Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TEMPLATE OCCIPITAL PLATE SMALL

Facility

$4,350.00

Service Code	HCPCS A4649
Hospital Charge Code	270697875
Hospital Revenue Code	272
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$652.50
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

TEMPORARY FIXATION PIN

Facility

$1,240.00

Hospital Charge Code	270704213
Hospital Revenue Code	279
Min. Negotiated Rate	$35.22
Max. Negotiated Rate	$620.00
Rate for Payer: Aetna Commercial	$471.20
Rate for Payer: Aetna Medicare Advantage	$372.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.20
Rate for Payer: Cigna Commercial	$620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.40
Rate for Payer: Oxford Commercial	$248.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.00
Rate for Payer: UnitedHealthcare Commercial	$248.00
Rate for Payer: UnitedHealthcare Community & State	$39.18
Rate for Payer: Wellpoint Medicaid Managed Care	$35.22

TEMPORARY FIXATION PIN

Facility

$1,240.00

Hospital Charge Code	270704213
Hospital Revenue Code	279
Min. Negotiated Rate	$186.00
Max. Negotiated Rate	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.00

TEMP PACEMAKER INSERTION

Facility

$18,455.00

Service Code	HCPCS 33210
Hospital Charge Code	366833210
Hospital Revenue Code	480
Min. Negotiated Rate	$2,768.25
Max. Negotiated Rate	$2,768.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,768.25

TEMP PACEMAKER INSERTION

Facility

$18,455.00

Service Code	HCPCS 33210
Hospital Charge Code	366833210
Hospital Revenue Code	480
Min. Negotiated Rate	$188.10
Max. Negotiated Rate	$35,663.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,663.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,663.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,663.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,798.30
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,768.25
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$583.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$524.12

TEMPURATURE PROBE 72

Facility

$45.00

Hospital Charge Code	270688450
Hospital Revenue Code	272
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$9.00
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.28

TEMPURATURE PROBE 72

Facility

$45.00

Hospital Charge Code	270688450
Hospital Revenue Code	272
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

TENA HELICAL BLADE 90MM

Facility

$3,389.60

Hospital Charge Code	270681850
Hospital Revenue Code	272
Min. Negotiated Rate	$96.26
Max. Negotiated Rate	$1,694.80
Rate for Payer: Aetna Commercial	$1,288.05
Rate for Payer: Aetna Medicare Advantage	$1,016.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.35
Rate for Payer: Cigna Commercial	$1,694.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.30
Rate for Payer: Oxford Commercial	$677.92
Rate for Payer: Qualcare PPO/HMO/WC	$508.44
Rate for Payer: UnitedHealthcare Commercial	$677.92
Rate for Payer: UnitedHealthcare Community & State	$107.11
Rate for Payer: Wellpoint Medicaid Managed Care	$96.26

TENA HELICAL BLADE 90MM

Facility

$3,389.60

Hospital Charge Code	270681850
Hospital Revenue Code	272
Min. Negotiated Rate	$508.44
Max. Negotiated Rate	$508.44
Rate for Payer: Qualcare PPO/HMO/WC	$508.44

TENDON ACHILLES 10MM DOWEL

Facility

$13,026.25

Service Code	HCPCS C1762
Hospital Charge Code	270668501
Hospital Revenue Code	278
Min. Negotiated Rate	$369.95
Max. Negotiated Rate	$6,513.12
Rate for Payer: Aetna Commercial	$4,949.98
Rate for Payer: Aetna Medicare Advantage	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,321.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,321.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,321.69
Rate for Payer: Cigna Commercial	$6,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.94
Rate for Payer: UnitedHealthcare Community & State	$411.63
Rate for Payer: Wellpoint Medicaid Managed Care	$369.95

TENDON ACHILLES 10MM DOWEL

Facility

$13,026.25

Service Code	HCPCS C1762
Hospital Charge Code	270668501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.94
Max. Negotiated Rate	$3,152.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.94

TENDON ANCHORS 8

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687116
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

TENDON ANCHORS 8

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270690426
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

TENDON ANCHORS 8

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270690426
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

TENDON ANCHORS 8

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687116
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

TENDONASIS SEMI 8x250MM

Facility

$7,565.00

Service Code	HCPCS C1762
Hospital Charge Code	270660383
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.75
Max. Negotiated Rate	$1,830.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,513.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.75

TENDONASIS SEMI 8x250MM

Facility

$7,565.00

Service Code	HCPCS C1762
Hospital Charge Code	270660383
Hospital Revenue Code	278
Min. Negotiated Rate	$214.85
Max. Negotiated Rate	$3,782.50
Rate for Payer: Aetna Commercial	$2,874.70
Rate for Payer: Aetna Medicare Advantage	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,929.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,929.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,929.08
Rate for Payer: Cigna Commercial	$3,782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.75
Rate for Payer: UnitedHealthcare Community & State	$239.05
Rate for Payer: Wellpoint Medicaid Managed Care	$214.85

TENDON BIOCLEANSE TIBIAL POSTE

Facility

$13,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270663884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$3,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

TENDON BIOCLEANSE TIBIAL POSTE

Facility

$13,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270663884
Hospital Revenue Code	278
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$6,500.00
Rate for Payer: Aetna Commercial	$4,940.00
Rate for Payer: Aetna Medicare Advantage	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,315.00
Rate for Payer: Cigna Commercial	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00
Rate for Payer: UnitedHealthcare Community & State	$410.80
Rate for Payer: Wellpoint Medicaid Managed Care	$369.20

TENDON GRACILIS

Facility

$5,512.50

Service Code	HCPCS C1762
Hospital Charge Code	270668349
Hospital Revenue Code	278
Min. Negotiated Rate	$826.88
Max. Negotiated Rate	$1,334.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.03
Rate for Payer: Qualcare PPO/HMO/WC	$826.88

TENDON GRACILIS

Facility

$5,512.50

Service Code	HCPCS C1762
Hospital Charge Code	270668349
Hospital Revenue Code	278
Min. Negotiated Rate	$156.56
Max. Negotiated Rate	$2,756.25
Rate for Payer: Aetna Commercial	$2,094.75
Rate for Payer: Aetna Medicare Advantage	$1,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,405.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,405.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,405.69
Rate for Payer: Cigna Commercial	$2,756.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.03
Rate for Payer: Qualcare PPO/HMO/WC	$826.88
Rate for Payer: UnitedHealthcare Community & State	$174.19
Rate for Payer: Wellpoint Medicaid Managed Care	$156.56

TENDONITIS, MYOSITIS AND BURSITIS WITH MCC

Facility

$66,441.15

Service Code	MSDRG 557
Min. Negotiated Rate	$20,230.48
Max. Negotiated Rate	$66,441.15
Rate for Payer: Aetna Commercial	$49,178.66
Rate for Payer: Aetna Medicare Advantage	$66,441.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,219.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,219.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,295.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,219.80
Rate for Payer: Cigna Commercial	$33,147.46
Rate for Payer: Cigna Medicare Advantage	$21,295.24
Rate for Payer: Clover Medicare Advantage	$20,230.48
Rate for Payer: EmblemHealth Commercial	$63,885.72
Rate for Payer: Humana Medicare Advantage	$21,934.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,295.24
Rate for Payer: Oxford Commercial	$26,199.18
Rate for Payer: UnitedHealthcare Commercial	$35,068.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,295.24
Rate for Payer: Wellcare Medicare Advantage	$21,295.24

TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC

Facility

$47,684.05

Service Code	MSDRG 558
Min. Negotiated Rate	$14,519.18
Max. Negotiated Rate	$47,684.05
Rate for Payer: Aetna Commercial	$35,819.63
Rate for Payer: Aetna Medicare Advantage	$47,684.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,283.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,380.40
Rate for Payer: Cigna Commercial	$19,912.11
Rate for Payer: Cigna Medicare Advantage	$15,283.35
Rate for Payer: Clover Medicare Advantage	$14,519.18
Rate for Payer: EmblemHealth Commercial	$45,850.05
Rate for Payer: Humana Medicare Advantage	$15,741.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,283.35
Rate for Payer: Oxford Commercial	$15,738.18
Rate for Payer: UnitedHealthcare Commercial	$21,066.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,283.35
Rate for Payer: Wellcare Medicare Advantage	$15,283.35

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$25,732.45

Service Code	APR-DRG 3173
Min. Negotiated Rate	$25,227.89
Max. Negotiated Rate	$25,732.45
Rate for Payer: UnitedHealthcare Community & State	$25,227.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,732.45
Rate for Payer: Wellpoint Medicaid Managed Care	$25,227.89

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$13,216.63

Service Code	APR-DRG 3171
Min. Negotiated Rate	$12,957.48
Max. Negotiated Rate	$13,216.63
Rate for Payer: UnitedHealthcare Community & State	$12,957.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,216.63
Rate for Payer: Wellpoint Medicaid Managed Care	$12,957.48

Know your out-of-pocket cost for care.

All Charges