
Rate for Payer: Aetna Medicare Advantage	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.14
Rate for Payer: Cigna Commercial	$19.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.34
Rate for Payer: Oxford Commercial	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$5.96
Rate for Payer: UnitedHealthcare Commercial	$7.95
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$39,079.68

Service Code	APR-DRG 9113
Min. Negotiated Rate	$38,313.41
Max. Negotiated Rate	$39,079.68
Rate for Payer: UnitedHealthcare Community & State	$38,313.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,079.68
Rate for Payer: Wellpoint Medicaid Managed Care	$38,313.41

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$20,666.87

Service Code	APR-DRG 9111
Min. Negotiated Rate	$20,261.64
Max. Negotiated Rate	$20,666.87
Rate for Payer: UnitedHealthcare Community & State	$20,261.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,666.87
Rate for Payer: Wellpoint Medicaid Managed Care	$20,261.64

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$29,538.37

Service Code	APR-DRG 9112
Min. Negotiated Rate	$28,959.19
Max. Negotiated Rate	$29,538.37
Rate for Payer: UnitedHealthcare Community & State	$28,959.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,538.37
Rate for Payer: Wellpoint Medicaid Managed Care	$28,959.19

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$81,044.05

Service Code	APR-DRG 9114
Min. Negotiated Rate	$79,454.95
Max. Negotiated Rate	$81,044.05
Rate for Payer: UnitedHealthcare Community & State	$79,454.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$81,044.05
Rate for Payer: Wellpoint Medicaid Managed Care	$79,454.95

EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT

Facility

$142,496.30

Service Code	MSDRG 933
Min. Negotiated Rate	$43,388.30
Max. Negotiated Rate	$142,496.30
Rate for Payer: Aetna Commercial	$103,346.01
Rate for Payer: Aetna Medicare Advantage	$142,496.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83,946.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83,946.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$45,671.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83,946.15
Rate for Payer: Cigna Commercial	$85,085.69
Rate for Payer: Cigna Medicare Advantage	$45,671.89
Rate for Payer: Clover Medicare Advantage	$43,388.30
Rate for Payer: EmblemHealth Commercial	$137,015.67
Rate for Payer: Humana Medicare Advantage	$47,042.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$45,671.89
Rate for Payer: Oxford Commercial	$67,250.25
Rate for Payer: UnitedHealthcare Commercial	$90,016.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$45,671.89
Rate for Payer: Wellcare Medicare Advantage	$45,671.89

EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT

Facility

$730,303.80

Service Code	MSDRG 927
Min. Negotiated Rate	$211,315.01
Max. Negotiated Rate	$730,303.80
Rate for Payer: Aetna Commercial	$496,135.46
Rate for Payer: Aetna Medicare Advantage	$694,002.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730,303.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730,303.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$222,436.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730,303.80
Rate for Payer: Cigna Commercial	$410,864.45
Rate for Payer: Cigna Medicare Advantage	$222,436.85
Rate for Payer: Clover Medicare Advantage	$211,315.01
Rate for Payer: EmblemHealth Commercial	$667,310.55
Rate for Payer: Humana Medicare Advantage	$229,109.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$222,436.85
Rate for Payer: Oxford Commercial	$324,740.12
Rate for Payer: UnitedHealthcare Commercial	$434,676.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$222,436.85
Rate for Payer: Wellcare Medicare Advantage	$222,436.85

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$23,569.76

Service Code	APR-DRG 7922
Min. Negotiated Rate	$23,107.61
Max. Negotiated Rate	$23,569.76
Rate for Payer: UnitedHealthcare Community & State	$23,107.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,569.76
Rate for Payer: Wellpoint Medicaid Managed Care	$23,107.61

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$18,842.60

Service Code	APR-DRG 7921
Min. Negotiated Rate	$18,473.14
Max. Negotiated Rate	$18,842.60
Rate for Payer: UnitedHealthcare Community & State	$18,473.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,842.60
Rate for Payer: Wellpoint Medicaid Managed Care	$18,473.14

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$64,774.28

Service Code	APR-DRG 7924
Min. Negotiated Rate	$63,504.20
Max. Negotiated Rate	$64,774.28
Rate for Payer: UnitedHealthcare Community & State	$63,504.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$64,774.28
Rate for Payer: Wellpoint Medicaid Managed Care	$63,504.20

EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT

Facility

$34,182.62

Service Code	APR-DRG 7923
Min. Negotiated Rate	$33,512.37
Max. Negotiated Rate	$34,182.62
Rate for Payer: UnitedHealthcare Community & State	$33,512.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,182.62
Rate for Payer: Wellpoint Medicaid Managed Care	$33,512.37

EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC

Facility

$97,137.46

Service Code	MSDRG 982
Min. Negotiated Rate	$29,577.11
Max. Negotiated Rate	$97,137.46
Rate for Payer: Aetna Commercial	$71,040.92
Rate for Payer: Aetna Medicare Advantage	$97,137.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68,985.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68,985.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68,985.45
Rate for Payer: Cigna Commercial	$54,807.34
Rate for Payer: Cigna Medicare Advantage	$31,133.80
Rate for Payer: Clover Medicare Advantage	$29,577.11
Rate for Payer: EmblemHealth Commercial	$93,401.40
Rate for Payer: Humana Medicare Advantage	$32,067.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$31,133.80
Rate for Payer: Oxford Commercial	$43,318.77
Rate for Payer: UnitedHealthcare Commercial	$57,983.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,133.80
Rate for Payer: Wellcare Medicare Advantage	$31,133.80

EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC

Facility

$167,695.29

Service Code	MSDRG 981
Min. Negotiated Rate	$51,061.07
Max. Negotiated Rate	$167,695.29
Rate for Payer: Aetna Commercial	$121,293.02
Rate for Payer: Aetna Medicare Advantage	$167,695.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131,321.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131,321.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$53,748.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131,321.70
Rate for Payer: Cigna Commercial	$104,594.30
Rate for Payer: Cigna Medicare Advantage	$53,748.49
Rate for Payer: Clover Medicare Advantage	$51,061.07
Rate for Payer: EmblemHealth Commercial	$161,245.47
Rate for Payer: Humana Medicare Advantage	$55,360.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$53,748.49
Rate for Payer: Oxford Commercial	$82,669.52
Rate for Payer: UnitedHealthcare Commercial	$110,656.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$53,748.49
Rate for Payer: Wellcare Medicare Advantage	$53,748.49

EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$73,615.99

Service Code	MSDRG 983
Min. Negotiated Rate	$22,415.13
Max. Negotiated Rate	$73,615.99
Rate for Payer: Aetna Commercial	$54,288.66
Rate for Payer: Aetna Medicare Advantage	$73,615.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,436.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,436.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,594.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,436.20
Rate for Payer: Cigna Commercial	$38,210.20
Rate for Payer: Cigna Medicare Advantage	$23,594.87
Rate for Payer: Clover Medicare Advantage	$22,415.13
Rate for Payer: EmblemHealth Commercial	$70,784.61
Rate for Payer: Humana Medicare Advantage	$24,302.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,594.87
Rate for Payer: Oxford Commercial	$30,200.68
Rate for Payer: UnitedHealthcare Commercial	$40,424.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,594.87
Rate for Payer: Wellcare Medicare Advantage	$23,594.87

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$26,964.09

Service Code	APR-DRG 9502
Min. Negotiated Rate	$26,435.38
Max. Negotiated Rate	$26,964.09
Rate for Payer: UnitedHealthcare Community & State	$26,435.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,964.09
Rate for Payer: Wellpoint Medicaid Managed Care	$26,435.38

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$40,901.18

Service Code	APR-DRG 9503
Min. Negotiated Rate	$40,099.20
Max. Negotiated Rate	$40,901.18
Rate for Payer: UnitedHealthcare Community & State	$40,099.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$40,901.18
Rate for Payer: Wellpoint Medicaid Managed Care	$40,099.20

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$74,367.64

Service Code	APR-DRG 9504
Min. Negotiated Rate	$72,909.45
Max. Negotiated Rate	$74,367.64
Rate for Payer: UnitedHealthcare Community & State	$72,909.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$74,367.64
Rate for Payer: Wellpoint Medicaid Managed Care	$72,909.45

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$20,339.65

Service Code	APR-DRG 9501
Min. Negotiated Rate	$19,940.83
Max. Negotiated Rate	$20,339.65
Rate for Payer: UnitedHealthcare Community & State	$19,940.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,339.65
Rate for Payer: Wellpoint Medicaid Managed Care	$19,940.83

EXTENSIVE PROSATE SURGERY

Facility

$36,779.00

Service Code	HCPCS 55845
Hospital Charge Code	1600000652
Hospital Revenue Code	360
Min. Negotiated Rate	$5,516.85
Max. Negotiated Rate	$5,516.85
Rate for Payer: Qualcare PPO/HMO/WC	$5,516.85

EXTENSIVE PROSATE SURGERY

Facility

$36,779.00

Service Code	HCPCS 55845
Hospital Charge Code	1600000652
Hospital Revenue Code	360
Min. Negotiated Rate	$1,044.52
Max. Negotiated Rate	$18,389.50
Rate for Payer: Aetna Commercial	$13,976.02
Rate for Payer: Aetna Medicare Advantage	$11,033.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,378.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,378.65
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	$9,378.65
Rate for Payer: Cigna Commercial	$18,389.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,562.54
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,516.85
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,162.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,044.52

EXTENSIVE REMOVAL OF LIVER

Facility

$110,145.20

Service Code	HCPCS 47122
Hospital Charge Code	1600000515
Hospital Revenue Code	360
Min. Negotiated Rate	$3,128.12
Max. Negotiated Rate	$55,072.60
Rate for Payer: Aetna Commercial	$41,855.18
Rate for Payer: Aetna Medicare Advantage	$33,043.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,087.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,087.03
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	$28,087.03
Rate for Payer: Cigna Commercial	$55,072.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28,637.75
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$16,521.78
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$3,480.59
Rate for Payer: Wellpoint Medicaid Managed Care	$3,128.12

EXTENSIVE REMOVAL OF LIVER

Facility

$110,145.20

Service Code	HCPCS 47122
Hospital Charge Code	1600000515
Hospital Revenue Code	360
Min. Negotiated Rate	$16,521.78
Max. Negotiated Rate	$16,521.78
Rate for Payer: Qualcare PPO/HMO/WC	$16,521.78

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$27,323.63

Service Code	APR-DRG 8434
Min. Negotiated Rate	$26,787.87
Max. Negotiated Rate	$27,323.63
Rate for Payer: UnitedHealthcare Community & State	$26,787.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,323.63
Rate for Payer: Wellpoint Medicaid Managed Care	$26,787.87

Know your out-of-pocket cost for care.

All Charges