Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

POD INJECTION NEUROLYSIS

Facility

$3,103.00

Service Code	HCPCS 64640
Hospital Charge Code	84208220
Hospital Revenue Code	519
Min. Negotiated Rate	$465.45
Max. Negotiated Rate	$465.45
Rate for Payer: Qualcare PPO/HMO/WC	$465.45

POD INJ TENDON, LIG, GANGLION

Facility

$1,091.00

Service Code	HCPCS 20550
Hospital Charge Code	84208115
Hospital Revenue Code	510
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

POD INJ TENDON, LIG, GANGLION

Facility

$1,091.00

Service Code	HCPCS 20550
Hospital Charge Code	84208115
Hospital Revenue Code	510
Min. Negotiated Rate	$30.98
Max. Negotiated Rate	$1,322.84
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,322.84
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.66
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Community & State	$34.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$30.98

POD NAIL FROST

Facility

$545.00

Service Code	HCPCS 11760
Hospital Charge Code	84208090
Hospital Revenue Code	510
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.70
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Community & State	$17.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

POD NAIL FROST

Facility

$545.00

Service Code	HCPCS 11760
Hospital Charge Code	84208090
Hospital Revenue Code	510
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

POD NAIL ONYCHO RED 1-5

Facility

$372.00

Service Code	HCPCS 11720
Hospital Charge Code	84208055
Hospital Revenue Code	361
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

POD NAIL ONYCHO RED 1-5

Facility

$372.00

Service Code	HCPCS 11720
Hospital Charge Code	84208055
Hospital Revenue Code	361
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
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	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

POD NAIL P+A

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	84208080
Hospital Revenue Code	361
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

POD NAIL P+A

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	84208080
Hospital Revenue Code	361
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$541.06
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$65.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$59.10

POD NAIL UNIT BIOPSY

Facility

$2,081.00

Service Code	HCPCS 11755
Hospital Charge Code	84208085
Hospital Revenue Code	361
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

POD NAIL UNIT BIOPSY

Facility

$2,081.00

Service Code	HCPCS 11755
Hospital Charge Code	84208085
Hospital Revenue Code	361
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
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	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$541.06
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$65.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$59.10

POD NONDYS NAILS

Facility

$186.30

Service Code	HCPCS 11719
Hospital Charge Code	84208050
Hospital Revenue Code	510
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$27.95

POD NONDYS NAILS

Facility

$186.30

Service Code	HCPCS 11719
Hospital Charge Code	84208050
Hospital Revenue Code	510
Min. Negotiated Rate	$5.29
Max. Negotiated Rate	$254.22
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.44
Rate for Payer: Qualcare PPO/HMO/WC	$27.95
Rate for Payer: UnitedHealthcare Community & State	$5.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$5.29

PODOFOLIX 0.5% TOP

Facility

$666.52

Service Code	NDC 591320413
Hospital Charge Code	6023412
Hospital Revenue Code	250
Min. Negotiated Rate	$18.93
Max. Negotiated Rate	$333.26
Rate for Payer: Aetna Commercial	$253.28
Rate for Payer: Aetna Medicare Advantage	$199.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.96
Rate for Payer: Cigna Commercial	$333.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.30
Rate for Payer: Oxford Commercial	$133.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.98
Rate for Payer: UnitedHealthcare Commercial	$133.30
Rate for Payer: UnitedHealthcare Community & State	$21.06
Rate for Payer: Wellpoint Medicaid Managed Care	$18.93

PODOFOLIX 0.5% TOP

Facility

$666.52

Service Code	NDC 591320413
Hospital Charge Code	6023412
Hospital Revenue Code	250
Min. Negotiated Rate	$99.98
Max. Negotiated Rate	$99.98
Rate for Payer: Qualcare PPO/HMO/WC	$99.98

POD ONYCHO RED 6+

Facility

$372.00

Service Code	HCPCS 11721
Hospital Charge Code	84208060
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

POD ONYCHO RED 6+

Facility

$372.00

Service Code	HCPCS 11721
Hospital Charge Code	84208060
Hospital Revenue Code	510
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$254.22
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

POD ORTHOTIC CHECK OUT

Facility

$545.00

Service Code	HCPCS 97762
Hospital Charge Code	84208235
Hospital Revenue Code	420
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

POD ORTHOTIC CHECK OUT

Facility

$545.00

Service Code	HCPCS 97762
Hospital Charge Code	84208235
Hospital Revenue Code	420
Min. Negotiated Rate	$15.48
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.70
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$17.22
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

POD OV-ESTABLISHED-BRIEF

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	84208265
Hospital Revenue Code	510
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

POD OV-ESTABLISHED-BRIEF

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	84208265
Hospital Revenue Code	510
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$155.50
Rate for Payer: Aetna Commercial	$118.18
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.86
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Community & State	$9.83
Rate for Payer: Wellpoint Medicaid Managed Care	$8.83

POD OV-NEW-BRIEF

Facility

$318.00

Service Code	HCPCS 99201
Hospital Charge Code	84208240
Hospital Revenue Code	510
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$120.84
Rate for Payer: Aetna Medicare Advantage	$95.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.09
Rate for Payer: Cigna Commercial	$159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.68
Rate for Payer: Qualcare PPO/HMO/WC	$47.70
Rate for Payer: UnitedHealthcare Community & State	$10.05
Rate for Payer: Wellpoint Medicaid Managed Care	$9.03

POD OV-NEW-BRIEF

Facility

$318.00

Service Code	HCPCS 99201
Hospital Charge Code	84208240
Hospital Revenue Code	510
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$47.70

POD POSTERIOR SPLINT

Facility

$458.00

Service Code	HCPCS 29730
Hospital Charge Code	84208205
Hospital Revenue Code	510
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

POD POSTERIOR SPLINT

Facility

$458.00

Service Code	HCPCS 29730
Hospital Charge Code	84208205
Hospital Revenue Code	510
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$700.29
Rate for Payer: Aetna Commercial	$525.10
Rate for Payer: Aetna Medicare Advantage	$625.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$700.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$193.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$700.29
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: Cigna Medicare Advantage	$193.05
Rate for Payer: Clover Medicare Advantage	$183.40
Rate for Payer: EmblemHealth Commercial	$579.15
Rate for Payer: Humana Medicare Advantage	$198.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$193.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$193.05
Rate for Payer: Wellcare Medicare Advantage	$193.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

Know your out-of-pocket cost for care.

All Charges