Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SKIN PARTIAL THICK,ABRASION

Facility

$1,050.00

Service Code	HCPCS 11040
Hospital Charge Code	1600000376
Hospital Revenue Code	360
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
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	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$33.18
Rate for Payer: Wellpoint Medicaid Managed Care	$29.82

SKIN PREP PREOP NASAL ANTISEPT

Facility

$79.35

Hospital Charge Code	270677880
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$39.67
Rate for Payer: Aetna Commercial	$30.15
Rate for Payer: Aetna Medicare Advantage	$23.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.23
Rate for Payer: Cigna Commercial	$39.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.63
Rate for Payer: Oxford Commercial	$15.87
Rate for Payer: Qualcare PPO/HMO/WC	$11.90
Rate for Payer: UnitedHealthcare Commercial	$15.87
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

SKIN PREP PREOP NASAL ANTISEPT

Facility

$79.35

Hospital Charge Code	270677880
Hospital Revenue Code	272
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$11.90
Rate for Payer: Qualcare PPO/HMO/WC	$11.90

SKIN SPLT GRFT TRNK/ARM/LEG

Facility

$26,848.40

Service Code	HCPCS 15100
Hospital Charge Code	1600000355
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	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
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 SPLT GRFT TRNK/ARM/LEG

Facility

$26,848.40

Service Code	HCPCS 15100
Hospital Charge Code	1600000355
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 SUB GRAFT FACE/NK/HF/G

Facility

$8,909.40

Service Code	HCPCS 15275
Hospital Charge Code	1600000379
Hospital Revenue Code	360
Min. Negotiated Rate	$1,336.41
Max. Negotiated Rate	$1,336.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.41

SKIN SUB GRAFT FACE/NK/HF/G

Facility

$8,909.40

Service Code	HCPCS 15275
Hospital Charge Code	1600000379
Hospital Revenue Code	360
Min. Negotiated Rate	$281.54
Max. Negotiated Rate	$5,347.00
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	$3,536.00
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	$2,316.44
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.41
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$281.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04

SKIN SUB GRAFT TRNK/ARM/LEG, 1

Facility

$7,013.50

Service Code	HCPCS 15271
Hospital Charge Code	160000241
Hospital Revenue Code	360
Min. Negotiated Rate	$199.18
Max. Negotiated Rate	$5,347.00
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	$3,536.00
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	$1,823.51
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.03
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$221.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$199.18

SKIN SUB GRAFT TRNK/ARM/LEG, 1

Facility

$7,013.50

Service Code	HCPCS 15271
Hospital Charge Code	160000241
Hospital Revenue Code	360
Min. Negotiated Rate	$1,052.03
Max. Negotiated Rate	$1,052.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.03

SKIN SUB GRFT T/ARM/LG CHILD

Facility

$12,712.96

Service Code	HCPCS 15273
Hospital Charge Code	16000784
Hospital Revenue Code	360
Min. Negotiated Rate	$361.05
Max. Negotiated Rate	$10,269.00
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	$3,305.37
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,906.94
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$401.73
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	$361.05

SKIN SUB GRFT T/ARM/LG CHILD

Facility

$12,712.96

Service Code	HCPCS 15273
Hospital Charge Code	16000784
Hospital Revenue Code	360
Min. Negotiated Rate	$1,906.94
Max. Negotiated Rate	$1,906.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,906.94

SKIN TAG REMOVAL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	412311200
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SKIN TAG REMOVAL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	412311200
Hospital Revenue Code	761
Min. Negotiated Rate	$10.56
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	$32.67
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	$96.72
Rate for Payer: Oxford Commercial	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$74.40
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

SKIN TAG REMVL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	5780005
Hospital Revenue Code	450
Min. Negotiated Rate	$10.56
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	$32.67
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	$96.72
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

SKIN TAG REMVL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	5780005
Hospital Revenue Code	450
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SKIN TE

Facility

$11,000.00

Service Code	HCPCS Q4200
Hospital Charge Code	270688706
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$2,662.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

SKIN TE

Facility

$11,000.00

Service Code	HCPCS Q4200
Hospital Charge Code	270688706
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

SKIN TE PRODUCT 256SQCM

Facility

$92,500.00

Service Code	HCPCS Q4200
Hospital Charge Code	270690189
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$22,385.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,385.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,875.00
Rate for Payer: UnitedHealthcare Community & State	$2,923.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$2,627.00

SKIN TE PRODUCT 256SQCM

Facility

$92,500.00

Service Code	HCPCS Q4200
Hospital Charge Code	270690189
Hospital Revenue Code	278
Min. Negotiated Rate	$13,875.00
Max. Negotiated Rate	$22,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,385.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,875.00

SKIN TISSUE REARRANGEMENT

Facility

$16,286.20

Service Code	HCPCS 14000
Hospital Charge Code	16000190
Hospital Revenue Code	360
Min. Negotiated Rate	$64.50
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	$4,234.41
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$514.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$65.79
Rate for Payer: Wellpoint Medicaid Managed Care	$64.50

SKIN TISSUE REARRANGEMENT

Facility

$16,286.20

Service Code	HCPCS 14000
Hospital Charge Code	16000190
Hospital Revenue Code	360
Min. Negotiated Rate	$2,442.93
Max. Negotiated Rate	$2,442.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93

SKIN ULCERS

Facility

$23,770.53

Service Code	APR-DRG 3804
Min. Negotiated Rate	$23,304.44
Max. Negotiated Rate	$23,770.53
Rate for Payer: UnitedHealthcare Community & State	$23,304.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,770.53
Rate for Payer: Wellpoint Medicaid Managed Care	$23,304.44

SKIN ULCERS

Facility

$13,661.85

Service Code	APR-DRG 3803
Min. Negotiated Rate	$13,393.97
Max. Negotiated Rate	$13,661.85
Rate for Payer: UnitedHealthcare Community & State	$13,393.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,661.85
Rate for Payer: Wellpoint Medicaid Managed Care	$13,393.97

SKIN ULCERS

Facility

$9,347.60

Service Code	APR-DRG 3802
Min. Negotiated Rate	$9,164.31
Max. Negotiated Rate	$9,347.60
Rate for Payer: UnitedHealthcare Community & State	$9,164.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,347.60
Rate for Payer: Wellpoint Medicaid Managed Care	$9,164.31

SKIN ULCERS

Facility

$7,256.45

Service Code	APR-DRG 3801
Min. Negotiated Rate	$7,114.17
Max. Negotiated Rate	$7,256.45
Rate for Payer: UnitedHealthcare Community & State	$7,114.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,256.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7,114.17

Know your out-of-pocket cost for care.

All Charges