Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SKIN FULL GRAFT SCLP/ARM/LEG

Facility

$16,584.80

Service Code	HCPCS 15220
Hospital Charge Code	16000659
Hospital Revenue Code	360
Min. Negotiated Rate	$471.01
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
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	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,312.05
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,487.72
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$524.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$471.01

SKIN FULL GRFT TRUNK =< 20SQCM

Facility

$26,848.40

Service Code	HCPCS 15200
Hospital Charge Code	16000437
Hospital Revenue Code	360
Min. Negotiated Rate	$762.49
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
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	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,980.58
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$848.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$762.49

SKIN FULL GRFT TRUNK =< 20SQCM

Facility

$26,848.40

Service Code	HCPCS 15200
Hospital Charge Code	16000437
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility

$103,209.72

Service Code	MSDRG 577
Min. Negotiated Rate	$31,426.04
Max. Negotiated Rate	$103,209.72
Rate for Payer: Aetna Commercial	$75,365.64
Rate for Payer: Aetna Medicare Advantage	$103,209.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73,418.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73,418.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,080.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73,418.25
Rate for Payer: Cigna Commercial	$59,092.06
Rate for Payer: Cigna Medicare Advantage	$33,080.04
Rate for Payer: Clover Medicare Advantage	$31,426.04
Rate for Payer: EmblemHealth Commercial	$99,240.12
Rate for Payer: Humana Medicare Advantage	$34,072.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33,080.04
Rate for Payer: Oxford Commercial	$46,705.33
Rate for Payer: UnitedHealthcare Commercial	$62,516.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,080.04
Rate for Payer: Wellcare Medicare Advantage	$33,080.04

SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility

$174,310.97

Service Code	MSDRG 576
Min. Negotiated Rate	$53,075.46
Max. Negotiated Rate	$174,310.97
Rate for Payer: Aetna Commercial	$126,004.79
Rate for Payer: Aetna Medicare Advantage	$174,310.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157,364.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157,364.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$55,868.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157,364.40
Rate for Payer: Cigna Commercial	$109,262.45
Rate for Payer: Cigna Medicare Advantage	$55,868.90
Rate for Payer: Clover Medicare Advantage	$53,075.46
Rate for Payer: EmblemHealth Commercial	$167,606.70
Rate for Payer: Humana Medicare Advantage	$57,544.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$55,868.90
Rate for Payer: Oxford Commercial	$86,359.14
Rate for Payer: UnitedHealthcare Commercial	$115,594.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$55,868.90
Rate for Payer: Wellcare Medicare Advantage	$55,868.90

SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$70,216.54

Service Code	MSDRG 578
Min. Negotiated Rate	$21,380.03
Max. Negotiated Rate	$70,216.54
Rate for Payer: Aetna Commercial	$51,867.55
Rate for Payer: Aetna Medicare Advantage	$70,216.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,605.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,505.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,605.05
Rate for Payer: Cigna Commercial	$35,811.48
Rate for Payer: Cigna Medicare Advantage	$22,505.30
Rate for Payer: Clover Medicare Advantage	$21,380.03
Rate for Payer: EmblemHealth Commercial	$67,515.90
Rate for Payer: Humana Medicare Advantage	$23,180.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,505.30
Rate for Payer: Oxford Commercial	$28,304.77
Rate for Payer: UnitedHealthcare Commercial	$37,886.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,505.30
Rate for Payer: Wellcare Medicare Advantage	$22,505.30

SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$74,416.77

Service Code	APR-DRG 3124
Min. Negotiated Rate	$72,957.62
Max. Negotiated Rate	$74,416.77
Rate for Payer: UnitedHealthcare Community & State	$72,957.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$74,416.77
Rate for Payer: Wellpoint Medicaid Managed Care	$72,957.62

SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$41,722.76

Service Code	APR-DRG 3123
Min. Negotiated Rate	$40,904.67
Max. Negotiated Rate	$41,722.76
Rate for Payer: UnitedHealthcare Community & State	$40,904.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$41,722.76
Rate for Payer: Wellpoint Medicaid Managed Care	$40,904.67

SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$15,855.49

Service Code	APR-DRG 3121
Min. Negotiated Rate	$15,544.60
Max. Negotiated Rate	$15,855.49
Rate for Payer: UnitedHealthcare Community & State	$15,544.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,855.49
Rate for Payer: Wellpoint Medicaid Managed Care	$15,544.60

SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES

Facility

$25,042.93

Service Code	APR-DRG 3122
Min. Negotiated Rate	$24,551.89
Max. Negotiated Rate	$25,042.93
Rate for Payer: UnitedHealthcare Community & State	$24,551.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,042.93
Rate for Payer: Wellpoint Medicaid Managed Care	$24,551.89

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$34,852.56

Service Code	APR-DRG 3613
Min. Negotiated Rate	$34,169.18
Max. Negotiated Rate	$34,852.56
Rate for Payer: UnitedHealthcare Community & State	$34,169.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,852.56
Rate for Payer: Wellpoint Medicaid Managed Care	$34,169.18

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$23,484.07

Service Code	APR-DRG 3612
Min. Negotiated Rate	$23,023.60
Max. Negotiated Rate	$23,484.07
Rate for Payer: UnitedHealthcare Community & State	$23,023.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,484.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23,023.60

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$18,648.74

Service Code	APR-DRG 3611
Min. Negotiated Rate	$18,283.08
Max. Negotiated Rate	$18,648.74
Rate for Payer: UnitedHealthcare Community & State	$18,283.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,648.74
Rate for Payer: Wellpoint Medicaid Managed Care	$18,283.08

SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES

Facility

$73,439.34

Service Code	APR-DRG 3614
Min. Negotiated Rate	$71,999.35
Max. Negotiated Rate	$73,439.34
Rate for Payer: UnitedHealthcare Community & State	$71,999.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$73,439.34
Rate for Payer: Wellpoint Medicaid Managed Care	$71,999.35

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC

Facility

$129,138.55

Service Code	MSDRG 574
Min. Negotiated Rate	$39,321.03
Max. Negotiated Rate	$129,138.55
Rate for Payer: Aetna Commercial	$93,832.48
Rate for Payer: Aetna Medicare Advantage	$129,138.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94,474.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94,474.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41,390.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94,474.05
Rate for Payer: Cigna Commercial	$77,387.92
Rate for Payer: Cigna Medicare Advantage	$41,390.56
Rate for Payer: Clover Medicare Advantage	$39,321.03
Rate for Payer: EmblemHealth Commercial	$124,171.68
Rate for Payer: Humana Medicare Advantage	$42,632.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41,390.56
Rate for Payer: Oxford Commercial	$61,166.07
Rate for Payer: UnitedHealthcare Commercial	$81,872.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$41,390.56
Rate for Payer: Wellcare Medicare Advantage	$41,390.56

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC

Facility

$226,446.73

Service Code	MSDRG 573
Min. Negotiated Rate	$68,950.13
Max. Negotiated Rate	$226,446.73
Rate for Payer: Aetna Commercial	$163,136.46
Rate for Payer: Aetna Medicare Advantage	$226,446.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172,325.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172,325.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$72,579.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172,325.10
Rate for Payer: Cigna Commercial	$146,050.36
Rate for Payer: Cigna Medicare Advantage	$72,579.08
Rate for Payer: Clover Medicare Advantage	$68,950.13
Rate for Payer: EmblemHealth Commercial	$217,737.24
Rate for Payer: Humana Medicare Advantage	$74,756.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$72,579.08
Rate for Payer: Oxford Commercial	$115,435.67
Rate for Payer: UnitedHealthcare Commercial	$154,514.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$72,579.08
Rate for Payer: Wellcare Medicare Advantage	$72,579.08

SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC

Facility

$76,238.26

Service Code	MSDRG 575
Min. Negotiated Rate	$23,213.57
Max. Negotiated Rate	$76,238.26
Rate for Payer: Aetna Commercial	$56,156.26
Rate for Payer: Aetna Medicare Advantage	$76,238.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56,795.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56,795.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,435.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56,795.25
Rate for Payer: Cigna Commercial	$36,417.84
Rate for Payer: Cigna Medicare Advantage	$24,435.34
Rate for Payer: Clover Medicare Advantage	$23,213.57
Rate for Payer: EmblemHealth Commercial	$73,306.02
Rate for Payer: Humana Medicare Advantage	$25,168.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,435.34
Rate for Payer: Oxford Commercial	$28,784.03
Rate for Payer: UnitedHealthcare Commercial	$38,528.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,435.34
Rate for Payer: Wellcare Medicare Advantage	$24,435.34

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC

Facility

$76,140.32

Service Code	MSDRG 623
Min. Negotiated Rate	$23,183.75
Max. Negotiated Rate	$76,140.32
Rate for Payer: Aetna Commercial	$56,086.51
Rate for Payer: Aetna Medicare Advantage	$76,140.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51,531.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51,531.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,403.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51,531.30
Rate for Payer: Cigna Commercial	$39,991.41
Rate for Payer: Cigna Medicare Advantage	$24,403.95
Rate for Payer: Clover Medicare Advantage	$23,183.75
Rate for Payer: EmblemHealth Commercial	$73,211.85
Rate for Payer: Humana Medicare Advantage	$25,136.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,403.95
Rate for Payer: Oxford Commercial	$31,608.52
Rate for Payer: UnitedHealthcare Commercial	$42,309.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,403.95
Rate for Payer: Wellcare Medicare Advantage	$24,403.95

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC

Facility

$131,912.45

Service Code	MSDRG 622
Min. Negotiated Rate	$40,165.65
Max. Negotiated Rate	$131,912.45
Rate for Payer: Aetna Commercial	$95,808.06
Rate for Payer: Aetna Medicare Advantage	$131,912.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106,110.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106,110.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42,279.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106,110.15
Rate for Payer: Cigna Commercial	$79,345.25
Rate for Payer: Cigna Medicare Advantage	$42,279.63
Rate for Payer: Clover Medicare Advantage	$40,165.65
Rate for Payer: EmblemHealth Commercial	$126,838.89
Rate for Payer: Humana Medicare Advantage	$43,548.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42,279.63
Rate for Payer: Oxford Commercial	$62,713.10
Rate for Payer: UnitedHealthcare Commercial	$83,943.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$42,279.63
Rate for Payer: Wellcare Medicare Advantage	$42,279.63

SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC

Facility

$59,016.64

Service Code	MSDRG 624
Min. Negotiated Rate	$17,969.81
Max. Negotiated Rate	$59,016.64
Rate for Payer: Aetna Commercial	$43,890.84
Rate for Payer: Aetna Medicare Advantage	$59,016.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,752.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,752.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,915.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,752.55
Rate for Payer: Cigna Commercial	$27,908.61
Rate for Payer: Cigna Medicare Advantage	$18,915.59
Rate for Payer: Clover Medicare Advantage	$17,969.81
Rate for Payer: EmblemHealth Commercial	$56,746.77
Rate for Payer: Humana Medicare Advantage	$19,483.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,915.59
Rate for Payer: Oxford Commercial	$22,058.48
Rate for Payer: UnitedHealthcare Commercial	$29,526.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,915.59
Rate for Payer: Wellcare Medicare Advantage	$18,915.59

SKIN GRAFTS FOR INJURIES WITH CC/MCC

Facility

$135,510.96

Service Code	MSDRG 904
Min. Negotiated Rate	$41,261.35
Max. Negotiated Rate	$135,510.96
Rate for Payer: Aetna Commercial	$98,370.97
Rate for Payer: Aetna Medicare Advantage	$135,510.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90,318.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90,318.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$43,433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90,318.30
Rate for Payer: Cigna Commercial	$81,884.42
Rate for Payer: Cigna Medicare Advantage	$43,433.00
Rate for Payer: Clover Medicare Advantage	$41,261.35
Rate for Payer: EmblemHealth Commercial	$130,299.00
Rate for Payer: Humana Medicare Advantage	$44,735.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$43,433.00
Rate for Payer: Oxford Commercial	$64,720.02
Rate for Payer: UnitedHealthcare Commercial	$86,630.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$43,433.00
Rate for Payer: Wellcare Medicare Advantage	$43,433.00

SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC

Facility

$66,330.51

Service Code	MSDRG 905
Min. Negotiated Rate	$20,196.79
Max. Negotiated Rate	$66,330.51
Rate for Payer: Aetna Commercial	$49,099.86
Rate for Payer: Aetna Medicare Advantage	$66,330.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,773.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,773.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,259.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,773.90
Rate for Payer: Cigna Commercial	$31,919.12
Rate for Payer: Cigna Medicare Advantage	$21,259.78
Rate for Payer: Clover Medicare Advantage	$20,196.79
Rate for Payer: EmblemHealth Commercial	$63,779.34
Rate for Payer: Humana Medicare Advantage	$21,897.57
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,259.78
Rate for Payer: Oxford Commercial	$25,228.32
Rate for Payer: UnitedHealthcare Commercial	$33,769.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,259.78
Rate for Payer: Wellcare Medicare Advantage	$21,259.78

SKIN HOOK JOSEPH DOUBLE 6 IN

Facility

$492.55

Hospital Charge Code	270684791
Hospital Revenue Code	272
Min. Negotiated Rate	$73.88
Max. Negotiated Rate	$73.88
Rate for Payer: Qualcare PPO/HMO/WC	$73.88

SKIN HOOK JOSEPH DOUBLE 6 IN

Facility

$492.55

Hospital Charge Code	270684791
Hospital Revenue Code	272
Min. Negotiated Rate	$13.99
Max. Negotiated Rate	$246.28
Rate for Payer: Aetna Commercial	$187.17
Rate for Payer: Aetna Medicare Advantage	$147.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.60
Rate for Payer: Cigna Commercial	$246.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.06
Rate for Payer: Oxford Commercial	$98.51
Rate for Payer: Qualcare PPO/HMO/WC	$73.88
Rate for Payer: UnitedHealthcare Commercial	$98.51
Rate for Payer: UnitedHealthcare Community & State	$15.56
Rate for Payer: Wellpoint Medicaid Managed Care	$13.99

SKIN PARTIAL THICK,ABRASION

Facility

$1,050.00

Service Code	HCPCS 11040
Hospital Charge Code	1600000376
Hospital Revenue Code	360
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

Know your out-of-pocket cost for care.

All Charges