Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRACH CARE TP TRACH 0598220135

Facility

$31.00

Hospital Charge Code	270633413
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$15.50
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.06
Rate for Payer: Oxford Commercial	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$6.20
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

TRACH CLS SYS DIR TIP W/ CLR

Facility

$37.85

Hospital Charge Code	270659655
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$18.93
Rate for Payer: Aetna Commercial	$14.38
Rate for Payer: Aetna Medicare Advantage	$11.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.65
Rate for Payer: Cigna Commercial	$18.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.84
Rate for Payer: Oxford Commercial	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$7.57
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

TRACH CLS SYS DIR TIP W/ CLR

Facility

$37.85

Hospital Charge Code	270659655
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

TRACHEOBRONCHIAL STENT ULTAFLE

Facility

$5,697.00

Hospital Charge Code	270335709
Hospital Revenue Code	278
Min. Negotiated Rate	$854.55
Max. Negotiated Rate	$1,378.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,139.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,378.67
Rate for Payer: Qualcare PPO/HMO/WC	$854.55

TRACHEOBRONCHIAL STENT ULTAFLE

Facility

$5,697.00

Hospital Charge Code	270335709
Hospital Revenue Code	278
Min. Negotiated Rate	$161.79
Max. Negotiated Rate	$2,848.50
Rate for Payer: Aetna Commercial	$2,164.86
Rate for Payer: Aetna Medicare Advantage	$1,709.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,452.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,452.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,139.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,452.73
Rate for Payer: Cigna Commercial	$2,848.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,378.67
Rate for Payer: Qualcare PPO/HMO/WC	$854.55
Rate for Payer: UnitedHealthcare Community & State	$180.03
Rate for Payer: Wellpoint Medicaid Managed Care	$161.79

TRACHEOBRONCH THRU OLD INCISN

Facility

$7,383.40

Service Code	HCPCS 31615
Hospital Charge Code	1600000575
Hospital Revenue Code	360
Min. Negotiated Rate	$209.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,742.81
Rate for Payer: Aetna Medicare Advantage	$2,076.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$640.74
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	$2,324.28
Rate for Payer: Cigna Commercial	$1,284.36
Rate for Payer: Cigna Medicare Advantage	$640.74
Rate for Payer: Clover Medicare Advantage	$608.70
Rate for Payer: EmblemHealth Commercial	$1,922.22
Rate for Payer: Humana Medicare Advantage	$659.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$640.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,919.68
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,107.51
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$233.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$640.74
Rate for Payer: Wellcare Medicare Advantage	$640.74
Rate for Payer: Wellpoint Medicaid Managed Care	$209.69

TRACHEOBRONCH THRU OLD INCISN

Facility

$7,383.40

Service Code	HCPCS 31615
Hospital Charge Code	1600000575
Hospital Revenue Code	360
Min. Negotiated Rate	$1,107.51
Max. Negotiated Rate	$1,107.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,107.51

TRACHEOSTOMMY

Facility

$22,083.40

Service Code	HCPCS 31600
Hospital Charge Code	160000244
Hospital Revenue Code	360
Min. Negotiated Rate	$3,312.51
Max. Negotiated Rate	$3,312.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51

TRACHEOSTOMMY

Facility

$22,083.40

Service Code	HCPCS 31600
Hospital Charge Code	160000244
Hospital Revenue Code	360
Min. Negotiated Rate	$697.84
Max. Negotiated Rate	$14,288.18
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,288.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
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	$14,288.18
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,741.68
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,312.51
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$697.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,864.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7,710.51

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC

Facility

$152,663.13

Service Code	MSDRG 012
Min. Negotiated Rate	$46,483.97
Max. Negotiated Rate	$152,663.13
Rate for Payer: Aetna Medicare Advantage	$152,663.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110,820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110,820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$48,930.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110,820.00
Rate for Payer: Cigna Commercial	$93,987.29
Rate for Payer: Cigna Medicare Advantage	$48,930.49
Rate for Payer: Clover Medicare Advantage	$46,483.97
Rate for Payer: EmblemHealth Commercial	$146,791.47
Rate for Payer: Humana Medicare Advantage	$50,398.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$48,930.49
Rate for Payer: Oxford Commercial	$74,285.92
Rate for Payer: UnitedHealthcare Commercial	$99,434.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$48,930.49
Rate for Payer: Wellcare Medicare Advantage	$48,930.49

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC

Facility

$191,779.10

Service Code	MSDRG 011
Min. Negotiated Rate	$58,394.28
Max. Negotiated Rate	$191,779.10
Rate for Payer: Aetna Medicare Advantage	$191,779.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142,957.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142,957.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61,467.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142,957.80
Rate for Payer: Cigna Commercial	$121,588.25
Rate for Payer: Cigna Medicare Advantage	$61,467.66
Rate for Payer: Clover Medicare Advantage	$58,394.28
Rate for Payer: EmblemHealth Commercial	$184,402.98
Rate for Payer: Humana Medicare Advantage	$63,311.69
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61,467.66
Rate for Payer: Oxford Commercial	$96,101.24
Rate for Payer: UnitedHealthcare Commercial	$128,634.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$61,467.66
Rate for Payer: Wellcare Medicare Advantage	$61,467.66

TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC

Facility

$110,510.93

Service Code	MSDRG 013
Min. Negotiated Rate	$33,649.16
Max. Negotiated Rate	$110,510.93
Rate for Payer: Aetna Medicare Advantage	$110,510.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74,526.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74,526.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35,420.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74,526.45
Rate for Payer: Cigna Commercial	$64,243.97
Rate for Payer: Cigna Medicare Advantage	$35,420.17
Rate for Payer: Clover Medicare Advantage	$33,649.16
Rate for Payer: EmblemHealth Commercial	$106,260.51
Rate for Payer: Humana Medicare Advantage	$36,482.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35,420.17
Rate for Payer: Oxford Commercial	$50,777.32
Rate for Payer: UnitedHealthcare Commercial	$67,967.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$35,420.17
Rate for Payer: Wellcare Medicare Advantage	$35,420.17

TRACHEOSTOMY TUBE #10 FENEST

Facility

$605.00

Hospital Charge Code	270331346
Hospital Revenue Code	272
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$302.50
Rate for Payer: Aetna Commercial	$229.90
Rate for Payer: Aetna Medicare Advantage	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.28
Rate for Payer: Cigna Commercial	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Oxford Commercial	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.75
Rate for Payer: UnitedHealthcare Commercial	$121.00
Rate for Payer: UnitedHealthcare Community & State	$19.12
Rate for Payer: Wellpoint Medicaid Managed Care	$17.18

TRACHEOSTOMY TUBE #10 FENEST

Facility

$605.00

Hospital Charge Code	270331346
Hospital Revenue Code	272
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.75

TRACHEOSTOMY TUBE #3, PEDIATR

Facility

$451.00

Hospital Charge Code	270331142
Hospital Revenue Code	272
Min. Negotiated Rate	$12.81
Max. Negotiated Rate	$225.50
Rate for Payer: Aetna Commercial	$171.38
Rate for Payer: Aetna Medicare Advantage	$135.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.00
Rate for Payer: Cigna Commercial	$225.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.26
Rate for Payer: Oxford Commercial	$90.20
Rate for Payer: Qualcare PPO/HMO/WC	$67.65
Rate for Payer: UnitedHealthcare Commercial	$90.20
Rate for Payer: UnitedHealthcare Community & State	$14.25
Rate for Payer: Wellpoint Medicaid Managed Care	$12.81

TRACHEOSTOMY TUBE #3, PEDIATR

Facility

$451.00

Hospital Charge Code	270331142
Hospital Revenue Code	272
Min. Negotiated Rate	$67.65
Max. Negotiated Rate	$67.65
Rate for Payer: Qualcare PPO/HMO/WC	$67.65

TRACHEOSTOMY TUBE SZ.9

Facility

$330.00

Hospital Charge Code	270332362
Hospital Revenue Code	272
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.50

TRACHEOSTOMY TUBE SZ.9

Facility

$330.00

Hospital Charge Code	270332362
Hospital Revenue Code	272
Min. Negotiated Rate	$9.37
Max. Negotiated Rate	$165.00
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.15
Rate for Payer: Cigna Commercial	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.50
Rate for Payer: UnitedHealthcare Commercial	$66.00
Rate for Payer: UnitedHealthcare Community & State	$10.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9.37

TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES

Facility

$457,079.69

Service Code	MSDRG 004
Min. Negotiated Rate	$139,174.90
Max. Negotiated Rate	$457,079.69
Rate for Payer: Aetna Medicare Advantage	$457,079.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407,263.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407,263.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$146,499.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407,263.50
Rate for Payer: Cigna Commercial	$308,789.26
Rate for Payer: Cigna Medicare Advantage	$146,499.90
Rate for Payer: Clover Medicare Advantage	$139,174.90
Rate for Payer: EmblemHealth Commercial	$439,499.70
Rate for Payer: Humana Medicare Advantage	$150,894.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$146,499.90
Rate for Payer: Oxford Commercial	$244,061.67
Rate for Payer: UnitedHealthcare Commercial	$326,685.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$146,499.90
Rate for Payer: Wellcare Medicare Advantage	$146,499.90

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$66,175.83

Service Code	APR-DRG 0041
Min. Negotiated Rate	$64,878.26
Max. Negotiated Rate	$66,175.83
Rate for Payer: UnitedHealthcare Community & State	$64,878.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$66,175.83
Rate for Payer: Wellpoint Medicaid Managed Care	$64,878.26

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$212,474.47

Service Code	APR-DRG 0044
Min. Negotiated Rate	$208,308.30
Max. Negotiated Rate	$212,474.47
Rate for Payer: UnitedHealthcare Community & State	$208,308.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$212,474.47
Rate for Payer: Wellpoint Medicaid Managed Care	$208,308.30

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$91,429.42

Service Code	APR-DRG 0042
Min. Negotiated Rate	$89,636.69
Max. Negotiated Rate	$91,429.42
Rate for Payer: UnitedHealthcare Community & State	$89,636.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$91,429.42
Rate for Payer: Wellpoint Medicaid Managed Care	$89,636.69

TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE

Facility

$140,432.52

Service Code	APR-DRG 0043
Min. Negotiated Rate	$137,678.94
Max. Negotiated Rate	$140,432.52
Rate for Payer: UnitedHealthcare Community & State	$137,678.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$140,432.52
Rate for Payer: Wellpoint Medicaid Managed Care	$137,678.94

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$68,528.15

Service Code	APR-DRG 0052
Min. Negotiated Rate	$67,184.46
Max. Negotiated Rate	$68,528.15
Rate for Payer: UnitedHealthcare Community & State	$67,184.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$68,528.15
Rate for Payer: Wellpoint Medicaid Managed Care	$67,184.46

TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE

Facility

$103,306.31

Service Code	APR-DRG 0053
Min. Negotiated Rate	$101,280.70
Max. Negotiated Rate	$103,306.31
Rate for Payer: UnitedHealthcare Community & State	$101,280.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$103,306.31
Rate for Payer: Wellpoint Medicaid Managed Care	$101,280.70

Know your out-of-pocket cost for care.

All Charges