Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TA ARTHRODESIS P/PL- 1L,BLW C2

Facility

$40,491.68

Service Code	HCPCS 22600
Hospital Charge Code	16000673
Hospital Revenue Code	360
Min. Negotiated Rate	$6,073.75
Max. Negotiated Rate	$6,073.75
Rate for Payer: Qualcare PPO/HMO/WC	$6,073.75

TA ARTHRODESIS P/PL- 1L,BLW C2

Facility

$40,491.68

Service Code	HCPCS 22600
Hospital Charge Code	16000673
Hospital Revenue Code	360
Min. Negotiated Rate	$1,149.96
Max. Negotiated Rate	$75,563.15
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,563.15
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,527.84
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,073.75
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,279.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,149.96

TA ARTIFIC DISC ADDL

Facility

$47,548.90

Service Code	HCPCS 22857
Hospital Charge Code	1600000870
Hospital Revenue Code	360
Min. Negotiated Rate	$1,350.39
Max. Negotiated Rate	$75,563.15
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,563.15
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,362.71
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,502.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,350.39

TA ARTIFIC DISC ADDL

Facility

$47,548.90

Service Code	HCPCS 22857
Hospital Charge Code	1600000870
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

TAB EXTENSION

Facility

$1,187.50

Service Code	HCPCS C1713
Hospital Charge Code	270705517
Hospital Revenue Code	278
Min. Negotiated Rate	$33.73
Max. Negotiated Rate	$593.75
Rate for Payer: Aetna Commercial	$451.25
Rate for Payer: Aetna Medicare Advantage	$356.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.81
Rate for Payer: Cigna Commercial	$593.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.38
Rate for Payer: Qualcare PPO/HMO/WC	$178.12
Rate for Payer: UnitedHealthcare Community & State	$37.52
Rate for Payer: Wellpoint Medicaid Managed Care	$33.73

TAB EXTENSION

Facility

$1,187.50

Service Code	HCPCS C1713
Hospital Charge Code	270705517
Hospital Revenue Code	278
Min. Negotiated Rate	$178.12
Max. Negotiated Rate	$287.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.38
Rate for Payer: Qualcare PPO/HMO/WC	$178.12

TACK PLATE

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270676418
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Community & State	$24.33
Rate for Payer: Wellpoint Medicaid Managed Care	$21.87

TACK PLATE

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270676418
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$186.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

TACROLIMUS

Facility

$303.00

Service Code	HCPCS 80197
Hospital Charge Code	38472920
Hospital Revenue Code	301
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$37.35
Rate for Payer: Aetna Medicare Advantage	$44.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.81
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: Cigna Medicare Advantage	$13.73
Rate for Payer: Clover Medicare Advantage	$13.04
Rate for Payer: EmblemHealth Commercial	$41.19
Rate for Payer: Humana Medicare Advantage	$14.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.73
Rate for Payer: Wellcare Medicare Advantage	$13.73
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

TACROLIMUS

Facility

$303.00

Service Code	HCPCS 80197
Hospital Charge Code	38472920
Hospital Revenue Code	301
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

TACROLIMUS 1 MG CAP UD

Facility

$35.04

Service Code	HCPCS J7507
Hospital Charge Code	60629951
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$17.52
Rate for Payer: Aetna Commercial	$13.32
Rate for Payer: Aetna Medicare Advantage	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.94
Rate for Payer: Cigna Commercial	$17.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.26
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

TACROLIMUS 1 MG CAP UD

Facility

$35.04

Service Code	HCPCS J7507
Hospital Charge Code	60629951
Hospital Revenue Code	636
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$8.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.26

TACROLIMUS LC/MS/MS

Facility

$390.00

Service Code	HCPCS 80197
Hospital Charge Code	39900011
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$37.35
Rate for Payer: Aetna Medicare Advantage	$44.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.81
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$13.73
Rate for Payer: Clover Medicare Advantage	$13.04
Rate for Payer: EmblemHealth Commercial	$41.19
Rate for Payer: Humana Medicare Advantage	$14.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.73
Rate for Payer: Wellcare Medicare Advantage	$13.73
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

TACROLIMUS LC/MS/MS

Facility

$390.00

Service Code	HCPCS 80197
Hospital Charge Code	39900011
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TACROLIUMUS 5MG ORAL

Facility

$149.41

Service Code	HCPCS J7507
Hospital Charge Code	6063943354
Hospital Revenue Code	636
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$74.70
Rate for Payer: Aetna Commercial	$56.78
Rate for Payer: Aetna Medicare Advantage	$44.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.10
Rate for Payer: Cigna Commercial	$74.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.41
Rate for Payer: UnitedHealthcare Community & State	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

TACROLIUMUS 5MG ORAL

Facility

$149.41

Service Code	HCPCS J7507
Hospital Charge Code	6063943354
Hospital Revenue Code	636
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$36.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.41

TACTRA 11MM X 16CM-25CM

Facility

$60,925.00

Service Code	HCPCS C1813
Hospital Charge Code	270689374
Hospital Revenue Code	278
Min. Negotiated Rate	$9,138.75
Max. Negotiated Rate	$14,743.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,743.85
Rate for Payer: Qualcare PPO/HMO/WC	$9,138.75

TACTRA 11MM X 16CM-25CM

Facility

$60,925.00

Service Code	HCPCS C1813
Hospital Charge Code	270689374
Hospital Revenue Code	278
Min. Negotiated Rate	$1,730.27
Max. Negotiated Rate	$30,462.50
Rate for Payer: Aetna Commercial	$23,151.50
Rate for Payer: Aetna Medicare Advantage	$18,277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,535.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,535.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,535.88
Rate for Payer: Cigna Commercial	$30,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,743.85
Rate for Payer: Qualcare PPO/HMO/WC	$9,138.75
Rate for Payer: UnitedHealthcare Community & State	$1,925.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1,730.27

TA EXPL PO HEMOR/THRMB/INF,NCK

Facility

$8,183.30

Service Code	HCPCS 35800
Hospital Charge Code	16000939
Hospital Revenue Code	360
Min. Negotiated Rate	$1,227.49
Max. Negotiated Rate	$1,227.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.49

TA EXPL PO HEMOR/THRMB/INF,NCK

Facility

$8,183.30

Service Code	HCPCS 35800
Hospital Charge Code	16000939
Hospital Revenue Code	360
Min. Negotiated Rate	$232.41
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,127.66
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.49
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$258.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$232.41

TA EXPLR RTRPRTNL AREA W/WO BX

Facility

$10,376.20

Service Code	HCPCS 49010
Hospital Charge Code	1600000578
Hospital Revenue Code	360
Min. Negotiated Rate	$294.68
Max. Negotiated Rate	$27,899.36
Rate for Payer: Aetna Commercial	$20,919.71
Rate for Payer: Aetna Medicare Advantage	$24,919.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,899.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,899.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,691.07
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	$27,899.36
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: Cigna Medicare Advantage	$7,691.07
Rate for Payer: Clover Medicare Advantage	$7,306.52
Rate for Payer: EmblemHealth Commercial	$23,073.21
Rate for Payer: Humana Medicare Advantage	$7,921.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,691.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,697.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,556.43
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$327.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,691.07
Rate for Payer: Wellcare Medicare Advantage	$7,691.07
Rate for Payer: Wellpoint Medicaid Managed Care	$294.68

TA EXPLR RTRPRTNL AREA W/WO BX

Facility

$10,376.20

Service Code	HCPCS 49010
Hospital Charge Code	1600000578
Hospital Revenue Code	360
Min. Negotiated Rate	$1,556.43
Max. Negotiated Rate	$1,556.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,556.43

TAKE DOWN SPLN FLXRE WP CLTMY

Facility

$2,513.20

Service Code	HCPCS 44139
Hospital Charge Code	1600000569
Hospital Revenue Code	360
Min. Negotiated Rate	$376.98
Max. Negotiated Rate	$376.98
Rate for Payer: Qualcare PPO/HMO/WC	$376.98

TAKE DOWN SPLN FLXRE WP CLTMY

Facility

$2,513.20

Service Code	HCPCS 44139
Hospital Charge Code	1600000569
Hospital Revenue Code	360
Min. Negotiated Rate	$71.37
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$955.02
Rate for Payer: Aetna Medicare Advantage	$753.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$640.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$640.87
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	$640.87
Rate for Payer: Cigna Commercial	$1,256.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.43
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$376.98
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$79.42
Rate for Payer: Wellpoint Medicaid Managed Care	$71.37

TALAR DOME FLAT CUT SZ 3

Facility

$69,143.90

Service Code	HCPCS C1713
Hospital Charge Code	270704972
Hospital Revenue Code	278
Min. Negotiated Rate	$1,963.69
Max. Negotiated Rate	$34,571.95
Rate for Payer: Aetna Commercial	$26,274.68
Rate for Payer: Aetna Medicare Advantage	$20,743.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,631.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,631.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,828.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,631.69
Rate for Payer: Cigna Commercial	$34,571.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,732.82
Rate for Payer: Qualcare PPO/HMO/WC	$10,371.58
Rate for Payer: UnitedHealthcare Community & State	$2,184.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1,963.69

Know your out-of-pocket cost for care.

All Charges