Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

REMOVAL OF KNEECAP

Facility

$30,595.00

Service Code	HCPCS 27350
Hospital Charge Code	16000561
Hospital Revenue Code	360
Min. Negotiated Rate	$868.90
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	$7,954.70
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$966.80
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	$868.90

REMOVAL OF LARYNX LESION

Facility

$19,096.15

Service Code	HCPCS 31300
Hospital Charge Code	1600000702
Hospital Revenue Code	360
Min. Negotiated Rate	$542.33
Max. Negotiated Rate	$14,288.18
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,288.18
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,965.00
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,864.42
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$603.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$542.33

REMOVAL OF LARYNX LESION

Facility

$19,096.15

Service Code	HCPCS 31300
Hospital Charge Code	1600000702
Hospital Revenue Code	360
Min. Negotiated Rate	$2,864.42
Max. Negotiated Rate	$2,864.42
Rate for Payer: Qualcare PPO/HMO/WC	$2,864.42

REMOVAL OF LUNG LESION

Facility

$23,450.23

Service Code	HCPCS 32540
Hospital Charge Code	1600000406
Hospital Revenue Code	360
Min. Negotiated Rate	$665.99
Max. Negotiated Rate	$11,725.11
Rate for Payer: Aetna Commercial	$8,911.09
Rate for Payer: Aetna Medicare Advantage	$7,035.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,979.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,979.81
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	$5,979.81
Rate for Payer: Cigna Commercial	$11,725.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,097.06
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,517.53
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$741.03
Rate for Payer: Wellpoint Medicaid Managed Care	$665.99

REMOVAL OF LUNG LESION

Facility

$23,450.23

Service Code	HCPCS 32540
Hospital Charge Code	1600000406
Hospital Revenue Code	360
Min. Negotiated Rate	$3,517.53
Max. Negotiated Rate	$3,517.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,517.53

REMOVAL OF NAIL BED

Facility

$1,822.15

Service Code	HCPCS 11750
Hospital Charge Code	412311750
Hospital Revenue Code	361
Min. Negotiated Rate	$51.75
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	$473.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.32
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$57.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$51.75

REMOVAL OF NAIL BED

Facility

$1,822.15

Service Code	HCPCS 11750
Hospital Charge Code	412311750
Hospital Revenue Code	361
Min. Negotiated Rate	$273.32
Max. Negotiated Rate	$273.32
Rate for Payer: Qualcare PPO/HMO/WC	$273.32

REMOVAL OF NAIL PLATE

Facility

$990.50

Service Code	HCPCS 11730
Hospital Charge Code	412311730
Hospital Revenue Code	361
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.53
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$31.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$28.13

REMOVAL OF NAIL PLATE

Facility

$990.50

Service Code	HCPCS 11730
Hospital Charge Code	412311730
Hospital Revenue Code	361
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

REMOVAL OF NAIL PLATE ADD-ON

Facility

$495.25

Service Code	HCPCS 11732
Hospital Charge Code	412311732
Hospital Revenue Code	361
Min. Negotiated Rate	$74.29
Max. Negotiated Rate	$74.29
Rate for Payer: Qualcare PPO/HMO/WC	$74.29

REMOVAL OF NAIL PLATE ADD-ON

Facility

$495.25

Service Code	HCPCS 11732
Hospital Charge Code	412311732
Hospital Revenue Code	361
Min. Negotiated Rate	$14.07
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$188.19
Rate for Payer: Aetna Medicare Advantage	$148.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.29
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	$126.29
Rate for Payer: Cigna Commercial	$247.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.76
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.29
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$15.65
Rate for Payer: Wellpoint Medicaid Managed Care	$14.07

REMOVAL OF PANCREAS

Facility

$38,810.60

Service Code	HCPCS 48155
Hospital Charge Code	1600000695
Hospital Revenue Code	360
Min. Negotiated Rate	$5,821.59
Max. Negotiated Rate	$5,821.59
Rate for Payer: Qualcare PPO/HMO/WC	$5,821.59

REMOVAL OF PANCREAS

Facility

$38,810.60

Service Code	HCPCS 48155
Hospital Charge Code	1600000695
Hospital Revenue Code	360
Min. Negotiated Rate	$1,102.22
Max. Negotiated Rate	$19,405.30
Rate for Payer: Aetna Commercial	$14,748.03
Rate for Payer: Aetna Medicare Advantage	$11,643.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,896.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,896.70
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	$9,896.70
Rate for Payer: Cigna Commercial	$19,405.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,090.76
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,821.59
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,226.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1,102.22

REMOVAL OF PELVIC STRUCTURES

Facility

$48,449.00

Service Code	HCPCS 51597
Hospital Charge Code	1600000727
Hospital Revenue Code	360
Min. Negotiated Rate	$7,267.35
Max. Negotiated Rate	$7,267.35
Rate for Payer: Qualcare PPO/HMO/WC	$7,267.35

REMOVAL OF PELVIC STRUCTURES

Facility

$48,449.00

Service Code	HCPCS 51597
Hospital Charge Code	1600000727
Hospital Revenue Code	360
Min. Negotiated Rate	$1,375.95
Max. Negotiated Rate	$24,224.50
Rate for Payer: Aetna Commercial	$18,410.62
Rate for Payer: Aetna Medicare Advantage	$14,534.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,354.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,354.50
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	$12,354.50
Rate for Payer: Cigna Commercial	$24,224.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,596.74
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,267.35
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,530.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1,375.95

REMOVAL OF PELVIS CONTENTS

Facility

$15,702.60

Service Code	HCPCS 58240
Hospital Charge Code	1600000729
Hospital Revenue Code	360
Min. Negotiated Rate	$445.95
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,966.99
Rate for Payer: Aetna Medicare Advantage	$4,710.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,004.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,004.16
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	$4,004.16
Rate for Payer: Cigna Commercial	$7,851.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,082.68
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,355.39
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$496.20
Rate for Payer: Wellpoint Medicaid Managed Care	$445.95

REMOVAL OF PELVIS CONTENTS

Facility

$15,702.60

Service Code	HCPCS 58240
Hospital Charge Code	1600000729
Hospital Revenue Code	360
Min. Negotiated Rate	$2,355.39
Max. Negotiated Rate	$2,355.39
Rate for Payer: Qualcare PPO/HMO/WC	$2,355.39

REMOVAL OF PENIS

Facility

$23,731.00

Service Code	HCPCS 54125
Hospital Charge Code	1600000767
Hospital Revenue Code	360
Min. Negotiated Rate	$3,559.65
Max. Negotiated Rate	$3,559.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,559.65

REMOVAL OF PENIS

Facility

$23,731.00

Service Code	HCPCS 54125
Hospital Charge Code	1600000767
Hospital Revenue Code	360
Min. Negotiated Rate	$673.96
Max. Negotiated Rate	$11,865.50
Rate for Payer: Aetna Commercial	$9,017.78
Rate for Payer: Aetna Medicare Advantage	$7,119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,051.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,051.40
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	$6,051.40
Rate for Payer: Cigna Commercial	$11,865.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,170.06
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,559.65
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$749.90
Rate for Payer: Wellpoint Medicaid Managed Care	$673.96

REMOVAL OF PM GENERATOR

Facility

$48,966.00

Service Code	HCPCS 33233
Hospital Charge Code	411033233
Hospital Revenue Code	481
Min. Negotiated Rate	$7,344.90
Max. Negotiated Rate	$7,344.90
Rate for Payer: Qualcare PPO/HMO/WC	$7,344.90

REMOVAL OF PM GENERATOR

Facility

$48,966.00

Service Code	HCPCS 33233
Hospital Charge Code	411033233
Hospital Revenue Code	481
Min. Negotiated Rate	$1,390.63
Max. Negotiated Rate	$35,663.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,663.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,663.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,663.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,731.16
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,344.90
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,547.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,390.63

REMOVAL OF SUPPORT IMPLANT

Facility

$13,615.50

Service Code	HCPCS 20670
Hospital Charge Code	16000668
Hospital Revenue Code	360
Min. Negotiated Rate	$386.68
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,540.03
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$430.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$386.68

REMOVAL OF SUPPORT IMPLANT

Facility

$11,677.88

Service Code	HCPCS 20680
Hospital Charge Code	16000180
Hospital Revenue Code	360
Min. Negotiated Rate	$331.65
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
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	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,036.25
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.68
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$369.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$331.65

REMOVAL OF SUPPORT IMPLANT

Facility

$11,677.88

Service Code	HCPCS 20680
Hospital Charge Code	16000180
Hospital Revenue Code	360
Min. Negotiated Rate	$1,751.68
Max. Negotiated Rate	$1,751.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.68

REMOVAL OF SUPPORT IMPLANT

Facility

$13,615.50

Service Code	HCPCS 20670
Hospital Charge Code	16000668
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

Know your out-of-pocket cost for care.

All Charges