Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FRACTURE ASSESSMENT VIA DXA

Facility

$352.40

Service Code	HCPCS 77086
Hospital Charge Code	85000890
Hospital Revenue Code	409
Min. Negotiated Rate	$10.01
Max. Negotiated Rate	$1,296.00
Rate for Payer: Aetna Commercial	$281.22
Rate for Payer: Aetna Medicare Advantage	$334.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$103.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.05
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: Cigna Medicare Advantage	$103.39
Rate for Payer: Clover Medicare Advantage	$98.22
Rate for Payer: EmblemHealth Commercial	$310.17
Rate for Payer: Humana Medicare Advantage	$106.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$103.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.62
Rate for Payer: Oxford Commercial	$1,142.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.86
Rate for Payer: UnitedHealthcare Commercial	$1,296.00
Rate for Payer: UnitedHealthcare Community & State	$11.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$103.39
Rate for Payer: Wellcare Medicare Advantage	$103.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.01

FRACTURE OF FEMUR

Facility

$6,448.93

Service Code	APR-DRG 3401
Min. Negotiated Rate	$6,322.48
Max. Negotiated Rate	$6,448.93
Rate for Payer: UnitedHealthcare Community & State	$6,322.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,448.93
Rate for Payer: Wellpoint Medicaid Managed Care	$6,322.48

FRACTURE OF FEMUR

Facility

$8,131.39

Service Code	APR-DRG 3402
Min. Negotiated Rate	$7,971.95
Max. Negotiated Rate	$8,131.39
Rate for Payer: UnitedHealthcare Community & State	$7,971.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,131.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7,971.95

FRACTURE OF FEMUR

Facility

$11,528.56

Service Code	APR-DRG 3403
Min. Negotiated Rate	$11,302.51
Max. Negotiated Rate	$11,528.56
Rate for Payer: UnitedHealthcare Community & State	$11,302.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,528.56
Rate for Payer: Wellpoint Medicaid Managed Care	$11,302.51

FRACTURE OF FEMUR

Facility

$18,530.82

Service Code	APR-DRG 3404
Min. Negotiated Rate	$18,167.47
Max. Negotiated Rate	$18,530.82
Rate for Payer: UnitedHealthcare Community & State	$18,167.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,530.82
Rate for Payer: Wellpoint Medicaid Managed Care	$18,167.47

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$6,995.19

Service Code	APR-DRG 3411
Min. Negotiated Rate	$6,858.03
Max. Negotiated Rate	$6,995.19
Rate for Payer: UnitedHealthcare Community & State	$6,858.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,995.19
Rate for Payer: Wellpoint Medicaid Managed Care	$6,858.03

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$8,441.72

Service Code	APR-DRG 3412
Min. Negotiated Rate	$8,276.20
Max. Negotiated Rate	$8,441.72
Rate for Payer: UnitedHealthcare Community & State	$8,276.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,441.72
Rate for Payer: Wellpoint Medicaid Managed Care	$8,276.20

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$11,081.96

Service Code	APR-DRG 3413
Min. Negotiated Rate	$10,864.67
Max. Negotiated Rate	$11,081.96
Rate for Payer: UnitedHealthcare Community & State	$10,864.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,081.96
Rate for Payer: Wellpoint Medicaid Managed Care	$10,864.67

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$20,311.55

Service Code	APR-DRG 3414
Min. Negotiated Rate	$19,913.28
Max. Negotiated Rate	$20,311.55
Rate for Payer: UnitedHealthcare Community & State	$19,913.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,311.55
Rate for Payer: Wellpoint Medicaid Managed Care	$19,913.28

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$7,005.01

Service Code	APR-DRG 3421
Min. Negotiated Rate	$6,867.66
Max. Negotiated Rate	$7,005.01
Rate for Payer: UnitedHealthcare Community & State	$6,867.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,005.01
Rate for Payer: Wellpoint Medicaid Managed Care	$6,867.66

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$13,173.10

Service Code	APR-DRG 3423
Min. Negotiated Rate	$12,914.80
Max. Negotiated Rate	$13,173.10
Rate for Payer: UnitedHealthcare Community & State	$12,914.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,173.10
Rate for Payer: Wellpoint Medicaid Managed Care	$12,914.80

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$22,762.23

Service Code	APR-DRG 3424
Min. Negotiated Rate	$22,315.91
Max. Negotiated Rate	$22,762.23
Rate for Payer: UnitedHealthcare Community & State	$22,315.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,762.23
Rate for Payer: Wellpoint Medicaid Managed Care	$22,315.91

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$9,249.25

Service Code	APR-DRG 3422
Min. Negotiated Rate	$9,067.89
Max. Negotiated Rate	$9,249.25
Rate for Payer: UnitedHealthcare Community & State	$9,067.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,249.25
Rate for Payer: Wellpoint Medicaid Managed Care	$9,067.89

FRACTURES OF FEMUR WITH MCC

Facility

$68,993.90

Service Code	MSDRG 533
Min. Negotiated Rate	$21,007.76
Max. Negotiated Rate	$68,993.90
Rate for Payer: Aetna Commercial	$50,996.76
Rate for Payer: Aetna Medicare Advantage	$68,993.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,159.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,159.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,113.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,159.15
Rate for Payer: Cigna Commercial	$34,948.74
Rate for Payer: Cigna Medicare Advantage	$22,113.43
Rate for Payer: Clover Medicare Advantage	$21,007.76
Rate for Payer: EmblemHealth Commercial	$66,340.29
Rate for Payer: Humana Medicare Advantage	$22,776.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,113.43
Rate for Payer: Oxford Commercial	$27,622.87
Rate for Payer: UnitedHealthcare Commercial	$36,974.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,113.43
Rate for Payer: Wellcare Medicare Advantage	$22,113.43

FRACTURES OF FEMUR WITHOUT MCC

Facility

$44,932.18

Service Code	MSDRG 534
Min. Negotiated Rate	$13,681.27
Max. Negotiated Rate	$44,932.18
Rate for Payer: Aetna Commercial	$33,859.73
Rate for Payer: Aetna Medicare Advantage	$44,932.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,441.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,441.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,401.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,441.05
Rate for Payer: Cigna Commercial	$17,970.39
Rate for Payer: Cigna Medicare Advantage	$14,401.34
Rate for Payer: Clover Medicare Advantage	$13,681.27
Rate for Payer: EmblemHealth Commercial	$43,204.02
Rate for Payer: Humana Medicare Advantage	$14,833.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,401.34
Rate for Payer: Oxford Commercial	$14,203.48
Rate for Payer: UnitedHealthcare Commercial	$19,011.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,401.34
Rate for Payer: Wellcare Medicare Advantage	$14,401.34

FRACTURES OF HIP AND PELVIS WITH MCC

Facility

$59,967.55

Service Code	MSDRG 535
Min. Negotiated Rate	$18,259.35
Max. Negotiated Rate	$59,967.55
Rate for Payer: Aetna Commercial	$44,568.09
Rate for Payer: Aetna Medicare Advantage	$59,967.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,016.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,016.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,220.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,016.50
Rate for Payer: Cigna Commercial	$28,579.63
Rate for Payer: Cigna Medicare Advantage	$19,220.37
Rate for Payer: Clover Medicare Advantage	$18,259.35
Rate for Payer: EmblemHealth Commercial	$57,661.11
Rate for Payer: Humana Medicare Advantage	$19,796.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,220.37
Rate for Payer: Oxford Commercial	$22,588.84
Rate for Payer: UnitedHealthcare Commercial	$30,235.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,220.37
Rate for Payer: Wellcare Medicare Advantage	$19,220.37

FRACTURES OF HIP AND PELVIS WITHOUT MCC

Facility

$44,979.64

Service Code	MSDRG 536
Min. Negotiated Rate	$13,695.72
Max. Negotiated Rate	$44,979.64
Rate for Payer: Aetna Commercial	$33,893.50
Rate for Payer: Aetna Medicare Advantage	$44,979.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,886.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,886.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,416.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,886.95
Rate for Payer: Cigna Commercial	$18,003.83
Rate for Payer: Cigna Medicare Advantage	$14,416.55
Rate for Payer: Clover Medicare Advantage	$13,695.72
Rate for Payer: EmblemHealth Commercial	$43,249.65
Rate for Payer: Humana Medicare Advantage	$14,849.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,416.55
Rate for Payer: Oxford Commercial	$14,229.91
Rate for Payer: UnitedHealthcare Commercial	$19,047.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,416.55
Rate for Payer: Wellcare Medicare Advantage	$14,416.55

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

Facility

$64,479.17

Service Code	MSDRG 562
Min. Negotiated Rate	$19,633.08
Max. Negotiated Rate	$64,479.17
Rate for Payer: Aetna Commercial	$47,781.29
Rate for Payer: Aetna Medicare Advantage	$64,479.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,666.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,111.60
Rate for Payer: Cigna Commercial	$31,763.07
Rate for Payer: Cigna Medicare Advantage	$20,666.40
Rate for Payer: Clover Medicare Advantage	$19,633.08
Rate for Payer: EmblemHealth Commercial	$61,999.20
Rate for Payer: Humana Medicare Advantage	$21,286.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,666.40
Rate for Payer: Oxford Commercial	$25,104.98
Rate for Payer: UnitedHealthcare Commercial	$33,603.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,666.40
Rate for Payer: Wellcare Medicare Advantage	$20,666.40

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC

Facility

$47,756.75

Service Code	MSDRG 563
Min. Negotiated Rate	$14,541.32
Max. Negotiated Rate	$47,756.75
Rate for Payer: Aetna Commercial	$35,871.42
Rate for Payer: Aetna Medicare Advantage	$47,756.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,934.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,934.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,306.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,934.50
Rate for Payer: Cigna Commercial	$19,963.38
Rate for Payer: Cigna Medicare Advantage	$15,306.65
Rate for Payer: Clover Medicare Advantage	$14,541.32
Rate for Payer: EmblemHealth Commercial	$45,919.95
Rate for Payer: Humana Medicare Advantage	$15,765.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,306.65
Rate for Payer: Oxford Commercial	$15,778.71
Rate for Payer: UnitedHealthcare Commercial	$21,120.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,306.65
Rate for Payer: Wellcare Medicare Advantage	$15,306.65

FRAGILE X PANEL

Facility

$100.00

Service Code	HCPCS 81243
Hospital Charge Code	38472939
Hospital Revenue Code	310
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

FRAGILE X PANEL

Facility

$100.00

Service Code	HCPCS 81243
Hospital Charge Code	38472939
Hospital Revenue Code	310
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$206.91
Rate for Payer: Aetna Commercial	$155.15
Rate for Payer: Aetna Medicare Advantage	$184.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$57.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.91
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: Cigna Medicare Advantage	$57.04
Rate for Payer: Clover Medicare Advantage	$54.19
Rate for Payer: EmblemHealth Commercial	$171.12
Rate for Payer: Humana Medicare Advantage	$58.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$57.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$45.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$57.04
Rate for Payer: Wellcare Medicare Advantage	$57.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

FRAGMENT 2.5 X 12

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687650
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

FRAGMENT 2.5 X 12

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687650
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

FRAGMENT2.5 X 14

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687651
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

FRAGMENT2.5 X 14

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270687651
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

Know your out-of-pocket cost for care.

All Charges