Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC

Facility

$72,908.28

Service Code	MSDRG 418
Min. Negotiated Rate	$22,199.64
Max. Negotiated Rate	$72,908.28
Rate for Payer: Aetna Commercial	$53,784.61
Rate for Payer: Aetna Medicare Advantage	$72,908.28
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	$23,368.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,159.15
Rate for Payer: Cigna Commercial	$37,710.84
Rate for Payer: Cigna Medicare Advantage	$23,368.04
Rate for Payer: Clover Medicare Advantage	$22,199.64
Rate for Payer: EmblemHealth Commercial	$70,104.12
Rate for Payer: Humana Medicare Advantage	$24,069.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,368.04
Rate for Payer: Oxford Commercial	$29,805.99
Rate for Payer: UnitedHealthcare Commercial	$39,896.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,368.04
Rate for Payer: Wellcare Medicare Advantage	$23,368.04

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC

Facility

$94,859.54

Service Code	MSDRG 417
Min. Negotiated Rate	$28,883.51
Max. Negotiated Rate	$94,859.54
Rate for Payer: Aetna Commercial	$69,418.57
Rate for Payer: Aetna Medicare Advantage	$94,859.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64,275.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64,275.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,403.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64,275.60
Rate for Payer: Cigna Commercial	$53,200.02
Rate for Payer: Cigna Medicare Advantage	$30,403.70
Rate for Payer: Clover Medicare Advantage	$28,883.51
Rate for Payer: EmblemHealth Commercial	$91,211.10
Rate for Payer: Humana Medicare Advantage	$31,315.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,403.70
Rate for Payer: Oxford Commercial	$42,048.37
Rate for Payer: UnitedHealthcare Commercial	$56,283.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,403.70
Rate for Payer: Wellcare Medicare Advantage	$30,403.70

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$62,615.19

Service Code	MSDRG 419
Min. Negotiated Rate	$19,065.52
Max. Negotiated Rate	$62,615.19
Rate for Payer: Aetna Commercial	$46,453.76
Rate for Payer: Aetna Medicare Advantage	$62,615.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,293.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,293.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,068.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,293.55
Rate for Payer: Cigna Commercial	$30,447.78
Rate for Payer: Cigna Medicare Advantage	$20,068.97
Rate for Payer: Clover Medicare Advantage	$19,065.52
Rate for Payer: EmblemHealth Commercial	$60,206.91
Rate for Payer: Humana Medicare Advantage	$20,671.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,068.97
Rate for Payer: Oxford Commercial	$24,065.40
Rate for Payer: UnitedHealthcare Commercial	$32,212.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,068.97
Rate for Payer: Wellcare Medicare Advantage	$20,068.97

LAPAROSCOPIC ELECTRODE

Facility

$874.00

Hospital Charge Code	270332563
Hospital Revenue Code	272
Min. Negotiated Rate	$24.82
Max. Negotiated Rate	$437.00
Rate for Payer: Aetna Commercial	$332.12
Rate for Payer: Aetna Medicare Advantage	$262.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.87
Rate for Payer: Cigna Commercial	$437.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.24
Rate for Payer: Oxford Commercial	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$131.10
Rate for Payer: UnitedHealthcare Commercial	$174.80
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$24.82

LAPAROSCOPIC ELECTRODE

Facility

$874.00

Hospital Charge Code	270332563
Hospital Revenue Code	272
Min. Negotiated Rate	$131.10
Max. Negotiated Rate	$131.10
Rate for Payer: Qualcare PPO/HMO/WC	$131.10

LAPAROSCOPIC PROC

Facility

$5,368.40

Service Code	HCPCS 45400
Hospital Charge Code	1600000551
Hospital Revenue Code	360
Min. Negotiated Rate	$805.26
Max. Negotiated Rate	$805.26
Rate for Payer: Qualcare PPO/HMO/WC	$805.26

LAPAROSCOPIC PROC

Facility

$5,368.40

Service Code	HCPCS 45400
Hospital Charge Code	1600000551
Hospital Revenue Code	360
Min. Negotiated Rate	$152.46
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,039.99
Rate for Payer: Aetna Medicare Advantage	$1,610.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,368.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,368.94
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	$1,368.94
Rate for Payer: Cigna Commercial	$2,684.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,395.78
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$805.26
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$169.64
Rate for Payer: Wellpoint Medicaid Managed Care	$152.46

LAPAROSCOPIC TUBING

Facility

$65.41

Hospital Charge Code	270664808
Hospital Revenue Code	270
Min. Negotiated Rate	$9.81
Max. Negotiated Rate	$9.81
Rate for Payer: Qualcare PPO/HMO/WC	$9.81

LAPAROSCOPIC TUBING

Facility

$65.41

Hospital Charge Code	270664808
Hospital Revenue Code	270
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$32.70
Rate for Payer: Aetna Commercial	$24.86
Rate for Payer: Aetna Medicare Advantage	$19.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.68
Rate for Payer: Cigna Commercial	$32.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Oxford Commercial	$13.08
Rate for Payer: Qualcare PPO/HMO/WC	$9.81
Rate for Payer: UnitedHealthcare Commercial	$13.08
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

LAPAROSCOPY CHOLECYSTECOMY

Facility

$58,549.97

Service Code	HCPCS 47562
Hospital Charge Code	16000590
Hospital Revenue Code	360
Min. Negotiated Rate	$1,662.82
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,222.99
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,850.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,662.82

LAPAROSCOPY CHOLECYSTECOMY

Facility

$58,549.97

Service Code	HCPCS 47562
Hospital Charge Code	16000590
Hospital Revenue Code	360
Min. Negotiated Rate	$8,782.50
Max. Negotiated Rate	$8,782.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50

LAPAROSCOPY DISC

Facility

$1,040.00

Hospital Charge Code	270338802
Hospital Revenue Code	272
Min. Negotiated Rate	$29.54
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$395.20
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.40
Rate for Payer: Oxford Commercial	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00
Rate for Payer: UnitedHealthcare Commercial	$208.00
Rate for Payer: UnitedHealthcare Community & State	$32.86
Rate for Payer: Wellpoint Medicaid Managed Care	$29.54

LAPAROSCOPY DISC

Facility

$1,040.00

Hospital Charge Code	270338802
Hospital Revenue Code	272
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000672
Hospital Revenue Code	360
Min. Negotiated Rate	$1,011.74
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,262.44
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,125.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,011.74

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000672
Hospital Revenue Code	360
Min. Negotiated Rate	$5,343.72
Max. Negotiated Rate	$5,343.72
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000491
Hospital Revenue Code	360
Min. Negotiated Rate	$5,343.72
Max. Negotiated Rate	$5,343.72
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72

LAPAROSCOPY FUNDOPLASTY

Facility

$35,624.77

Service Code	HCPCS 43280
Hospital Charge Code	1600000491
Hospital Revenue Code	360
Min. Negotiated Rate	$1,011.74
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,262.44
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,343.72
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,125.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,011.74

LAPAROSCOPY LYMPHADENECTOMY

Facility

$33,033.35

Service Code	HCPCS 38572
Hospital Charge Code	1600000516
Hospital Revenue Code	360
Min. Negotiated Rate	$4,955.00
Max. Negotiated Rate	$4,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00

LAPAROSCOPY LYMPHADENECTOMY

Facility

$33,033.35

Service Code	HCPCS 38572
Hospital Charge Code	1600000516
Hospital Revenue Code	360
Min. Negotiated Rate	$938.15
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,588.67
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,043.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$938.15

LAPAROSCOPY SPLENECTOMY

Facility

$61,304.40

Service Code	HCPCS 38120
Hospital Charge Code	1600000676
Hospital Revenue Code	360
Min. Negotiated Rate	$9,195.66
Max. Negotiated Rate	$9,195.66
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66

LAPAROSCOPY SPLENECTOMY

Facility

$61,304.40

Service Code	HCPCS 38120
Hospital Charge Code	1600000676
Hospital Revenue Code	360
Min. Negotiated Rate	$1,741.04
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,939.14
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,937.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,741.04

LAPAROSCOPY, SURGICAL, MYOMECTOMY, EXCISION; 5 OR MORE INTRAMURAL MYOMAS AND/OR INTRAMURAL MYOMAS WITH TOTAL WEIGHT GREATER THAN 250 G

Facility

$45,809.96

Service Code	CPT 58546
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52

LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITH IMPLANTATION OF MESH

Facility

$45,809.96

Service Code	CPT 43282
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52

LAPAROSCOPY, SURGICAL, SUPRACERVICAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;

Facility

$45,809.96

Service Code	CPT 58541
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52

LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;

Facility

$45,809.96

Service Code	CPT 58570
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52

Know your out-of-pocket cost for care.

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