Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INCISION OF TOUNGUE FOLD

Facility

$6,938.46

Service Code	HCPCS 41010
Hospital Charge Code	1600000327
Hospital Revenue Code	360
Min. Negotiated Rate	$197.05
Max. Negotiated Rate	$6,686.64
Rate for Payer: Aetna Commercial	$5,013.83
Rate for Payer: Aetna Medicare Advantage	$5,972.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,686.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,686.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,843.32
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	$6,686.64
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: Cigna Medicare Advantage	$1,843.32
Rate for Payer: Clover Medicare Advantage	$1,751.15
Rate for Payer: EmblemHealth Commercial	$5,529.96
Rate for Payer: Humana Medicare Advantage	$1,898.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,843.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,804.00
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,040.77
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$219.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,843.32
Rate for Payer: Wellcare Medicare Advantage	$1,843.32
Rate for Payer: Wellpoint Medicaid Managed Care	$197.05

INCISION OF TOUNGUE FOLD

Facility

$6,938.46

Service Code	HCPCS 41010
Hospital Charge Code	1600000327
Hospital Revenue Code	360
Min. Negotiated Rate	$1,040.77
Max. Negotiated Rate	$1,040.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,040.77

INCISION OF URETHA

Facility

$29,933.90

Service Code	HCPCS 53010
Hospital Charge Code	1600000768
Hospital Revenue Code	360
Min. Negotiated Rate	$850.12
Max. Negotiated Rate	$23,107.03
Rate for Payer: Aetna Commercial	$17,326.29
Rate for Payer: Aetna Medicare Advantage	$20,638.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,107.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,107.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,369.96
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	$23,107.03
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: Cigna Medicare Advantage	$6,369.96
Rate for Payer: Clover Medicare Advantage	$6,051.46
Rate for Payer: EmblemHealth Commercial	$19,109.88
Rate for Payer: Humana Medicare Advantage	$6,561.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,369.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,782.81
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,490.09
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$945.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,369.96
Rate for Payer: Wellcare Medicare Advantage	$6,369.96
Rate for Payer: Wellpoint Medicaid Managed Care	$850.12

INCISION OF URETHA

Facility

$29,933.90

Service Code	HCPCS 53010
Hospital Charge Code	1600000768
Hospital Revenue Code	360
Min. Negotiated Rate	$4,490.09
Max. Negotiated Rate	$4,490.09
Rate for Payer: Qualcare PPO/HMO/WC	$4,490.09

INCISION OF WINDPIPE

Facility

$34,833.20

Service Code	HCPCS 31601
Hospital Charge Code	1600000747
Hospital Revenue Code	360
Min. Negotiated Rate	$5,224.98
Max. Negotiated Rate	$5,224.98
Rate for Payer: Qualcare PPO/HMO/WC	$5,224.98

INCISION OF WINDPIPE

Facility

$34,833.20

Service Code	HCPCS 31601
Hospital Charge Code	1600000747
Hospital Revenue Code	360
Min. Negotiated Rate	$989.26
Max. Negotiated Rate	$25,511.88
Rate for Payer: Aetna Commercial	$19,129.52
Rate for Payer: Aetna Medicare Advantage	$22,786.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,511.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,511.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,032.91
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	$25,511.88
Rate for Payer: Cigna Commercial	$14,097.46
Rate for Payer: Cigna Medicare Advantage	$7,032.91
Rate for Payer: Clover Medicare Advantage	$6,681.26
Rate for Payer: EmblemHealth Commercial	$21,098.73
Rate for Payer: Humana Medicare Advantage	$7,243.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,032.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,056.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,224.98
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$1,100.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,032.91
Rate for Payer: Wellcare Medicare Advantage	$7,032.91
Rate for Payer: Wellpoint Medicaid Managed Care	$989.26

INCISION SUPERF TISSUE ABSCESS

Facility

$450.00

Service Code	HCPCS 20000
Hospital Charge Code	5780015
Hospital Revenue Code	450
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

INCISION SUPERF TISSUE ABSCESS

Facility

$450.00

Service Code	HCPCS 20000
Hospital Charge Code	5780015
Hospital Revenue Code	450
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

INCISOR 4.5MM

Facility

$454.55

Hospital Charge Code	270676717
Hospital Revenue Code	272
Min. Negotiated Rate	$12.91
Max. Negotiated Rate	$227.28
Rate for Payer: Aetna Commercial	$172.73
Rate for Payer: Aetna Medicare Advantage	$136.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.91
Rate for Payer: Cigna Commercial	$227.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.18
Rate for Payer: Oxford Commercial	$90.91
Rate for Payer: Qualcare PPO/HMO/WC	$68.18
Rate for Payer: UnitedHealthcare Commercial	$90.91
Rate for Payer: UnitedHealthcare Community & State	$14.36
Rate for Payer: Wellpoint Medicaid Managed Care	$12.91

INCISOR 4.5MM

Facility

$454.55

Hospital Charge Code	270676717
Hospital Revenue Code	272
Min. Negotiated Rate	$68.18
Max. Negotiated Rate	$68.18
Rate for Payer: Qualcare PPO/HMO/WC	$68.18

INCORE

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688020
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

INCORE

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688020
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

INCORE 3.5MM X 28MM TI SCREW

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270692231
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

INCORE 3.5MM X 28MM TI SCREW

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270692231
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$820.00
Rate for Payer: Aetna Commercial	$623.20
Rate for Payer: Aetna Medicare Advantage	$492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.20
Rate for Payer: Cigna Commercial	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00
Rate for Payer: UnitedHealthcare Community & State	$51.82
Rate for Payer: Wellpoint Medicaid Managed Care	$46.58

INCORE 3.5MM X 36MM TI SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687659
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

INCORE 3.5MM X 36MM TI SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687659
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

INCORE 3.5MM X 44MM TI SCREW

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270692232
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

INCORE 3.5MM X 44MM TI SCREW

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270692232
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$820.00
Rate for Payer: Aetna Commercial	$623.20
Rate for Payer: Aetna Medicare Advantage	$492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.20
Rate for Payer: Cigna Commercial	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00
Rate for Payer: UnitedHealthcare Community & State	$51.82
Rate for Payer: Wellpoint Medicaid Managed Care	$46.58

INCORE 3.5MM X 48MM TI SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687658
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

INCORE 3.5MM X 48MM TI SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687658
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

INCORE 3.5 X 56MM SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687706
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

INCORE 3.5 X 56MM SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687706
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

INCORE 5.9MMX 28MM

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270687705
Hospital Revenue Code	278
Min. Negotiated Rate	$495.30
Max. Negotiated Rate	$8,720.00
Rate for Payer: Aetna Commercial	$6,627.20
Rate for Payer: Aetna Medicare Advantage	$5,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,447.20
Rate for Payer: Cigna Commercial	$8,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00
Rate for Payer: UnitedHealthcare Community & State	$551.10
Rate for Payer: Wellpoint Medicaid Managed Care	$495.30

INCORE 5.9MMX 28MM

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270687705
Hospital Revenue Code	278
Min. Negotiated Rate	$2,616.00
Max. Negotiated Rate	$4,220.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00

INCORE 5.9MM X 28MM TI SCREW

Facility

$22,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270692230
Hospital Revenue Code	278
Min. Negotiated Rate	$3,427.50
Max. Negotiated Rate	$5,529.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,529.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,427.50

Know your out-of-pocket cost for care.

All Charges