Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TENOMYOTOMY SHOULDER,SINGLE R

Facility

$30,595.00

Service Code	HCPCS 23405
Hospital Charge Code	16000502
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

TENOMYOTOMY SHOULDER,SINGLE R

Facility

$30,595.00

Service Code	HCPCS 23405
Hospital Charge Code	16000502
Hospital Revenue Code	360
Min. Negotiated Rate	$868.90
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	$7,954.70
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$966.80
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	$868.90

TENOTMY OP FLEXOR,TOE SINGLE

Facility

$21,066.25

Service Code	HCPCS 28232
Hospital Charge Code	16000416
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.94
Max. Negotiated Rate	$3,159.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94

TENOTMY OP FLEXOR,TOE SINGLE

Facility

$21,066.25

Service Code	HCPCS 28232
Hospital Charge Code	16000416
Hospital Revenue Code	360
Min. Negotiated Rate	$598.28
Max. Negotiated Rate	$8,192.00
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	$5,477.23
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$665.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$598.28

TENOTOMY HIP FLEXOR(S) OPEN

Facility

$29,369.08

Service Code	HCPCS 27005
Hospital Charge Code	1600000576
Hospital Revenue Code	360
Min. Negotiated Rate	$834.08
Max. Negotiated Rate	$14,869.00
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	$7,635.96
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,405.36
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$928.06
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	$834.08

TENOTOMY HIP FLEXOR(S) OPEN

Facility

$29,369.08

Service Code	HCPCS 27005
Hospital Charge Code	1600000576
Hospital Revenue Code	360
Min. Negotiated Rate	$4,405.36
Max. Negotiated Rate	$4,405.36
Rate for Payer: Qualcare PPO/HMO/WC	$4,405.36

TENOTOMY OP FLEXOR,FT SGL/MULT

Facility

$19,998.60

Service Code	HCPCS 28230
Hospital Charge Code	16000634
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

TENOTOMY OP FLEXOR,FT SGL/MULT

Facility

$19,998.60

Service Code	HCPCS 28230
Hospital Charge Code	16000634
Hospital Revenue Code	360
Min. Negotiated Rate	$567.96
Max. Negotiated Rate	$8,192.00
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	$5,199.64
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$631.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$567.96

TENOTOMY SQ TOE,SINGLE T9

Facility

$19,998.60

Service Code	HCPCS 28010
Hospital Charge Code	16000903
Hospital Revenue Code	360
Min. Negotiated Rate	$567.96
Max. Negotiated Rate	$8,192.00
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	$5,199.64
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$631.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$567.96

TENOTOMY SQ TOE,SINGLE T9

Facility

$19,998.60

Service Code	HCPCS 28010
Hospital Charge Code	16000903
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

TENSIX DBM 10CC

Facility

$18,325.00

Service Code	HCPCS Q4146
Hospital Charge Code	270694926
Hospital Revenue Code	278
Min. Negotiated Rate	$2,748.75
Max. Negotiated Rate	$4,434.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,434.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,748.75

TENSIX DBM 10CC

Facility

$18,325.00

Service Code	HCPCS Q4146
Hospital Charge Code	270694926
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$4,434.65
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,434.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,748.75
Rate for Payer: UnitedHealthcare Community & State	$579.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$520.43

TENSIX DBM COMP 10CC

Facility

$18,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270694902
Hospital Revenue Code	278
Min. Negotiated Rate	$2,748.75
Max. Negotiated Rate	$4,434.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,434.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,748.75

TENSIX DBM COMP 10CC

Facility

$18,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270694902
Hospital Revenue Code	278
Min. Negotiated Rate	$520.43
Max. Negotiated Rate	$9,162.50
Rate for Payer: Aetna Commercial	$6,963.50
Rate for Payer: Aetna Medicare Advantage	$5,497.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,672.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,672.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,672.88
Rate for Payer: Cigna Commercial	$9,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,434.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,748.75
Rate for Payer: UnitedHealthcare Community & State	$579.07
Rate for Payer: Wellpoint Medicaid Managed Care	$520.43

TERAZOSIN 1 MG CAP

Facility

$10.79

Service Code	NDC 51079093601
Hospital Charge Code	6027106
Hospital Revenue Code	251
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$5.39
Rate for Payer: Aetna Commercial	$4.10
Rate for Payer: Aetna Medicare Advantage	$3.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.81
Rate for Payer: Oxford Commercial	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.62
Rate for Payer: UnitedHealthcare Commercial	$2.16
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

TERAZOSIN 1 MG CAP

Facility

$10.79

Service Code	NDC 51079093601
Hospital Charge Code	6027106
Hospital Revenue Code	251
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.62

TERAZOSIN 5 MG CAP

Facility

$10.79

Service Code	NDC 51079093820
Hospital Charge Code	6027098
Hospital Revenue Code	251
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$5.39
Rate for Payer: Aetna Commercial	$4.10
Rate for Payer: Aetna Medicare Advantage	$3.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.81
Rate for Payer: Oxford Commercial	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.62
Rate for Payer: UnitedHealthcare Commercial	$2.16
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

TERAZOSIN 5 MG CAP

Facility

$10.79

Service Code	NDC 51079093820
Hospital Charge Code	6027098
Hospital Revenue Code	251
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.62

TERBUTALINE 1 MG/ML INJ

Facility

$150.68

Service Code	HCPCS J3105
Hospital Charge Code	60627471
Hospital Revenue Code	636
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$75.34
Rate for Payer: Aetna Commercial	$57.26
Rate for Payer: Aetna Medicare Advantage	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.42
Rate for Payer: Cigna Commercial	$75.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60
Rate for Payer: UnitedHealthcare Community & State	$4.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

TERBUTALINE 1 MG/ML INJ

Facility

$150.68

Service Code	HCPCS J3105
Hospital Charge Code	60627471
Hospital Revenue Code	636
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$36.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60

TERBUTALINE 2.5 MG TAB

Facility

$36.45

Service Code	NDC 115261101
Hospital Charge Code	60627472
Hospital Revenue Code	250
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$5.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.47

TERBUTALINE 2.5 MG TAB

Facility

$36.45

Service Code	NDC 115261101
Hospital Charge Code	60627472
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$18.23
Rate for Payer: Aetna Commercial	$13.85
Rate for Payer: Aetna Medicare Advantage	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.29
Rate for Payer: Cigna Commercial	$18.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.48
Rate for Payer: Oxford Commercial	$7.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.47
Rate for Payer: UnitedHealthcare Commercial	$7.29
Rate for Payer: UnitedHealthcare Community & State	$1.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

TERCONAZOLE 0.4% VAG CREAM 45G

Facility

$274.23

Service Code	NDC 591319689
Hospital Charge Code	6063943314
Hospital Revenue Code	250
Min. Negotiated Rate	$41.13
Max. Negotiated Rate	$41.13
Rate for Payer: Qualcare PPO/HMO/WC	$41.13

TERCONAZOLE 0.4% VAG CREAM 45G

Facility

$274.23

Service Code	NDC 591319689
Hospital Charge Code	6063943314
Hospital Revenue Code	250
Min. Negotiated Rate	$7.79
Max. Negotiated Rate	$137.12
Rate for Payer: Aetna Commercial	$104.21
Rate for Payer: Aetna Medicare Advantage	$82.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.93
Rate for Payer: Cigna Commercial	$137.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.30
Rate for Payer: Oxford Commercial	$54.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.13
Rate for Payer: UnitedHealthcare Commercial	$54.85
Rate for Payer: UnitedHealthcare Community & State	$8.67
Rate for Payer: Wellpoint Medicaid Managed Care	$7.79

TERCONAZOLE 0.8% VAG CRM 20GM

Facility

$436.17

Service Code	NDC 50458053601
Hospital Charge Code	606361042
Hospital Revenue Code	250
Min. Negotiated Rate	$65.43
Max. Negotiated Rate	$65.43
Rate for Payer: Qualcare PPO/HMO/WC	$65.43

Know your out-of-pocket cost for care.

All Charges