Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$46,417.59

Service Code	APR-DRG 3174
Min. Negotiated Rate	$45,507.44
Max. Negotiated Rate	$46,417.59
Rate for Payer: UnitedHealthcare Community & State	$45,507.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$46,417.59
Rate for Payer: Wellpoint Medicaid Managed Care	$45,507.44

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$17,046.35

Service Code	APR-DRG 3172
Min. Negotiated Rate	$16,712.11
Max. Negotiated Rate	$17,046.35
Rate for Payer: UnitedHealthcare Community & State	$16,712.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,046.35
Rate for Payer: Wellpoint Medicaid Managed Care	$16,712.11

TENDON PULLEY RECONSTRUCTION

Facility

$28,255.00

Service Code	HCPCS 26500
Hospital Charge Code	16000848
Hospital Revenue Code	360
Min. Negotiated Rate	$4,238.25
Max. Negotiated Rate	$4,238.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25

TENDON PULLEY RECONSTRUCTION

Facility

$28,255.00

Service Code	HCPCS 26500
Hospital Charge Code	16000848
Hospital Revenue Code	360
Min. Negotiated Rate	$802.44
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,346.30
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,238.25
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$892.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$802.44

TENDON SHEATH 1 DIG AND/PALM

Facility

$14,854.00

Service Code	HCPCS 26020
Hospital Charge Code	16000839
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

TENDON SHEATH 1 DIG AND/PALM

Facility

$14,854.00

Service Code	HCPCS 26020
Hospital Charge Code	16000839
Hospital Revenue Code	360
Min. Negotiated Rate	$421.85
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,862.04
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$469.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$421.85

TENDON SHEATH INCISION

Facility

$6,974.20

Service Code	HCPCS 26055
Hospital Charge Code	412325055
Hospital Revenue Code	361
Min. Negotiated Rate	$220.38
Max. Negotiated Rate	$6,929.76
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,813.29
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.13
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$220.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4,318.43

TENDON SHEATH INCISION

Facility

$6,974.20

Service Code	HCPCS 26055
Hospital Charge Code	412325055
Hospital Revenue Code	361
Min. Negotiated Rate	$1,046.13
Max. Negotiated Rate	$1,046.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.13

TENDON SHEATH INCISION

Facility

$14,854.00

Service Code	HCPCS 26055
Hospital Charge Code	16000224
Hospital Revenue Code	360
Min. Negotiated Rate	$469.39
Max. Negotiated Rate	$6,929.76
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,862.04
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$469.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4,318.43

TENDON SHEATH INCISION

Facility

$14,854.00

Service Code	HCPCS 26055
Hospital Charge Code	16000224
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

TENDON SPACER HUNTER 4MMX24CM

Facility

$12,100.00

Service Code	HCPCS C1763
Hospital Charge Code	270696019
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

TENDON SPACER HUNTER 4MMX24CM

Facility

$12,100.00

Service Code	HCPCS C1763
Hospital Charge Code	270696019
Hospital Revenue Code	278
Min. Negotiated Rate	$343.64
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$382.36
Rate for Payer: Wellpoint Medicaid Managed Care	$343.64

TENDON TIBIAL POST 10.5x260MM

Facility

$8,415.00

Service Code	HCPCS C1762
Hospital Charge Code	270676202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,262.25
Max. Negotiated Rate	$2,036.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,683.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,036.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,262.25

TENDON TIBIAL POST 10.5x260MM

Facility

$8,415.00

Service Code	HCPCS C1762
Hospital Charge Code	270676202
Hospital Revenue Code	278
Min. Negotiated Rate	$238.99
Max. Negotiated Rate	$4,207.50
Rate for Payer: Aetna Commercial	$3,197.70
Rate for Payer: Aetna Medicare Advantage	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,145.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,145.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,145.82
Rate for Payer: Cigna Commercial	$4,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,036.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,262.25
Rate for Payer: UnitedHealthcare Community & State	$265.91
Rate for Payer: Wellpoint Medicaid Managed Care	$238.99

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233S
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233N
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443N
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443S
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRILLEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

TENDRILLEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000S
Hospital Revenue Code	278
Min. Negotiated Rate	$677.25
Max. Negotiated Rate	$1,092.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: Qualcare PPO/HMO/WC	$677.25

Know your out-of-pocket cost for care.

All Charges