Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	450211103
Hospital Revenue Code	761
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.49
Rate for Payer: Oxford Commercial	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$103.45
Rate for Payer: UnitedHealthcare Community & State	$16.35
Rate for Payer: Wellpoint Medicaid Managed Care	$14.69

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	303511103
Hospital Revenue Code	510
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	303511103
Hospital Revenue Code	510
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.49
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Community & State	$16.35
Rate for Payer: Wellpoint Medicaid Managed Care	$14.69

TAP

Facility

$484.00

Hospital Charge Code	270335104
Hospital Revenue Code	272
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$242.00
Rate for Payer: Aetna Commercial	$183.92
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Oxford Commercial	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$96.80
Rate for Payer: UnitedHealthcare Community & State	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$13.75

TAP

Facility

$484.00

Hospital Charge Code	270335104
Hospital Revenue Code	272
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

TAP 2.7mm 2346-028

Facility

$249.00

Service Code	HCPCS C1713
Hospital Charge Code	270610165
Hospital Revenue Code	278
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

TAP 2.7mm 2346-028

Facility

$249.00

Service Code	HCPCS C1713
Hospital Charge Code	270610165
Hospital Revenue Code	278
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$124.50
Rate for Payer: Aetna Commercial	$94.62
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Community & State	$7.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.07

TAP 3.5MM 18MM

Facility

$773.65

Hospital Charge Code	270697902
Hospital Revenue Code	272
Min. Negotiated Rate	$116.05
Max. Negotiated Rate	$116.05
Rate for Payer: Qualcare PPO/HMO/WC	$116.05

TAP 3.5MM 18MM

Facility

$773.65

Hospital Charge Code	270697902
Hospital Revenue Code	272
Min. Negotiated Rate	$21.97
Max. Negotiated Rate	$386.82
Rate for Payer: Aetna Commercial	$293.99
Rate for Payer: Aetna Medicare Advantage	$232.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.28
Rate for Payer: Cigna Commercial	$386.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.15
Rate for Payer: Oxford Commercial	$154.73
Rate for Payer: Qualcare PPO/HMO/WC	$116.05
Rate for Payer: UnitedHealthcare Commercial	$154.73
Rate for Payer: UnitedHealthcare Community & State	$24.45
Rate for Payer: Wellpoint Medicaid Managed Care	$21.97

TAP 3.5mm CORTEX SCREWS

Facility

$491.30

Service Code	HCPCS C1713
Hospital Charge Code	270604141
Hospital Revenue Code	278
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.89
Rate for Payer: Qualcare PPO/HMO/WC	$73.69

TAP 3.5mm CORTEX SCREWS

Facility

$491.30

Service Code	HCPCS C1713
Hospital Charge Code	270604141
Hospital Revenue Code	278
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$245.65
Rate for Payer: Aetna Commercial	$186.69
Rate for Payer: Aetna Medicare Advantage	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.28
Rate for Payer: Cigna Commercial	$245.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.89
Rate for Payer: Qualcare PPO/HMO/WC	$73.69
Rate for Payer: UnitedHealthcare Community & State	$15.53
Rate for Payer: Wellpoint Medicaid Managed Care	$13.95

TAP 3MM 20-35MM

Facility

$1,895.00

Hospital Charge Code	270693360
Hospital Revenue Code	272
Min. Negotiated Rate	$284.25
Max. Negotiated Rate	$284.25
Rate for Payer: Qualcare PPO/HMO/WC	$284.25

TAP 3MM 20-35MM

Facility

$1,895.00

Hospital Charge Code	270693360
Hospital Revenue Code	272
Min. Negotiated Rate	$53.82
Max. Negotiated Rate	$947.50
Rate for Payer: Aetna Commercial	$720.10
Rate for Payer: Aetna Medicare Advantage	$568.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.23
Rate for Payer: Cigna Commercial	$947.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.70
Rate for Payer: Oxford Commercial	$379.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.25
Rate for Payer: UnitedHealthcare Commercial	$379.00
Rate for Payer: UnitedHealthcare Community & State	$59.88
Rate for Payer: Wellpoint Medicaid Managed Care	$53.82

TAP 4.0mm CANCELLOUS SCREW

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270604464
Hospital Revenue Code	278
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

TAP 4.0mm CANCELLOUS SCREW

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270604464
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

TAP 4 5MM CANNULATED

Facility

$1,000.00

Hospital Charge Code	270680219
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

TAP 4 5MM CANNULATED

Facility

$1,000.00

Hospital Charge Code	270680219
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

TAP 5.5MM CAN

Facility

$1,086.25

Hospital Charge Code	270701727
Hospital Revenue Code	278
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$34.33
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

TAP 5.5MM CAN

Facility

$1,086.25

Hospital Charge Code	270701727
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

TAP 6.5 MM

Facility

$1,890.00

Service Code	HCPCS C1713
Hospital Charge Code	270692306
Hospital Revenue Code	278
Min. Negotiated Rate	$283.50
Max. Negotiated Rate	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: Qualcare PPO/HMO/WC	$283.50

TAP 6.5 MM

Facility

$1,890.00

Service Code	HCPCS C1713
Hospital Charge Code	270692306
Hospital Revenue Code	278
Min. Negotiated Rate	$53.68
Max. Negotiated Rate	$945.00
Rate for Payer: Aetna Commercial	$718.20
Rate for Payer: Aetna Medicare Advantage	$567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$481.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$481.95
Rate for Payer: Cigna Commercial	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.38
Rate for Payer: Qualcare PPO/HMO/WC	$283.50
Rate for Payer: UnitedHealthcare Community & State	$59.72
Rate for Payer: Wellpoint Medicaid Managed Care	$53.68

TAP 6.5MM BONE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270702587
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

TAP 6.5MM BONE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270702587
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

TAP BLOCK

Facility

$2,196.25

Service Code	HCPCS 64486
Hospital Charge Code	1650116A
Hospital Revenue Code	361
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$329.44
Rate for Payer: Qualcare PPO/HMO/WC	$329.44

TAP BLOCK

Facility

$2,196.25

Service Code	HCPCS 64486
Hospital Charge Code	1650116A
Hospital Revenue Code	361
Min. Negotiated Rate	$62.37
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$834.58
Rate for Payer: Aetna Medicare Advantage	$658.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$560.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$560.04
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	$560.04
Rate for Payer: Cigna Commercial	$1,098.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.02
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$329.44
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$69.40
Rate for Payer: Wellpoint Medicaid Managed Care	$62.37

Know your out-of-pocket cost for care.

All Charges