Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$7,830.82

Service Code	APR-DRG 3852
Min. Negotiated Rate	$7,677.27
Max. Negotiated Rate	$7,830.82
Rate for Payer: UnitedHealthcare Community & State	$7,677.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,830.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7,677.27

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$21,964.53

Service Code	APR-DRG 3854
Min. Negotiated Rate	$21,533.85
Max. Negotiated Rate	$21,964.53
Rate for Payer: UnitedHealthcare Community & State	$21,533.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,964.53
Rate for Payer: Wellpoint Medicaid Managed Care	$21,533.85

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$12,187.23

Service Code	APR-DRG 3853
Min. Negotiated Rate	$11,948.26
Max. Negotiated Rate	$12,187.23
Rate for Payer: UnitedHealthcare Community & State	$11,948.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,187.23
Rate for Payer: Wellpoint Medicaid Managed Care	$11,948.26

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC

Facility

$74,058.32

Service Code	MSDRG 580
Min. Negotiated Rate	$22,549.81
Max. Negotiated Rate	$74,058.32
Rate for Payer: Aetna Commercial	$54,603.66
Rate for Payer: Aetna Medicare Advantage	$74,058.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48,483.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48,483.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,736.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48,483.75
Rate for Payer: Cigna Commercial	$38,522.30
Rate for Payer: Cigna Medicare Advantage	$23,736.64
Rate for Payer: Clover Medicare Advantage	$22,549.81
Rate for Payer: EmblemHealth Commercial	$71,209.92
Rate for Payer: Humana Medicare Advantage	$24,448.74
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,736.64
Rate for Payer: Oxford Commercial	$30,447.36
Rate for Payer: UnitedHealthcare Commercial	$40,754.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,736.64
Rate for Payer: Wellcare Medicare Advantage	$23,736.64

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC

Facility

$121,780.37

Service Code	MSDRG 579
Min. Negotiated Rate	$37,080.56
Max. Negotiated Rate	$121,780.37
Rate for Payer: Aetna Commercial	$88,591.89
Rate for Payer: Aetna Medicare Advantage	$121,780.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92,534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92,534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$39,032.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92,534.70
Rate for Payer: Cigna Commercial	$72,195.88
Rate for Payer: Cigna Medicare Advantage	$39,032.17
Rate for Payer: Clover Medicare Advantage	$37,080.56
Rate for Payer: EmblemHealth Commercial	$117,096.51
Rate for Payer: Humana Medicare Advantage	$40,203.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$39,032.17
Rate for Payer: Oxford Commercial	$57,062.37
Rate for Payer: UnitedHealthcare Commercial	$76,380.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$39,032.17
Rate for Payer: Wellcare Medicare Advantage	$39,032.17

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC

Facility

$65,057.27

Service Code	MSDRG 581
Min. Negotiated Rate	$19,809.11
Max. Negotiated Rate	$65,057.27
Rate for Payer: Aetna Commercial	$48,193.03
Rate for Payer: Aetna Medicare Advantage	$65,057.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,401.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,851.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,401.75
Rate for Payer: Cigna Commercial	$32,171.03
Rate for Payer: Cigna Medicare Advantage	$20,851.69
Rate for Payer: Clover Medicare Advantage	$19,809.11
Rate for Payer: EmblemHealth Commercial	$62,555.07
Rate for Payer: Humana Medicare Advantage	$21,477.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,851.69
Rate for Payer: Oxford Commercial	$25,427.42
Rate for Payer: UnitedHealthcare Commercial	$34,035.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,851.69
Rate for Payer: Wellcare Medicare Advantage	$20,851.69

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$22,371.82

Service Code	APR-DRG 3643
Min. Negotiated Rate	$21,933.16
Max. Negotiated Rate	$22,371.82
Rate for Payer: UnitedHealthcare Community & State	$21,933.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,371.82
Rate for Payer: Wellpoint Medicaid Managed Care	$21,933.16

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$10,364.33

Service Code	APR-DRG 3641
Min. Negotiated Rate	$10,161.11
Max. Negotiated Rate	$10,364.33
Rate for Payer: UnitedHealthcare Community & State	$10,161.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,364.33
Rate for Payer: Wellpoint Medicaid Managed Care	$10,161.11

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$39,405.52

Service Code	APR-DRG 3644
Min. Negotiated Rate	$38,632.86
Max. Negotiated Rate	$39,405.52
Rate for Payer: UnitedHealthcare Community & State	$38,632.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,405.52
Rate for Payer: Wellpoint Medicaid Managed Care	$38,632.86

OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES

Facility

$14,157.59

Service Code	APR-DRG 3642
Min. Negotiated Rate	$13,879.99
Max. Negotiated Rate	$14,157.59
Rate for Payer: UnitedHealthcare Community & State	$13,879.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,157.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13,879.99

Other SLP Current Status CH

Facility

$0.01

Service Code	HCPCS G9174GNCH
Hospital Charge Code	74204089CH
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Other SLP Current Status CH

Facility

$0.01

Service Code	HCPCS G9174GNCH
Hospital Charge Code	74204089CH
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Current Status CI

Facility

$0.01

Service Code	HCPCS G9174GNCI
Hospital Charge Code	74204089CI
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Current Status CI

Facility

$0.01

Service Code	HCPCS G9174GNCI
Hospital Charge Code	74204089CI
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Other SLP Current Status CJ

Facility

$0.01

Service Code	HCPCS G9174GNCJ
Hospital Charge Code	74204089CJ
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Other SLP Current Status CJ

Facility

$0.01

Service Code	HCPCS G9174GNCJ
Hospital Charge Code	74204089CJ
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Current Status CK

Facility

$0.01

Service Code	HCPCS G9174GNCK
Hospital Charge Code	74204089CK
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Other SLP Current Status CK

Facility

$0.01

Service Code	HCPCS G9174GNCK
Hospital Charge Code	74204089CK
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Current Status CL

Facility

$0.01

Service Code	HCPCS G9174GNCL
Hospital Charge Code	74204089CL
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Other SLP Current Status CL

Facility

$0.01

Service Code	HCPCS G9174GNCL
Hospital Charge Code	74204089CL
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Current Status CM

Facility

$0.01

Service Code	HCPCS G9174GNCM
Hospital Charge Code	74204089CM
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP Current Status CM

Facility

$0.01

Service Code	HCPCS G9174GNCM
Hospital Charge Code	74204089CM
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

OTHER SLP CURRENT STATUS CN

Facility

$0.01

Service Code	HCPCS G9174GNCN
Hospital Charge Code	74204089CN
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

OTHER SLP CURRENT STATUS CN

Facility

$0.01

Service Code	HCPCS G9174GNCN
Hospital Charge Code	74204089CN
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Other SLP D/C Status CH

Facility

$0.01

Service Code	HCPCS G9176GNCH
Hospital Charge Code	74204093CH
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges