Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FOOT AP LAT LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	2002459
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT ARCH LRF 155MM

Facility

$11,108.10

Service Code	HCPCS A4649
Hospital Charge Code	270699602
Hospital Revenue Code	272
Min. Negotiated Rate	$315.47
Max. Negotiated Rate	$5,554.05
Rate for Payer: Aetna Commercial	$4,221.08
Rate for Payer: Aetna Medicare Advantage	$3,332.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,832.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,832.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,832.57
Rate for Payer: Cigna Commercial	$5,554.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.11
Rate for Payer: Oxford Commercial	$2,221.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21
Rate for Payer: UnitedHealthcare Commercial	$2,221.62
Rate for Payer: UnitedHealthcare Community & State	$351.02
Rate for Payer: Wellpoint Medicaid Managed Care	$315.47

FOOT ARCH LRF 155MM

Facility

$11,108.10

Service Code	HCPCS A4649
Hospital Charge Code	270699602
Hospital Revenue Code	272
Min. Negotiated Rate	$1,666.21
Max. Negotiated Rate	$1,666.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21

FOOT COMPL 3 VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7363050
Hospital Charge Code	94061253
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT COMPL 3 VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7363050
Hospital Charge Code	94061253
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FOOT COMPL 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73630LT
Hospital Charge Code	94061401
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FOOT COMPL 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73630LT
Hospital Charge Code	94061401
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT COMPL 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	94061403
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT COMPL 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	94061403
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FOOTPRINT ULR 4.5 PK SUT SL.

Facility

$1,716.00

Service Code	HCPCS C1713
Hospital Charge Code	270688722
Hospital Revenue Code	278
Min. Negotiated Rate	$257.40
Max. Negotiated Rate	$415.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: Qualcare PPO/HMO/WC	$257.40

FOOTPRINT ULR 4.5 PK SUT SL.

Facility

$1,716.00

Service Code	HCPCS C1713
Hospital Charge Code	270688722
Hospital Revenue Code	278
Min. Negotiated Rate	$48.73
Max. Negotiated Rate	$858.00
Rate for Payer: Aetna Commercial	$652.08
Rate for Payer: Aetna Medicare Advantage	$514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.58
Rate for Payer: Cigna Commercial	$858.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.27
Rate for Payer: Qualcare PPO/HMO/WC	$257.40
Rate for Payer: UnitedHealthcare Community & State	$54.23
Rate for Payer: Wellpoint Medicaid Managed Care	$48.73

FOOT PROCEDURES WITH CC

Facility

$78,519.32

Service Code	MSDRG 504
Min. Negotiated Rate	$23,908.13
Max. Negotiated Rate	$78,519.32
Rate for Payer: Aetna Commercial	$57,780.85
Rate for Payer: Aetna Medicare Advantage	$78,519.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,929.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,929.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,166.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,929.65
Rate for Payer: Cigna Commercial	$41,670.08
Rate for Payer: Cigna Medicare Advantage	$25,166.45
Rate for Payer: Clover Medicare Advantage	$23,908.13
Rate for Payer: EmblemHealth Commercial	$75,499.35
Rate for Payer: Humana Medicare Advantage	$25,921.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,166.45
Rate for Payer: Oxford Commercial	$32,935.30
Rate for Payer: UnitedHealthcare Commercial	$44,085.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,166.45
Rate for Payer: Wellcare Medicare Advantage	$25,166.45

FOOT PROCEDURES WITH MCC

Facility

$107,645.49

Service Code	MSDRG 503
Min. Negotiated Rate	$32,776.67
Max. Negotiated Rate	$107,645.49
Rate for Payer: Aetna Commercial	$78,524.84
Rate for Payer: Aetna Medicare Advantage	$107,645.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74,249.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74,249.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,501.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74,249.40
Rate for Payer: Cigna Commercial	$62,221.99
Rate for Payer: Cigna Medicare Advantage	$34,501.76
Rate for Payer: Clover Medicare Advantage	$32,776.67
Rate for Payer: EmblemHealth Commercial	$103,505.28
Rate for Payer: Humana Medicare Advantage	$35,536.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34,501.76
Rate for Payer: Oxford Commercial	$49,179.18
Rate for Payer: UnitedHealthcare Commercial	$65,828.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,501.76
Rate for Payer: Wellcare Medicare Advantage	$34,501.76

FOOT PROCEDURES WITHOUT CC/MCC

Facility

$76,105.60

Service Code	MSDRG 505
Min. Negotiated Rate	$23,173.18
Max. Negotiated Rate	$76,105.60
Rate for Payer: Aetna Commercial	$56,061.78
Rate for Payer: Aetna Medicare Advantage	$76,105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,375.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,375.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,392.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,375.55
Rate for Payer: Cigna Commercial	$39,966.89
Rate for Payer: Cigna Medicare Advantage	$24,392.82
Rate for Payer: Clover Medicare Advantage	$23,173.18
Rate for Payer: EmblemHealth Commercial	$73,178.46
Rate for Payer: Humana Medicare Advantage	$25,124.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,392.82
Rate for Payer: Oxford Commercial	$31,589.14
Rate for Payer: UnitedHealthcare Commercial	$42,283.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,392.82
Rate for Payer: Wellcare Medicare Advantage	$24,392.82

FOOT RIGHT 3 VIEWS ROUTINE

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	2000165
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FOOT RIGHT 3 VIEWS ROUTINE

Facility

$6,601.19

Service Code	HCPCS 73630RT
Hospital Charge Code	2000165
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT RING LONG 155MM

Facility

$9,270.00

Hospital Charge Code	270674286
Hospital Revenue Code	272
Min. Negotiated Rate	$263.27
Max. Negotiated Rate	$4,635.00
Rate for Payer: Aetna Commercial	$3,522.60
Rate for Payer: Aetna Medicare Advantage	$2,781.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,363.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,363.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,363.85
Rate for Payer: Cigna Commercial	$4,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,410.20
Rate for Payer: Oxford Commercial	$1,854.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,390.50
Rate for Payer: UnitedHealthcare Commercial	$1,854.00
Rate for Payer: UnitedHealthcare Community & State	$292.93
Rate for Payer: Wellpoint Medicaid Managed Care	$263.27

FOOT RING LONG 155MM

Facility

$9,270.00

Hospital Charge Code	270674286
Hospital Revenue Code	272
Min. Negotiated Rate	$1,390.50
Max. Negotiated Rate	$1,390.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,390.50

FOOT RING LONG LRF 155MM

Facility

$12,916.75

Service Code	HCPCS C1713
Hospital Charge Code	270699600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,937.51
Max. Negotiated Rate	$3,125.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,583.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,125.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,937.51

FOOT RING LONG LRF 155MM

Facility

$12,916.75

Service Code	HCPCS C1713
Hospital Charge Code	270699600
Hospital Revenue Code	278
Min. Negotiated Rate	$366.84
Max. Negotiated Rate	$6,458.38
Rate for Payer: Aetna Commercial	$4,908.36
Rate for Payer: Aetna Medicare Advantage	$3,875.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,293.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,293.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,583.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,293.77
Rate for Payer: Cigna Commercial	$6,458.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,125.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,937.51
Rate for Payer: UnitedHealthcare Community & State	$408.17
Rate for Payer: Wellpoint Medicaid Managed Care	$366.84

FOOT RING SHORT LRF 155MM

Facility

$11,108.10

Service Code	HCPCS C1713
Hospital Charge Code	270699601
Hospital Revenue Code	278
Min. Negotiated Rate	$1,666.21
Max. Negotiated Rate	$2,688.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,221.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,688.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21

FOOT RING SHORT LRF 155MM

Facility

$11,108.10

Service Code	HCPCS C1713
Hospital Charge Code	270699601
Hospital Revenue Code	278
Min. Negotiated Rate	$315.47
Max. Negotiated Rate	$5,554.05
Rate for Payer: Aetna Commercial	$4,221.08
Rate for Payer: Aetna Medicare Advantage	$3,332.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,832.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,832.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,221.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,832.57
Rate for Payer: Cigna Commercial	$5,554.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,688.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.21
Rate for Payer: UnitedHealthcare Community & State	$351.02
Rate for Payer: Wellpoint Medicaid Managed Care	$315.47

FOOT - TWO VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7362050
Hospital Charge Code	94061251
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FOOT - TWO VIEWS-BIL

Facility

$6,601.19

Service Code	HCPCS 7362050
Hospital Charge Code	94061251
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOOT - TWO VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73620LT
Hospital Charge Code	94061397
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

Know your out-of-pocket cost for care.

All Charges