Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EXT EXC THROMBOTIC HEMORROID

Facility

$6,384.10

Service Code	HCPCS 46320
Hospital Charge Code	5780230
Hospital Revenue Code	450
Min. Negotiated Rate	$957.62
Max. Negotiated Rate	$957.62
Rate for Payer: Qualcare PPO/HMO/WC	$957.62

EXT EXC THROMBOTIC HEMORROID

Facility

$6,384.10

Service Code	HCPCS 46320
Hospital Charge Code	5780230
Hospital Revenue Code	450
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$5,157.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,157.00
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,659.87
Rate for Payer: Qualcare PPO/HMO/WC	$957.62
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$181.31

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$54,373.39

Service Code	APR-DRG 0091
Min. Negotiated Rate	$53,307.25
Max. Negotiated Rate	$54,373.39
Rate for Payer: UnitedHealthcare Community & State	$53,307.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$54,373.39
Rate for Payer: Wellpoint Medicaid Managed Care	$53,307.25

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$57,235.53

Service Code	APR-DRG 0092
Min. Negotiated Rate	$56,113.26
Max. Negotiated Rate	$57,235.53
Rate for Payer: UnitedHealthcare Community & State	$56,113.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$57,235.53
Rate for Payer: Wellpoint Medicaid Managed Care	$56,113.26

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$216,478.31

Service Code	APR-DRG 0094
Min. Negotiated Rate	$212,233.64
Max. Negotiated Rate	$216,478.31
Rate for Payer: UnitedHealthcare Community & State	$212,233.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216,478.31
Rate for Payer: Wellpoint Medicaid Managed Care	$212,233.64

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$98,031.45

Service Code	APR-DRG 0093
Min. Negotiated Rate	$96,109.26
Max. Negotiated Rate	$98,031.45
Rate for Payer: UnitedHealthcare Community & State	$96,109.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$98,031.45
Rate for Payer: Wellpoint Medicaid Managed Care	$96,109.26

EXTRACRANIAL PROCEDURES WITH CC

Facility

$70,728.37

Service Code	MSDRG 038
Min. Negotiated Rate	$21,535.88
Max. Negotiated Rate	$70,728.37
Rate for Payer: Aetna Medicare Advantage	$70,728.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,669.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,328.00
Rate for Payer: Cigna Commercial	$36,172.62
Rate for Payer: Cigna Medicare Advantage	$22,669.35
Rate for Payer: Clover Medicare Advantage	$21,535.88
Rate for Payer: EmblemHealth Commercial	$68,008.05
Rate for Payer: Humana Medicare Advantage	$23,349.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,669.35
Rate for Payer: Oxford Commercial	$28,590.21
Rate for Payer: UnitedHealthcare Commercial	$38,269.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,669.35
Rate for Payer: Wellcare Medicare Advantage	$22,669.35

EXTRACRANIAL PROCEDURES WITH MCC

Facility

$123,473.81

Service Code	MSDRG 037
Min. Negotiated Rate	$37,596.19
Max. Negotiated Rate	$123,473.81
Rate for Payer: Aetna Medicare Advantage	$123,473.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93,642.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93,642.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$39,574.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93,642.90
Rate for Payer: Cigna Commercial	$73,390.79
Rate for Payer: Cigna Medicare Advantage	$39,574.94
Rate for Payer: Clover Medicare Advantage	$37,596.19
Rate for Payer: EmblemHealth Commercial	$118,724.82
Rate for Payer: Humana Medicare Advantage	$40,762.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$39,574.94
Rate for Payer: Oxford Commercial	$58,006.80
Rate for Payer: UnitedHealthcare Commercial	$77,644.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$39,574.94
Rate for Payer: Wellcare Medicare Advantage	$39,574.94

EXTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$56,602.88

Service Code	MSDRG 039
Min. Negotiated Rate	$17,234.85
Max. Negotiated Rate	$56,602.88
Rate for Payer: Aetna Medicare Advantage	$56,602.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,583.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,583.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,141.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,583.70
Rate for Payer: Cigna Commercial	$26,205.42
Rate for Payer: Cigna Medicare Advantage	$18,141.95
Rate for Payer: Clover Medicare Advantage	$17,234.85
Rate for Payer: EmblemHealth Commercial	$54,425.85
Rate for Payer: Humana Medicare Advantage	$18,686.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,141.95
Rate for Payer: Oxford Commercial	$20,712.31
Rate for Payer: UnitedHealthcare Commercial	$27,724.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,141.95
Rate for Payer: Wellcare Medicare Advantage	$18,141.95

EXTRACTABLE NUC ANTIGENS

Facility

$476.00

Service Code	HCPCS 86235
Hospital Charge Code	38476051
Hospital Revenue Code	302
Min. Negotiated Rate	$71.40
Max. Negotiated Rate	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$71.40

EXTRACTABLE NUC ANTIGENS

Facility

$476.00

Service Code	HCPCS 86235
Hospital Charge Code	38476051
Hospital Revenue Code	302
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$238.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$238.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$13.52

EXTRACTION ERUPTED TOOTH EXR

Facility

$9,790.05

Service Code	HCPCS D7140
Hospital Charge Code	1600000777
Hospital Revenue Code	360
Min. Negotiated Rate	$278.04
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,089.07
Rate for Payer: Aetna Medicare Advantage	$2,488.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$768.04
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	$2,786.07
Rate for Payer: Cigna Commercial	$1,539.55
Rate for Payer: Cigna Medicare Advantage	$768.04
Rate for Payer: Clover Medicare Advantage	$729.64
Rate for Payer: EmblemHealth Commercial	$2,304.12
Rate for Payer: Humana Medicare Advantage	$791.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$768.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,545.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51
Rate for Payer: UnitedHealthcare Community & State	$309.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$768.04
Rate for Payer: Wellcare Medicare Advantage	$768.04
Rate for Payer: Wellpoint Medicaid Managed Care	$278.04

EXTRACTION ERUPTED TOOTH EXR

Facility

$9,790.05

Service Code	HCPCS D7140
Hospital Charge Code	1600000777
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.51
Max. Negotiated Rate	$1,468.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

EXTRACTION ERUPTED TOOTH/EXR

Facility

$9,790.05

Service Code	HCPCS D7140
Hospital Charge Code	1600000743
Hospital Revenue Code	360
Min. Negotiated Rate	$278.04
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,089.07
Rate for Payer: Aetna Medicare Advantage	$2,488.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$768.04
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	$2,786.07
Rate for Payer: Cigna Commercial	$1,539.55
Rate for Payer: Cigna Medicare Advantage	$768.04
Rate for Payer: Clover Medicare Advantage	$729.64
Rate for Payer: EmblemHealth Commercial	$2,304.12
Rate for Payer: Humana Medicare Advantage	$791.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$768.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,545.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51
Rate for Payer: UnitedHealthcare Community & State	$309.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$768.04
Rate for Payer: Wellcare Medicare Advantage	$768.04
Rate for Payer: Wellpoint Medicaid Managed Care	$278.04

EXTRACTION ERUPTED TOOTH/EXR

Facility

$9,790.05

Service Code	HCPCS D7140
Hospital Charge Code	1600000743
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.51
Max. Negotiated Rate	$1,468.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

EXTRACTOR BROKEN SCREW 7MM

Facility

$1,550.00

Hospital Charge Code	270694536
Hospital Revenue Code	272
Min. Negotiated Rate	$44.02
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$589.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.00
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$310.00
Rate for Payer: UnitedHealthcare Community & State	$48.98
Rate for Payer: Wellpoint Medicaid Managed Care	$44.02

EXTRACTOR BROKEN SCREW 7MM

Facility

$1,550.00

Hospital Charge Code	270694536
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

EXTRACTOR CONICAL LARGE

Facility

$1,750.00

Hospital Charge Code	270688297
Hospital Revenue Code	272
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

EXTRACTOR CONICAL LARGE

Facility

$1,750.00

Hospital Charge Code	270688297
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694535
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694535
Hospital Revenue Code	272
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694835
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

EXTRACTOR NAIL CONICAL 12MM

Facility

$1,750.00

Hospital Charge Code	270694835
Hospital Revenue Code	272
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

EXTRACTOR NAIL SOLID LARGE

Facility

$1,500.00

Hospital Charge Code	270688298
Hospital Revenue Code	272
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

EXTRACTOR NAIL SOLID LARGE

Facility

$1,500.00

Hospital Charge Code	270688298
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges