Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OPD INDIVIDUAL MD 20-30MIN

Facility

$730.00

Service Code	HCPCS 90805
Hospital Charge Code	84310020
Hospital Revenue Code	914
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$109.50
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

OPD INDIVIDUAL MD 20-30MIN

Facility

$730.00

Service Code	HCPCS 90805
Hospital Charge Code	84310020
Hospital Revenue Code	914
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.80
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$23.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.73

OPD PLAY TX NON MD 20-30 MIN

Facility

$491.00

Service Code	HCPCS 90810
Hospital Charge Code	84310030
Hospital Revenue Code	914
Min. Negotiated Rate	$73.65
Max. Negotiated Rate	$73.65
Rate for Payer: Qualcare PPO/HMO/WC	$73.65

OPD PLAY TX NON MD 20-30 MIN

Facility

$491.00

Service Code	HCPCS 90810
Hospital Charge Code	84310030
Hospital Revenue Code	914
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$245.50
Rate for Payer: Aetna Commercial	$186.58
Rate for Payer: Aetna Medicare Advantage	$147.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.20
Rate for Payer: Cigna Commercial	$245.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.66
Rate for Payer: Qualcare PPO/HMO/WC	$73.65
Rate for Payer: UnitedHealthcare Community & State	$15.52
Rate for Payer: Wellpoint Medicaid Managed Care	$13.94

OPD PSYCHIATRIC EVALUATION

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	84310010
Hospital Revenue Code	900
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

OPD PSYCHIATRIC EVALUATION

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	84310010
Hospital Revenue Code	900
Min. Negotiated Rate	$36.81
Max. Negotiated Rate	$3,080.00
Rate for Payer: Aetna Commercial	$492.48
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.96
Rate for Payer: Oxford Commercial	$2,715.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Commercial	$3,080.00
Rate for Payer: UnitedHealthcare Community & State	$40.95
Rate for Payer: Wellpoint Medicaid Managed Care	$36.81

OPEN ANKLE JNT FUSION

Facility

$77,285.80

Service Code	HCPCS 27870
Hospital Charge Code	1600000297
Hospital Revenue Code	360
Min. Negotiated Rate	$11,592.87
Max. Negotiated Rate	$11,592.87
Rate for Payer: Qualcare PPO/HMO/WC	$11,592.87

OPEN ANKLE JNT FUSION

Facility

$77,285.80

Service Code	HCPCS 27870
Hospital Charge Code	1600000297
Hospital Revenue Code	360
Min. Negotiated Rate	$2,194.92
Max. Negotiated Rate	$55,329.13
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,329.13
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,094.31
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,592.87
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$2,442.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2,194.92

OPEN BOWEL TO SKIN

Facility

$12,361.00

Service Code	HCPCS 44300
Hospital Charge Code	1600000634
Hospital Revenue Code	360
Min. Negotiated Rate	$351.05
Max. Negotiated Rate	$8,269.65
Rate for Payer: Aetna Commercial	$6,200.81
Rate for Payer: Aetna Medicare Advantage	$7,386.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,269.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,269.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,279.71
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	$8,269.65
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: Cigna Medicare Advantage	$2,279.71
Rate for Payer: Clover Medicare Advantage	$2,165.72
Rate for Payer: EmblemHealth Commercial	$6,839.13
Rate for Payer: Humana Medicare Advantage	$2,348.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,279.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,213.86
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,854.15
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$390.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,279.71
Rate for Payer: Wellcare Medicare Advantage	$2,279.71
Rate for Payer: Wellpoint Medicaid Managed Care	$351.05

OPEN BOWEL TO SKIN

Facility

$12,361.00

Service Code	HCPCS 44300
Hospital Charge Code	1600000634
Hospital Revenue Code	360
Min. Negotiated Rate	$1,854.15
Max. Negotiated Rate	$1,854.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,854.15

OPEN BX/EXC INGUINOFEM NODES

Facility

$18,038.36

Service Code	HCPCS 38531
Hospital Charge Code	160000223
Hospital Revenue Code	360
Min. Negotiated Rate	$2,705.75
Max. Negotiated Rate	$2,705.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,705.75

OPEN BX/EXC INGUINOFEM NODES

Facility

$18,038.36

Service Code	HCPCS 38531
Hospital Charge Code	160000223
Hospital Revenue Code	360
Min. Negotiated Rate	$512.29
Max. Negotiated Rate	$16,873.82
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
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	$16,873.82
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,689.97
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,705.75
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$570.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$512.29

OPEN BX/EXC LN; INT MAMM NODE(

Facility

$15,259.20

Service Code	HCPCS 38530
Hospital Charge Code	16000957
Hospital Revenue Code	360
Min. Negotiated Rate	$2,288.88
Max. Negotiated Rate	$2,288.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,288.88

OPEN BX/EXC LN; INT MAMM NODE(

Facility

$15,259.20

Service Code	HCPCS 38530
Hospital Charge Code	16000957
Hospital Revenue Code	360
Min. Negotiated Rate	$433.36
Max. Negotiated Rate	$16,873.82
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
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	$16,873.82
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,967.39
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,288.88
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$482.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$433.36

OPEN BX OR EXC LN,SUPERFICIAL

Facility

$24,074.90

Service Code	HCPCS 38500
Hospital Charge Code	16000265
Hospital Revenue Code	360
Min. Negotiated Rate	$3,611.24
Max. Negotiated Rate	$3,611.24
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24

OPEN BX OR EXC LN,SUPERFICIAL

Facility

$24,074.90

Service Code	HCPCS 38500
Hospital Charge Code	16000265
Hospital Revenue Code	360
Min. Negotiated Rate	$683.73
Max. Negotiated Rate	$16,873.82
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
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	$16,873.82
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,259.47
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$760.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$683.73

OPEN CONNECTOR 30MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699333
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

OPEN CONNECTOR 30MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699333
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$79,160.74

Service Code	APR-DRG 0214
Min. Negotiated Rate	$77,608.57
Max. Negotiated Rate	$79,160.74
Rate for Payer: UnitedHealthcare Community & State	$77,608.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$79,160.74
Rate for Payer: Wellpoint Medicaid Managed Care	$77,608.57

OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$50,441.18

Service Code	APR-DRG 0213
Min. Negotiated Rate	$49,452.14
Max. Negotiated Rate	$50,441.18
Rate for Payer: UnitedHealthcare Community & State	$49,452.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$50,441.18
Rate for Payer: Wellpoint Medicaid Managed Care	$49,452.14

OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$34,028.15

Service Code	APR-DRG 0212
Min. Negotiated Rate	$33,360.93
Max. Negotiated Rate	$34,028.15
Rate for Payer: UnitedHealthcare Community & State	$33,360.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,028.15
Rate for Payer: Wellpoint Medicaid Managed Care	$33,360.93

OPEN CRANIOTOMY EXCEPT TRAUMA

Facility

$26,750.65

Service Code	APR-DRG 0211
Min. Negotiated Rate	$26,226.13
Max. Negotiated Rate	$26,750.65
Rate for Payer: UnitedHealthcare Community & State	$26,226.13
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,750.65
Rate for Payer: Wellpoint Medicaid Managed Care	$26,226.13

OPEN CRANIOTOMY FOR TRAUMA

Facility

$28,473.81

Service Code	APR-DRG 0201
Min. Negotiated Rate	$27,915.50
Max. Negotiated Rate	$28,473.81
Rate for Payer: UnitedHealthcare Community & State	$27,915.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,473.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27,915.50

OPEN CRANIOTOMY FOR TRAUMA

Facility

$33,347.06

Service Code	APR-DRG 0202
Min. Negotiated Rate	$32,693.20
Max. Negotiated Rate	$33,347.06
Rate for Payer: UnitedHealthcare Community & State	$32,693.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$33,347.06
Rate for Payer: Wellpoint Medicaid Managed Care	$32,693.20

OPEN CRANIOTOMY FOR TRAUMA

Facility

$74,356.35

Service Code	APR-DRG 0204
Min. Negotiated Rate	$72,898.38
Max. Negotiated Rate	$74,356.35
Rate for Payer: UnitedHealthcare Community & State	$72,898.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$74,356.35
Rate for Payer: Wellpoint Medicaid Managed Care	$72,898.38

Know your out-of-pocket cost for care.

All Charges