Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RW BX SKIN & ADD LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	87502070
Hospital Revenue Code	761
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

RW BX SKIN & ADDN'L LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	84206040
Hospital Revenue Code	761
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

RW BX SKIN & ADDN'L LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	84206040
Hospital Revenue Code	761
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.10
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$37.00
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

RW BX SKIN IINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	875020065
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

RW BX SKIN IINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	875020065
Hospital Revenue Code	761
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	87502065
Hospital Revenue Code	761
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	84206035
Hospital Revenue Code	761
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	87502065
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	84206035
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

RW CERUMEN REMOVAL

Facility

$274.00

Hospital Charge Code	87502090
Hospital Revenue Code	761
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

RW CERUMEN REMOVAL

Facility

$274.00

Service Code	HCPCS 69210
Hospital Charge Code	84206130
Hospital Revenue Code	761
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

RW CERUMEN REMOVAL

Facility

$274.00

Service Code	HCPCS 69210
Hospital Charge Code	84206130
Hospital Revenue Code	761
Min. Negotiated Rate	$7.78
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	$31.72
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	$71.24
Rate for Payer: Oxford Commercial	$54.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$54.80
Rate for Payer: UnitedHealthcare Community & State	$8.66
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	$7.78

RW CERUMEN REMOVAL

Facility

$274.00

Hospital Charge Code	87502090
Hospital Revenue Code	761
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$137.00
Rate for Payer: Aetna Commercial	$104.12
Rate for Payer: Aetna Medicare Advantage	$82.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.87
Rate for Payer: Cigna Commercial	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.24
Rate for Payer: Oxford Commercial	$54.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$54.80
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$7.78

RW COLLECTION CAP BLOOD SPECM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	87502340
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

RW COLLECTION CAP BLOOD SPECM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	87502340
Hospital Revenue Code	300
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$22.04
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

RW COLLECTION CAP BLOOD SPECMT

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	84206100
Hospital Revenue Code	300
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$22.04
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$1.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

RW COLLECTION CAP BLOOD SPECMT

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	84206100
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

RW COLPOSCOPY CERVIX

Facility

$135.80

Service Code	HCPCS 57452
Hospital Charge Code	84206105
Hospital Revenue Code	361
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
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	$871.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.31
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.37
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$4.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.86

RW COLPOSCOPY CERVIX

Facility

$135.80

Service Code	HCPCS 57452
Hospital Charge Code	84206105
Hospital Revenue Code	361
Min. Negotiated Rate	$20.37
Max. Negotiated Rate	$20.37
Rate for Payer: Qualcare PPO/HMO/WC	$20.37

RW COLPOSCOPY CERVIX/VAG W BX

Facility

$807.00

Service Code	HCPCS 57455
Hospital Charge Code	84206110
Hospital Revenue Code	361
Min. Negotiated Rate	$121.05
Max. Negotiated Rate	$121.05
Rate for Payer: Qualcare PPO/HMO/WC	$121.05

RW COLPOSCOPY CERVIX/VAG W BX

Facility

$807.00

Service Code	HCPCS 57455
Hospital Charge Code	84206110
Hospital Revenue Code	361
Min. Negotiated Rate	$22.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
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	$1,313.26
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.05
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$25.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$22.92

RW COLPOSCOPY CERVIX/VAG W/BX

Facility

$807.00

Service Code	HCPCS 57455
Hospital Charge Code	87520185
Hospital Revenue Code	361
Min. Negotiated Rate	$121.05
Max. Negotiated Rate	$121.05
Rate for Payer: Qualcare PPO/HMO/WC	$121.05

RW COLPOSCOPY CERVIX/VAG W/BX

Facility

$807.00

Service Code	HCPCS 57455
Hospital Charge Code	87520185
Hospital Revenue Code	361
Min. Negotiated Rate	$22.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
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	$1,313.26
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.82
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.05
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$25.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$22.92

RW COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	87502601
Hospital Revenue Code	361
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$222.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

RW COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	87502601
Hospital Revenue Code	361
Min. Negotiated Rate	$42.03
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$984.72
Rate for Payer: Aetna Medicare Advantage	$1,172.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$362.03
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	$1,313.26
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: Cigna Medicare Advantage	$362.03
Rate for Payer: Clover Medicare Advantage	$343.93
Rate for Payer: EmblemHealth Commercial	$1,086.09
Rate for Payer: Humana Medicare Advantage	$372.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$362.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.80
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$46.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$362.03
Rate for Payer: Wellcare Medicare Advantage	$362.03
Rate for Payer: Wellpoint Medicaid Managed Care	$42.03

Know your out-of-pocket cost for care.

All Charges