Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPLENIC PROCEDURES

Facility

$25,006.38

Service Code	APR-DRG 6502
Min. Negotiated Rate	$24,516.06
Max. Negotiated Rate	$25,006.38
Rate for Payer: UnitedHealthcare Community & State	$24,516.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,006.38
Rate for Payer: Wellpoint Medicaid Managed Care	$24,516.06

SPLENIC PROCEDURES

Facility

$19,093.96

Service Code	APR-DRG 6501
Min. Negotiated Rate	$18,719.57
Max. Negotiated Rate	$19,093.96
Rate for Payer: UnitedHealthcare Community & State	$18,719.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,093.96
Rate for Payer: Wellpoint Medicaid Managed Care	$18,719.57

SPLENIC PROCEDURES

Facility

$56,536.17

Service Code	APR-DRG 6504
Min. Negotiated Rate	$55,427.62
Max. Negotiated Rate	$56,536.17
Rate for Payer: UnitedHealthcare Community & State	$55,427.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$56,536.17
Rate for Payer: Wellpoint Medicaid Managed Care	$55,427.62

SPLENIC PROCEDURES WITH CC

Facility

$108,223.60

Service Code	MSDRG 800
Min. Negotiated Rate	$32,952.70
Max. Negotiated Rate	$108,223.60
Rate for Payer: Aetna Commercial	$78,936.58
Rate for Payer: Aetna Medicare Advantage	$108,223.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,687.05
Rate for Payer: Cigna Commercial	$62,629.95
Rate for Payer: Cigna Medicare Advantage	$34,687.05
Rate for Payer: Clover Medicare Advantage	$32,952.70
Rate for Payer: EmblemHealth Commercial	$104,061.15
Rate for Payer: Humana Medicare Advantage	$35,727.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34,687.05
Rate for Payer: Oxford Commercial	$49,501.63
Rate for Payer: UnitedHealthcare Commercial	$66,259.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,687.05
Rate for Payer: Wellcare Medicare Advantage	$34,687.05

SPLENIC PROCEDURES WITH MCC

Facility

$162,548.72

Service Code	MSDRG 799
Min. Negotiated Rate	$49,494.00
Max. Negotiated Rate	$162,548.72
Rate for Payer: Aetna Commercial	$117,627.58
Rate for Payer: Aetna Medicare Advantage	$162,548.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$52,098.95
Rate for Payer: Cigna Commercial	$100,962.77
Rate for Payer: Cigna Medicare Advantage	$52,098.95
Rate for Payer: Clover Medicare Advantage	$49,494.00
Rate for Payer: EmblemHealth Commercial	$156,296.85
Rate for Payer: Humana Medicare Advantage	$53,661.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$52,098.95
Rate for Payer: Oxford Commercial	$79,799.22
Rate for Payer: UnitedHealthcare Commercial	$106,814.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$52,098.95
Rate for Payer: Wellcare Medicare Advantage	$52,098.95

SPLENIC PROCEDURES WITHOUT CC/MCC

Facility

$79,773.60

Service Code	MSDRG 801
Min. Negotiated Rate	$24,290.04
Max. Negotiated Rate	$79,773.60
Rate for Payer: Aetna Commercial	$58,674.19
Rate for Payer: Aetna Medicare Advantage	$79,773.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,568.46
Rate for Payer: Cigna Commercial	$42,555.11
Rate for Payer: Cigna Medicare Advantage	$25,568.46
Rate for Payer: Clover Medicare Advantage	$24,290.04
Rate for Payer: EmblemHealth Commercial	$76,705.38
Rate for Payer: Humana Medicare Advantage	$26,335.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,568.46
Rate for Payer: Oxford Commercial	$33,634.82
Rate for Payer: UnitedHealthcare Commercial	$45,021.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,568.46
Rate for Payer: Wellcare Medicare Advantage	$25,568.46

SPLINT ALUMINUM FINGER

Facility

$9.65

Hospital Charge Code	270302020
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

SPLINT ALUMINUM FINGER

Facility

$9.65

Hospital Charge Code	270302020
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.51
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SPLINT BUCKS BOOT SM

Facility

$91.25

Hospital Charge Code	270600074
Hospital Revenue Code	270
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.73
Rate for Payer: Oxford Commercial	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$18.25
Rate for Payer: UnitedHealthcare Community & State	$2.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.59

SPLINT BUCKS BOOT SM

Facility

$91.25

Hospital Charge Code	270600074
Hospital Revenue Code	270
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

SPLINT COCK UP

Facility

$299.90

Hospital Charge Code	270644330
Hospital Revenue Code	272
Min. Negotiated Rate	$44.98
Max. Negotiated Rate	$44.98
Rate for Payer: Qualcare PPO/HMO/WC	$44.98

SPLINT COCK UP

Facility

$299.90

Hospital Charge Code	270644330
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$149.95
Rate for Payer: Aetna Commercial	$113.96
Rate for Payer: Aetna Medicare Advantage	$89.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.47
Rate for Payer: Cigna Commercial	$149.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.97
Rate for Payer: Oxford Commercial	$59.98
Rate for Payer: Qualcare PPO/HMO/WC	$44.98
Rate for Payer: UnitedHealthcare Commercial	$59.98
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SPLINT COCK-UP WRIST MED RT

Facility

$32.60

Hospital Charge Code	270649000
Hospital Revenue Code	272
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$4.89
Rate for Payer: Qualcare PPO/HMO/WC	$4.89

SPLINT COCK-UP WRIST MED RT

Facility

$32.60

Hospital Charge Code	270649000
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.30
Rate for Payer: Aetna Commercial	$12.39
Rate for Payer: Aetna Medicare Advantage	$9.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.31
Rate for Payer: Cigna Commercial	$16.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Oxford Commercial	$6.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.89
Rate for Payer: UnitedHealthcare Commercial	$6.52
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759
Hospital Revenue Code	270
Min. Negotiated Rate	$8.02
Max. Negotiated Rate	$141.20
Rate for Payer: Aetna Commercial	$107.31
Rate for Payer: Aetna Medicare Advantage	$84.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.01
Rate for Payer: Cigna Commercial	$141.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.42
Rate for Payer: Oxford Commercial	$56.48
Rate for Payer: Qualcare PPO/HMO/WC	$42.36
Rate for Payer: UnitedHealthcare Commercial	$56.48
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.02

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759W
Hospital Revenue Code	270
Min. Negotiated Rate	$42.36
Max. Negotiated Rate	$42.36
Rate for Payer: Qualcare PPO/HMO/WC	$42.36

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759
Hospital Revenue Code	270
Min. Negotiated Rate	$42.36
Max. Negotiated Rate	$42.36
Rate for Payer: Qualcare PPO/HMO/WC	$42.36

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759W
Hospital Revenue Code	270
Min. Negotiated Rate	$8.02
Max. Negotiated Rate	$141.20
Rate for Payer: Aetna Commercial	$107.31
Rate for Payer: Aetna Medicare Advantage	$84.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.01
Rate for Payer: Cigna Commercial	$141.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.42
Rate for Payer: Oxford Commercial	$56.48
Rate for Payer: Qualcare PPO/HMO/WC	$42.36
Rate for Payer: UnitedHealthcare Commercial	$56.48
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.02

SPLINT GLASS ROLL 4X15

Facility

$334.50

Hospital Charge Code	270600745W
Hospital Revenue Code	270
Min. Negotiated Rate	$50.17
Max. Negotiated Rate	$50.17
Rate for Payer: Qualcare PPO/HMO/WC	$50.17

SPLINT GLASS ROLL 4X15

Facility

$334.50

Hospital Charge Code	270600745
Hospital Revenue Code	270
Min. Negotiated Rate	$9.50
Max. Negotiated Rate	$167.25
Rate for Payer: Aetna Commercial	$127.11
Rate for Payer: Aetna Medicare Advantage	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.30
Rate for Payer: Cigna Commercial	$167.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$50.17
Rate for Payer: UnitedHealthcare Commercial	$66.90
Rate for Payer: UnitedHealthcare Community & State	$10.57
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

SPLINT GLASS ROLL 4X15

Facility

$334.50

Hospital Charge Code	270600745W
Hospital Revenue Code	270
Min. Negotiated Rate	$9.50
Max. Negotiated Rate	$167.25
Rate for Payer: Aetna Commercial	$127.11
Rate for Payer: Aetna Medicare Advantage	$100.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.30
Rate for Payer: Cigna Commercial	$167.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$50.17
Rate for Payer: UnitedHealthcare Commercial	$66.90
Rate for Payer: UnitedHealthcare Community & State	$10.57
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

SPLINT GLASS ROLL 4X15

Facility

$334.50

Hospital Charge Code	270600745
Hospital Revenue Code	270
Min. Negotiated Rate	$50.17
Max. Negotiated Rate	$50.17
Rate for Payer: Qualcare PPO/HMO/WC	$50.17

SPLINT GLASS ROLL 5X15

Facility

$392.50

Hospital Charge Code	270600760W
Hospital Revenue Code	270
Min. Negotiated Rate	$58.88
Max. Negotiated Rate	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$58.88

SPLINT GLASS ROLL 5X15

Facility

$392.50

Hospital Charge Code	270600760
Hospital Revenue Code	270
Min. Negotiated Rate	$11.15
Max. Negotiated Rate	$196.25
Rate for Payer: Aetna Commercial	$149.15
Rate for Payer: Aetna Medicare Advantage	$117.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.09
Rate for Payer: Cigna Commercial	$196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.05
Rate for Payer: Oxford Commercial	$78.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.88
Rate for Payer: UnitedHealthcare Commercial	$78.50
Rate for Payer: UnitedHealthcare Community & State	$12.40
Rate for Payer: Wellpoint Medicaid Managed Care	$11.15

SPLINT GLASS ROLL 5X15

Facility

$392.50

Hospital Charge Code	270600760
Hospital Revenue Code	270
Min. Negotiated Rate	$58.88
Max. Negotiated Rate	$58.88
Rate for Payer: Qualcare PPO/HMO/WC	$58.88

Know your out-of-pocket cost for care.

All Charges