Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FOREARM AP & LAT-LT

Facility

$6,601.19

Service Code	HCPCS 73090LT
Hospital Charge Code	94061305
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOREARM AP & LAT-RT

Facility

$6,601.19

Service Code	HCPCS 73090RT
Hospital Charge Code	94061307
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FOREARM AP & LAT-RT

Facility

$6,601.19

Service Code	HCPCS 73090RT
Hospital Charge Code	94061307
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

FOREFOOT RECONSTRUC. (IMPLANT)

Facility

$16,050.00

Hospital Charge Code	270335443
Hospital Revenue Code	278
Min. Negotiated Rate	$455.82
Max. Negotiated Rate	$8,025.00
Rate for Payer: Aetna Commercial	$6,099.00
Rate for Payer: Aetna Medicare Advantage	$4,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,092.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,092.75
Rate for Payer: Cigna Commercial	$8,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,884.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.50
Rate for Payer: UnitedHealthcare Community & State	$507.18
Rate for Payer: Wellpoint Medicaid Managed Care	$455.82

FOREFOOT RECONSTRUC. (IMPLANT)

Facility

$16,050.00

Hospital Charge Code	270335443
Hospital Revenue Code	278
Min. Negotiated Rate	$2,407.50
Max. Negotiated Rate	$3,884.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,884.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.50

FOREIGN BODY RETRIEVAL

Facility

$315.33

Service Code	HCPCS 37197
Hospital Charge Code	2200402
Hospital Revenue Code	350
Min. Negotiated Rate	$47.30
Max. Negotiated Rate	$47.30
Rate for Payer: Qualcare PPO/HMO/WC	$47.30

FOREIGN BODY RETRIEVAL

Facility

$315.33

Service Code	HCPCS 37197
Hospital Charge Code	2200402
Hospital Revenue Code	350
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,161.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$2,625.82
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.99
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.30
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$9.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$8.96

FORESKIN MANIPULATION

Facility

$1,247.64

Service Code	HCPCS 54450
Hospital Charge Code	16001001
Hospital Revenue Code	360
Min. Negotiated Rate	$187.15
Max. Negotiated Rate	$187.15
Rate for Payer: Qualcare PPO/HMO/WC	$187.15

FORESKIN MANIPULATION

Facility

$1,247.64

Service Code	HCPCS 54450
Hospital Charge Code	16001001
Hospital Revenue Code	360
Min. Negotiated Rate	$35.43
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$807.38
Rate for Payer: Aetna Medicare Advantage	$961.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$296.83
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	$1,076.75
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: Cigna Medicare Advantage	$296.83
Rate for Payer: Clover Medicare Advantage	$281.99
Rate for Payer: EmblemHealth Commercial	$890.49
Rate for Payer: Humana Medicare Advantage	$305.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$296.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.39
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.15
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$39.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$296.83
Rate for Payer: Wellcare Medicare Advantage	$296.83
Rate for Payer: Wellpoint Medicaid Managed Care	$35.43

FORG BODY REM EXT AUD CNL

Facility

$8,054.80

Service Code	HCPCS 69205
Hospital Charge Code	5790220
Hospital Revenue Code	450
Min. Negotiated Rate	$44.30
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	$44.30
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	$2,094.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Community & State	$140.00
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	$228.76

FORG BODY REM EXT AUD CNL

Facility

$8,054.80

Service Code	HCPCS 69205
Hospital Charge Code	5790220
Hospital Revenue Code	450
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

FORMAGRAFT LARGE

Facility

$9,000.00

Hospital Charge Code	270663769
Hospital Revenue Code	270
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

FORMAGRAFT LARGE

Facility

$9,000.00

Hospital Charge Code	270663769
Hospital Revenue Code	270
Min. Negotiated Rate	$255.60
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.00
Rate for Payer: Oxford Commercial	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Commercial	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$284.40
Rate for Payer: Wellpoint Medicaid Managed Care	$255.60

FORMAGRAFT XL BLOCKS, LARGE

Facility

$11,465.00

Hospital Charge Code	270667570
Hospital Revenue Code	278
Min. Negotiated Rate	$325.61
Max. Negotiated Rate	$5,732.50
Rate for Payer: Aetna Commercial	$4,356.70
Rate for Payer: Aetna Medicare Advantage	$3,439.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,923.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,923.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,923.57
Rate for Payer: Cigna Commercial	$5,732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,774.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,719.75
Rate for Payer: UnitedHealthcare Community & State	$362.29
Rate for Payer: Wellpoint Medicaid Managed Care	$325.61

FORMAGRAFT XL BLOCKS, LARGE

Facility

$11,465.00

Hospital Charge Code	270667570
Hospital Revenue Code	278
Min. Negotiated Rate	$1,719.75
Max. Negotiated Rate	$2,774.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,774.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,719.75

FORTE CNCLLOUS SCRE 4.0MMX12MM

Facility

$299.10

Hospital Charge Code	270663184
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

FORTE CNCLLOUS SCRE 4.0MMX12MM

Facility

$299.10

Hospital Charge Code	270663184
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX10MM

Facility

$299.10

Hospital Charge Code	270663183
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

FORTE CNCLLOUS SCRW 4.0MMX10MM

Facility

$299.10

Hospital Charge Code	270663183
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX18MM

Facility

$299.10

Hospital Charge Code	270663185
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

FORTE CNCLLOUS SCRW 4.0MMX18MM

Facility

$299.10

Hospital Charge Code	270663185
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX22MM

Facility

$299.10

Hospital Charge Code	270663186
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX22MM

Facility

$299.10

Hospital Charge Code	270663186
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

FORTE CNCLLOUS SCRW 4.0MMX24MM

Facility

$299.10

Hospital Charge Code	270663187
Hospital Revenue Code	278
Min. Negotiated Rate	$44.87
Max. Negotiated Rate	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87

FORTE CNCLLOUS SCRW 4.0MMX24MM

Facility

$299.10

Hospital Charge Code	270663187
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$149.55
Rate for Payer: Aetna Commercial	$113.66
Rate for Payer: Aetna Medicare Advantage	$89.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.27
Rate for Payer: Cigna Commercial	$149.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$44.87
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8.49

Know your out-of-pocket cost for care.

All Charges