Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RW NAIL AVULSION,PART/COMP SNG

Facility

$535.00

Service Code	HCPCS 11730
Hospital Charge Code	84206055
Hospital Revenue Code	761
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$864.65
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	$59.48
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	$139.10
Rate for Payer: Oxford Commercial	$107.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Commercial	$107.00
Rate for Payer: UnitedHealthcare Community & State	$16.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$15.19

RW NAIL EXCISION-MATRIX PERMNT

Facility

$1,208.00

Service Code	HCPCS 11750
Hospital Charge Code	84206060
Hospital Revenue Code	761
Min. Negotiated Rate	$181.20
Max. Negotiated Rate	$181.20
Rate for Payer: Qualcare PPO/HMO/WC	$181.20

RW NAIL EXCISION-MATRIX PERMNT

Facility

$1,208.00

Service Code	HCPCS 11750
Hospital Charge Code	84206060
Hospital Revenue Code	761
Min. Negotiated Rate	$34.31
Max. Negotiated Rate	$1,751.90
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	$134.87
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	$314.08
Rate for Payer: Oxford Commercial	$241.60
Rate for Payer: Qualcare PPO/HMO/WC	$181.20
Rate for Payer: UnitedHealthcare Commercial	$241.60
Rate for Payer: UnitedHealthcare Community & State	$38.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$34.31

RW NEW PT - VISIT - COMPREHENS

Facility

$1,068.20

Service Code	HCPCS 99204
Hospital Charge Code	84206325
Hospital Revenue Code	510
Min. Negotiated Rate	$30.34
Max. Negotiated Rate	$534.10
Rate for Payer: Aetna Commercial	$405.92
Rate for Payer: Aetna Medicare Advantage	$320.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.39
Rate for Payer: Cigna Commercial	$534.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.73
Rate for Payer: Qualcare PPO/HMO/WC	$160.23
Rate for Payer: UnitedHealthcare Community & State	$33.76
Rate for Payer: Wellpoint Medicaid Managed Care	$30.34

RW NEW PT - VISIT - COMPREHENS

Facility

$1,068.20

Service Code	HCPCS 99204
Hospital Charge Code	84206325
Hospital Revenue Code	510
Min. Negotiated Rate	$160.23
Max. Negotiated Rate	$160.23
Rate for Payer: Qualcare PPO/HMO/WC	$160.23

RW NEW PT - VISIT - DETAILED

Facility

$174.00

Service Code	HCPCS 99203
Hospital Charge Code	84206320
Hospital Revenue Code	510
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

RW NEW PT - VISIT - DETAILED

Facility

$174.00

Service Code	HCPCS 99203
Hospital Charge Code	84206320
Hospital Revenue Code	510
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

RW NEW PT - VISIT - EXPANDED

Facility

$91.00

Service Code	HCPCS 99202
Hospital Charge Code	84206315
Hospital Revenue Code	510
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

RW NEW PT - VISIT - EXPANDED

Facility

$91.00

Service Code	HCPCS 99202
Hospital Charge Code	84206315
Hospital Revenue Code	510
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

RW NEW PT - VISIT - FOCUSED

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	84206310
Hospital Revenue Code	510
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$88.92
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.84
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Community & State	$7.39
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

RW NEW PT - VISIT - FOCUSED

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	84206310
Hospital Revenue Code	510
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

RW OFF VISIT EST PT MINIMAL

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	87502225
Hospital Revenue Code	510
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW OFF VISIT EST PT MINIMAL

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	87502225
Hospital Revenue Code	510
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.64
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Community & State	$3.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

RW OFF VISIT FOCUSED NP

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	87502200
Hospital Revenue Code	510
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$88.92
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.84
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Community & State	$7.39
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

RW OFF VISIT FOCUSED NP

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	87502200
Hospital Revenue Code	510
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

RW PAIRING BENIGN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	87502145
Hospital Revenue Code	761
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

RW PAIRING BENIGN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	87502145
Hospital Revenue Code	761
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$864.65
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	$35.00
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	$169.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

RW PAIRING BENIGN >4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	87502150
Hospital Revenue Code	761
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

RW PAIRING BENIGN >4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	87502150
Hospital Revenue Code	761
Min. Negotiated Rate	$39.76
Max. Negotiated Rate	$864.65
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	$43.28
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	$364.00
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$280.00
Rate for Payer: UnitedHealthcare Community & State	$44.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$39.76

RW PAIRING BENIGN LES SINGLE

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	87502140
Hospital Revenue Code	761
Min. Negotiated Rate	$14.54
Max. Negotiated Rate	$864.65
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	$31.20
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	$133.12
Rate for Payer: Oxford Commercial	$102.40
Rate for Payer: Qualcare PPO/HMO/WC	$76.80
Rate for Payer: UnitedHealthcare Commercial	$102.40
Rate for Payer: UnitedHealthcare Community & State	$16.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$14.54

RW PAIRING BENIGN LES SINGLE

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	87502140
Hospital Revenue Code	761
Min. Negotiated Rate	$76.80
Max. Negotiated Rate	$76.80
Rate for Payer: Qualcare PPO/HMO/WC	$76.80

RW PAP SMEAR

Facility

$143.00

Service Code	HCPCS Q0091
Hospital Charge Code	87502295
Hospital Revenue Code	770
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$21.45

RW PAP SMEAR

Facility

$143.00

Service Code	HCPCS Q0091
Hospital Charge Code	87502295
Hospital Revenue Code	770
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$124.64
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: Oxford Commercial	$28.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.45
Rate for Payer: UnitedHealthcare Commercial	$28.60
Rate for Payer: UnitedHealthcare Community & State	$4.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

RW PAP SMEAR

Facility

$143.00

Hospital Charge Code	83652627
Hospital Revenue Code	770
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$71.50
Rate for Payer: Aetna Commercial	$54.34
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.47
Rate for Payer: Cigna Commercial	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: Oxford Commercial	$28.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.45
Rate for Payer: UnitedHealthcare Commercial	$28.60
Rate for Payer: UnitedHealthcare Community & State	$4.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.06

RW PAP SMEAR

Facility

$143.00

Hospital Charge Code	83652627
Hospital Revenue Code	770
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$21.45

Know your out-of-pocket cost for care.

All Charges