Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	74308335
Hospital Revenue Code	514
Min. Negotiated Rate	$32.96
Max. Negotiated Rate	$580.30
Rate for Payer: Aetna Commercial	$441.03
Rate for Payer: Aetna Medicare Advantage	$348.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.95
Rate for Payer: Cigna Commercial	$580.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.76
Rate for Payer: Qualcare PPO/HMO/WC	$174.09
Rate for Payer: UnitedHealthcare Community & State	$36.67
Rate for Payer: Wellpoint Medicaid Managed Care	$32.96

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	83653210
Hospital Revenue Code	514
Min. Negotiated Rate	$174.09
Max. Negotiated Rate	$174.09
Rate for Payer: Qualcare PPO/HMO/WC	$174.09

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	74308335
Hospital Revenue Code	514
Min. Negotiated Rate	$174.09
Max. Negotiated Rate	$174.09
Rate for Payer: Qualcare PPO/HMO/WC	$174.09

OFFICE CONSULT DETAILED

Facility

$245.50

Service Code	HCPCS 99243
Hospital Charge Code	412399243
Hospital Revenue Code	510
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$122.75
Rate for Payer: Aetna Commercial	$93.29
Rate for Payer: Aetna Medicare Advantage	$73.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.60
Rate for Payer: Cigna Commercial	$122.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.83
Rate for Payer: Qualcare PPO/HMO/WC	$36.83
Rate for Payer: UnitedHealthcare Community & State	$7.76
Rate for Payer: Wellpoint Medicaid Managed Care	$6.97

OFFICE CONSULT DETAILED

Facility

$245.50

Service Code	HCPCS 99243
Hospital Charge Code	412399243
Hospital Revenue Code	510
Min. Negotiated Rate	$36.83
Max. Negotiated Rate	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$36.83

OFFICE CONSULT EXPANDED

Facility

$225.20

Service Code	HCPCS 99242
Hospital Charge Code	412399242
Hospital Revenue Code	510
Min. Negotiated Rate	$6.40
Max. Negotiated Rate	$112.60
Rate for Payer: Aetna Commercial	$85.58
Rate for Payer: Aetna Medicare Advantage	$67.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$112.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.55
Rate for Payer: Qualcare PPO/HMO/WC	$33.78
Rate for Payer: UnitedHealthcare Community & State	$7.12
Rate for Payer: Wellpoint Medicaid Managed Care	$6.40

OFFICE CONSULT EXPANDED

Facility

$225.20

Service Code	HCPCS 99242
Hospital Charge Code	412399242
Hospital Revenue Code	510
Min. Negotiated Rate	$33.78
Max. Negotiated Rate	$33.78
Rate for Payer: Qualcare PPO/HMO/WC	$33.78

OFFICE CONSULT EXPANDED

Facility

$566.00

Service Code	HCPCS 99242
Hospital Charge Code	83653205
Hospital Revenue Code	514
Min. Negotiated Rate	$84.90
Max. Negotiated Rate	$84.90
Rate for Payer: Qualcare PPO/HMO/WC	$84.90

OFFICE CONSULT EXPANDED

Facility

$566.00

Service Code	HCPCS 99242
Hospital Charge Code	83653205
Hospital Revenue Code	514
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$283.00
Rate for Payer: Aetna Commercial	$215.08
Rate for Payer: Aetna Medicare Advantage	$169.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.33
Rate for Payer: Cigna Commercial	$283.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.16
Rate for Payer: Qualcare PPO/HMO/WC	$84.90
Rate for Payer: UnitedHealthcare Community & State	$17.89
Rate for Payer: Wellpoint Medicaid Managed Care	$16.07

OFFICE CONSULT FOCUSED

Facility

$453.00

Service Code	HCPCS 99241
Hospital Charge Code	83653200
Hospital Revenue Code	761
Min. Negotiated Rate	$12.87
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$172.14
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.78
Rate for Payer: Oxford Commercial	$90.60
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Commercial	$90.60
Rate for Payer: UnitedHealthcare Community & State	$14.31
Rate for Payer: Wellpoint Medicaid Managed Care	$12.87

OFFICE CONSULT FOCUSED

Facility

$453.00

Service Code	HCPCS 99241
Hospital Charge Code	83653200
Hospital Revenue Code	761
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

OFFICE CONSULT MINOR

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	412399241
Hospital Revenue Code	510
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

OFFICE CONSULT MINOR

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	412399241
Hospital Revenue Code	510
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$66.33
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.18
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.96

OF FOOT FRACTURE

Facility

$48,992.10

Service Code	HCPCS 28465
Hospital Charge Code	16000574
Hospital Revenue Code	360
Min. Negotiated Rate	$7,348.81
Max. Negotiated Rate	$7,348.81
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81

OF FOOT FRACTURE

Facility

$48,992.10

Service Code	HCPCS 28465
Hospital Charge Code	16000574
Hospital Revenue Code	360
Min. Negotiated Rate	$1,391.38
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,737.95
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,548.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,391.38

OFFSET CONNECTOR 3MM

Facility

$12,265.00

Service Code	HCPCS C1713
Hospital Charge Code	270687950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,839.75
Max. Negotiated Rate	$2,968.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,453.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,968.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,839.75

OFFSET CONNECTOR 3MM

Facility

$12,265.00

Service Code	HCPCS C1713
Hospital Charge Code	270687950
Hospital Revenue Code	278
Min. Negotiated Rate	$348.33
Max. Negotiated Rate	$6,132.50
Rate for Payer: Aetna Commercial	$4,660.70
Rate for Payer: Aetna Medicare Advantage	$3,679.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,127.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,127.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,453.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,127.57
Rate for Payer: Cigna Commercial	$6,132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,968.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,839.75
Rate for Payer: UnitedHealthcare Community & State	$387.57
Rate for Payer: Wellpoint Medicaid Managed Care	$348.33

OFFSET CONNECTOR 5MM

Facility

$12,265.00

Service Code	HCPCS C1713
Hospital Charge Code	270687676
Hospital Revenue Code	278
Min. Negotiated Rate	$1,839.75
Max. Negotiated Rate	$2,968.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,453.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,968.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,839.75

OFFSET CONNECTOR 5MM

Facility

$12,265.00

Service Code	HCPCS C1713
Hospital Charge Code	270687676
Hospital Revenue Code	278
Min. Negotiated Rate	$348.33
Max. Negotiated Rate	$6,132.50
Rate for Payer: Aetna Commercial	$4,660.70
Rate for Payer: Aetna Medicare Advantage	$3,679.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,127.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,127.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,453.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,127.57
Rate for Payer: Cigna Commercial	$6,132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,968.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,839.75
Rate for Payer: UnitedHealthcare Community & State	$387.57
Rate for Payer: Wellpoint Medicaid Managed Care	$348.33

OFFSET LAT TOPLOAD 30MM

Facility

$4,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270695326
Hospital Revenue Code	278
Min. Negotiated Rate	$128.51
Max. Negotiated Rate	$2,262.50
Rate for Payer: Aetna Commercial	$1,719.50
Rate for Payer: Aetna Medicare Advantage	$1,357.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,153.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,153.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,153.88
Rate for Payer: Cigna Commercial	$2,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,095.05
Rate for Payer: Qualcare PPO/HMO/WC	$678.75
Rate for Payer: UnitedHealthcare Community & State	$142.99
Rate for Payer: Wellpoint Medicaid Managed Care	$128.51

OFFSET LAT TOPLOAD 30MM

Facility

$4,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270695326
Hospital Revenue Code	278
Min. Negotiated Rate	$678.75
Max. Negotiated Rate	$1,095.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,095.05
Rate for Payer: Qualcare PPO/HMO/WC	$678.75

OFFSET TIBIAL TRAY 67MM

Facility

$12,870.00

Service Code	HCPCS C1776
Hospital Charge Code	270680591
Hospital Revenue Code	278
Min. Negotiated Rate	$1,930.50
Max. Negotiated Rate	$3,114.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,574.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,114.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.50

OFFSET TIBIAL TRAY 67MM

Facility

$12,870.00

Service Code	HCPCS C1776
Hospital Charge Code	270680591
Hospital Revenue Code	278
Min. Negotiated Rate	$365.51
Max. Negotiated Rate	$6,435.00
Rate for Payer: Aetna Commercial	$4,890.60
Rate for Payer: Aetna Medicare Advantage	$3,861.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,281.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,281.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,281.85
Rate for Payer: Cigna Commercial	$6,435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,114.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.50
Rate for Payer: UnitedHealthcare Community & State	$406.69
Rate for Payer: Wellpoint Medicaid Managed Care	$365.51

OFFSET TIBIAL TRAY 71MM

Facility

$12,870.00

Service Code	HCPCS C1776
Hospital Charge Code	270682263
Hospital Revenue Code	278
Min. Negotiated Rate	$365.51
Max. Negotiated Rate	$6,435.00
Rate for Payer: Aetna Commercial	$4,890.60
Rate for Payer: Aetna Medicare Advantage	$3,861.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,281.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,281.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,281.85
Rate for Payer: Cigna Commercial	$6,435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,114.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.50
Rate for Payer: UnitedHealthcare Community & State	$406.69
Rate for Payer: Wellpoint Medicaid Managed Care	$365.51

OFFSET TIBIAL TRAY 71MM

Facility

$12,870.00

Service Code	HCPCS C1776
Hospital Charge Code	270682263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,930.50
Max. Negotiated Rate	$3,114.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,574.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,114.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,930.50

Know your out-of-pocket cost for care.

All Charges