Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OP TX SESAMOID FRACTURE

Facility

$30,274.24

Service Code	HCPCS 28531
Hospital Charge Code	16000913
Hospital Revenue Code	360
Min. Negotiated Rate	$859.79
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	$7,871.30
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,541.14
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$956.67
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	$859.79

OP TX TRANS-SCAPHRL FX DISLCAT

Facility

$23,899.60

Service Code	HCPCS 25685
Hospital Charge Code	16000697
Hospital Revenue Code	360
Min. Negotiated Rate	$678.75
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	$6,213.90
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$755.23
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	$678.75

OP TX TRANS-SCAPHRL FX DISLCAT

Facility

$23,899.60

Service Code	HCPCS 25685
Hospital Charge Code	16000697
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

OP TX TRMLELR ANKL W FX PSTLIP

Facility

$63,943.60

Service Code	HCPCS 27823
Hospital Charge Code	16000400
Hospital Revenue Code	360
Min. Negotiated Rate	$1,816.00
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	$16,625.34
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$2,020.62
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	$1,816.00

OP TX TRMLELR ANKL W FX PSTLIP

Facility

$63,943.60

Service Code	HCPCS 27823
Hospital Charge Code	16000400
Hospital Revenue Code	360
Min. Negotiated Rate	$9,591.54
Max. Negotiated Rate	$9,591.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54

OP TX ULNAR STYL FX

Facility

$49,826.60

Service Code	HCPCS 25652
Hospital Charge Code	16000838
Hospital Revenue Code	360
Min. Negotiated Rate	$1,415.08
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	$12,954.92
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,473.99
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,574.52
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	$1,415.08

OP TX ULNAR STYL FX

Facility

$49,826.60

Service Code	HCPCS 25652
Hospital Charge Code	16000838
Hospital Revenue Code	360
Min. Negotiated Rate	$7,473.99
Max. Negotiated Rate	$7,473.99
Rate for Payer: Qualcare PPO/HMO/WC	$7,473.99

OPUS MAGNUM IMPLANT/ANCHOR SCR

Facility

$983.00

Hospital Charge Code	270335285
Hospital Revenue Code	278
Min. Negotiated Rate	$147.45
Max. Negotiated Rate	$237.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.89
Rate for Payer: Qualcare PPO/HMO/WC	$147.45

OPUS MAGNUM IMPLANT/ANCHOR SCR

Facility

$983.00

Hospital Charge Code	270335285
Hospital Revenue Code	278
Min. Negotiated Rate	$27.92
Max. Negotiated Rate	$491.50
Rate for Payer: Aetna Commercial	$373.54
Rate for Payer: Aetna Medicare Advantage	$294.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.66
Rate for Payer: Cigna Commercial	$491.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.89
Rate for Payer: Qualcare PPO/HMO/WC	$147.45
Rate for Payer: UnitedHealthcare Community & State	$31.06
Rate for Payer: Wellpoint Medicaid Managed Care	$27.92

OPUS SMART STITCH CONNECTOR

Facility

$434.00

Hospital Charge Code	270335289
Hospital Revenue Code	272
Min. Negotiated Rate	$12.33
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.84
Rate for Payer: Oxford Commercial	$86.80
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$86.80
Rate for Payer: UnitedHealthcare Community & State	$13.71
Rate for Payer: Wellpoint Medicaid Managed Care	$12.33

OPUS SMART STITCH CONNECTOR

Facility

$434.00

Hospital Charge Code	270335289
Hospital Revenue Code	272
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

OPUS SMART SUTURE CARTDGE

Facility

$434.00

Hospital Charge Code	270335290
Hospital Revenue Code	272
Min. Negotiated Rate	$12.33
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.84
Rate for Payer: Oxford Commercial	$86.80
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$86.80
Rate for Payer: UnitedHealthcare Community & State	$13.71
Rate for Payer: Wellpoint Medicaid Managed Care	$12.33

OPUS SMART SUTURE CARTDGE

Facility

$434.00

Hospital Charge Code	270335290
Hospital Revenue Code	272
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

ORAL COLON LAVAGE SOL

Facility

$154.10

Service Code	NDC 52268010001
Hospital Charge Code	60628134
Hospital Revenue Code	250
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$77.05
Rate for Payer: Aetna Commercial	$58.56
Rate for Payer: Aetna Medicare Advantage	$46.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.30
Rate for Payer: Cigna Commercial	$77.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.07
Rate for Payer: Oxford Commercial	$30.82
Rate for Payer: Qualcare PPO/HMO/WC	$23.11
Rate for Payer: UnitedHealthcare Commercial	$30.82
Rate for Payer: UnitedHealthcare Community & State	$4.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.38

ORAL COLON LAVAGE SOL

Facility

$154.10

Service Code	NDC 52268010001
Hospital Charge Code	60628134
Hospital Revenue Code	250
Min. Negotiated Rate	$23.11
Max. Negotiated Rate	$23.11
Rate for Payer: Qualcare PPO/HMO/WC	$23.11

ORAL SUCTION KIT VAPREVENT

Facility

$84.06

Hospital Charge Code	270644015
Hospital Revenue Code	270
Min. Negotiated Rate	$12.61
Max. Negotiated Rate	$12.61
Rate for Payer: Qualcare PPO/HMO/WC	$12.61

ORAL SUCTION KIT VAPREVENT

Facility

$84.06

Hospital Charge Code	270644015
Hospital Revenue Code	270
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$42.03
Rate for Payer: Aetna Commercial	$31.94
Rate for Payer: Aetna Medicare Advantage	$25.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.44
Rate for Payer: Cigna Commercial	$42.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.86
Rate for Payer: Oxford Commercial	$16.81
Rate for Payer: Qualcare PPO/HMO/WC	$12.61
Rate for Payer: UnitedHealthcare Commercial	$16.81
Rate for Payer: UnitedHealthcare Community & State	$2.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.39

ORAL SWAB SUCTION SYST W/PEROX

Facility

$26.65

Hospital Charge Code	270650069
Hospital Revenue Code	270
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.00

ORAL SWAB SUCTION SYST W/PEROX

Facility

$26.65

Hospital Charge Code	270650069
Hospital Revenue Code	270
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.32
Rate for Payer: Aetna Commercial	$10.13
Rate for Payer: Aetna Medicare Advantage	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.80
Rate for Payer: Cigna Commercial	$13.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.93
Rate for Payer: Oxford Commercial	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.00
Rate for Payer: UnitedHealthcare Commercial	$5.33
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

OR BILAYER MATRIX WND DRSG

Facility

$10,000.00

Hospital Charge Code	1610005
Hospital Revenue Code	272
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,600.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

OR BILAYER MATRIX WND DRSG

Facility

$10,000.00

Hospital Charge Code	1610005
Hospital Revenue Code	272
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

ORBITAL PROCEDURES WITH CC/MCC

Facility

$93,744.24

Service Code	MSDRG 113
Min. Negotiated Rate	$28,543.92
Max. Negotiated Rate	$93,744.24
Rate for Payer: Aetna Commercial	$68,624.21
Rate for Payer: Aetna Medicare Advantage	$93,744.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69,539.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69,539.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30,046.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69,539.55
Rate for Payer: Cigna Commercial	$52,413.07
Rate for Payer: Cigna Medicare Advantage	$30,046.23
Rate for Payer: Clover Medicare Advantage	$28,543.92
Rate for Payer: EmblemHealth Commercial	$90,138.69
Rate for Payer: Humana Medicare Advantage	$30,947.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$30,046.23
Rate for Payer: Oxford Commercial	$41,426.38
Rate for Payer: UnitedHealthcare Commercial	$55,450.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$30,046.23
Rate for Payer: Wellcare Medicare Advantage	$30,046.23

ORBITAL PROCEDURES WITHOUT CC/MCC

Facility

$62,210.71

Service Code	MSDRG 114
Min. Negotiated Rate	$18,942.36
Max. Negotiated Rate	$62,210.71
Rate for Payer: Aetna Commercial	$46,165.69
Rate for Payer: Aetna Medicare Advantage	$62,210.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,077.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,077.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,939.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,077.15
Rate for Payer: Cigna Commercial	$30,162.43
Rate for Payer: Cigna Medicare Advantage	$19,939.33
Rate for Payer: Clover Medicare Advantage	$18,942.36
Rate for Payer: EmblemHealth Commercial	$59,817.99
Rate for Payer: Humana Medicare Advantage	$20,537.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,939.33
Rate for Payer: Oxford Commercial	$23,839.86
Rate for Payer: UnitedHealthcare Commercial	$31,910.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,939.33
Rate for Payer: Wellcare Medicare Advantage	$19,939.33

ORBIT AND EYE PROCEDURES

Facility

$44,506.26

Service Code	APR-DRG 0734
Min. Negotiated Rate	$43,633.59
Max. Negotiated Rate	$44,506.26
Rate for Payer: UnitedHealthcare Community & State	$43,633.59
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$44,506.26
Rate for Payer: Wellpoint Medicaid Managed Care	$43,633.59

ORBIT AND EYE PROCEDURES

Facility

$24,412.37

Service Code	APR-DRG 0733
Min. Negotiated Rate	$23,933.70
Max. Negotiated Rate	$24,412.37
Rate for Payer: UnitedHealthcare Community & State	$23,933.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,412.37
Rate for Payer: Wellpoint Medicaid Managed Care	$23,933.70

Know your out-of-pocket cost for care.

All Charges