Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	83652103
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	87502775
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	87502775
Hospital Revenue Code	300
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$22.04
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

FP CRITICAL CARE @ ADDT'L 30 M

Professional

Both

$174.00

Service Code	HCPCS 99292
Hospital Charge Code	83652461
Hospital Revenue Code	981
Min. Negotiated Rate	$101.81
Max. Negotiated Rate	$385.80
Rate for Payer: Aetna Commercial	$101.81
Rate for Payer: Aetna Medicare Advantage	$239.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$385.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.80
Rate for Payer: Cigna Commercial	$239.01
Rate for Payer: Cigna Medicare Advantage	$239.01
Rate for Payer: Clover Medicare Advantage	$109.51
Rate for Payer: Fidelis All Plans	$109.51
Rate for Payer: UnitedHealthcare Commercial	$109.51
Rate for Payer: UnitedHealthcare Community & State	$109.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$109.51

FP CRITICAL CARE E&M 30-40 MTS

Professional

Both

$788.00

Service Code	HCPCS 99291
Hospital Charge Code	83652459
Hospital Revenue Code	981
Min. Negotiated Rate	$84.68
Max. Negotiated Rate	$475.68
Rate for Payer: Aetna Commercial	$216.34
Rate for Payer: Aetna Medicare Advantage	$210.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.68
Rate for Payer: Cigna Commercial	$475.68
Rate for Payer: Cigna Medicare Advantage	$475.68
Rate for Payer: Clover Medicare Advantage	$217.79
Rate for Payer: EmblemHealth Commercial	$128.44
Rate for Payer: Fidelis All Plans	$146.02
Rate for Payer: Healthfirst NY All Plans	$84.68
Rate for Payer: Humana Medicare Advantage	$225.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.33
Rate for Payer: Marpai Administrators LLC Commercial	$185.46
Rate for Payer: MetroPlus Health All Plans	$84.68
Rate for Payer: Oscar Health Commercial	$475.68
Rate for Payer: UnitedHealthcare Commercial	$210.63
Rate for Payer: UnitedHealthcare Community & State	$210.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.63
Rate for Payer: Wellpoint Medicaid Managed Care	$219.49

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$23.46

Service Code	HCPCS 17003
Hospital Charge Code	87502650
Hospital Revenue Code	761
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$3.52
Rate for Payer: Qualcare PPO/HMO/WC	$3.52

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$23.46

Service Code	HCPCS 17003
Hospital Charge Code	87502650
Hospital Revenue Code	761
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$11.73
Rate for Payer: Aetna Commercial	$8.91
Rate for Payer: Aetna Medicare Advantage	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.98
Rate for Payer: Cigna Commercial	$11.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.10
Rate for Payer: Oxford Commercial	$4.69
Rate for Payer: Qualcare PPO/HMO/WC	$3.52
Rate for Payer: UnitedHealthcare Commercial	$4.69
Rate for Payer: UnitedHealthcare Community & State	$0.74
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$290.00

Service Code	HCPCS 17003
Hospital Charge Code	83652083
Hospital Revenue Code	510
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$110.20
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.40
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Community & State	$9.16
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$290.00

Service Code	HCPCS 17003
Hospital Charge Code	83652083
Hospital Revenue Code	510
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

FP CRYO PREMLG LES 1ST LESION

Facility

$268.40

Service Code	HCPCS 17000
Hospital Charge Code	87502645
Hospital Revenue Code	761
Min. Negotiated Rate	$40.26
Max. Negotiated Rate	$40.26
Rate for Payer: Qualcare PPO/HMO/WC	$40.26

FP CRYO PREMLG LES 1ST LESION

Facility

$268.40

Service Code	HCPCS 17000
Hospital Charge Code	87502645
Hospital Revenue Code	761
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$864.65
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.78
Rate for Payer: Oxford Commercial	$53.68
Rate for Payer: Qualcare PPO/HMO/WC	$40.26
Rate for Payer: UnitedHealthcare Commercial	$53.68
Rate for Payer: UnitedHealthcare Community & State	$8.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$7.62

FP CRYO PREMLG LESION; 1ST LES

Facility

$372.00

Service Code	HCPCS 17000
Hospital Charge Code	83652081
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

FP CRYO PREMLG LESION; 1ST LES

Facility

$372.00

Service Code	HCPCS 17000
Hospital Charge Code	83652081
Hospital Revenue Code	510
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$864.65
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	87502445
Hospital Revenue Code	761
Min. Negotiated Rate	$44.55
Max. Negotiated Rate	$44.55
Rate for Payer: Qualcare PPO/HMO/WC	$44.55

FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	87502445
Hospital Revenue Code	761
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.22
Rate for Payer: Oxford Commercial	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.55
Rate for Payer: UnitedHealthcare Commercial	$59.40
Rate for Payer: UnitedHealthcare Community & State	$9.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38
Rate for Payer: Wellpoint Medicaid Managed Care	$8.43

FP DEBRID SKIN & ADDITN'L 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	83652015
Hospital Revenue Code	761
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$141.36
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$74.40
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

FP DEBRID SKIN & ADDITN'L 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	83652015
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

FP DEBRID SKIN & ADDTL 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	87502450
Hospital Revenue Code	761
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$141.36
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$74.40
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

FP DEBRID SKIN & ADDTL 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	87502450
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

FP DEBRID SKIN & SUBC TISSUE

Facility

$499.00

Service Code	HCPCS 11042
Hospital Charge Code	83652017
Hospital Revenue Code	761
Min. Negotiated Rate	$74.85
Max. Negotiated Rate	$74.85
Rate for Payer: Qualcare PPO/HMO/WC	$74.85

FP DEBRID SKIN & SUBC TISSUE

Facility

$499.00

Service Code	HCPCS 11042
Hospital Charge Code	83652017
Hospital Revenue Code	761
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.74
Rate for Payer: Oxford Commercial	$99.80
Rate for Payer: Qualcare PPO/HMO/WC	$74.85
Rate for Payer: UnitedHealthcare Commercial	$99.80
Rate for Payer: UnitedHealthcare Community & State	$15.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$14.17

FP DEBRID SKIN & SUB CU TISSUE

Facility

$356.32

Service Code	HCPCS 11042
Hospital Charge Code	87502455
Hospital Revenue Code	761
Min. Negotiated Rate	$53.45
Max. Negotiated Rate	$53.45
Rate for Payer: Qualcare PPO/HMO/WC	$53.45

FP DEBRID SKIN & SUB CU TISSUE

Facility

$356.32

Service Code	HCPCS 11042
Hospital Charge Code	87502455
Hospital Revenue Code	761
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.64
Rate for Payer: Oxford Commercial	$71.26
Rate for Payer: Qualcare PPO/HMO/WC	$53.45
Rate for Payer: UnitedHealthcare Commercial	$71.26
Rate for Payer: UnitedHealthcare Community & State	$11.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$10.12

FP DEST.CRYOTHERAPY LESIONS-14

Facility

$372.00

Service Code	HCPCS 17110
Hospital Charge Code	83652085
Hospital Revenue Code	761
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$864.65
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$74.40
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

FP DEST.CRYOTHERAPY LESIONS-14

Facility

$372.00

Service Code	HCPCS 17110
Hospital Charge Code	83652085
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

Know your out-of-pocket cost for care.

All Charges