Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRAP MUCOUS SPECIMEN 80cc

Facility

$6.54

Hospital Charge Code	270649870
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna Commercial	$2.49
Rate for Payer: Aetna Medicare Advantage	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.67
Rate for Payer: Cigna Commercial	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.70
Rate for Payer: Oxford Commercial	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$1.31
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

TRAP MUCOUS SPECIMEN 80cc

Facility

$6.54

Hospital Charge Code	270649870
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

TRAP MUCOUS SPECIMEN STERILE

Facility

$8.18

Hospital Charge Code	270649775
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

TRAP MUCOUS SPECIMEN STERILE

Facility

$8.18

Hospital Charge Code	270649775
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.09
Rate for Payer: Aetna Commercial	$3.11
Rate for Payer: Aetna Medicare Advantage	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.09
Rate for Payer: Cigna Commercial	$4.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$1.64
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

TRAP SPECIMEN

Facility

$7.52

Hospital Charge Code	270302215
Hospital Revenue Code	270
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

TRAP SPECIMEN

Facility

$7.52

Hospital Charge Code	270302215
Hospital Revenue Code	270
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.76
Rate for Payer: Aetna Commercial	$2.86
Rate for Payer: Aetna Medicare Advantage	$2.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.92
Rate for Payer: Cigna Commercial	$3.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.96
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$1.50
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

TRAP SPECIMEN STER 40cc

Facility

$5.86

Hospital Charge Code	270651478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.88

TRAP SPECIMEN STER 40cc

Facility

$5.86

Hospital Charge Code	270651478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.93
Rate for Payer: Aetna Commercial	$2.23
Rate for Payer: Aetna Medicare Advantage	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.49
Rate for Payer: Cigna Commercial	$2.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.52
Rate for Payer: Oxford Commercial	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.88
Rate for Payer: UnitedHealthcare Commercial	$1.17
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

TRASTUZUMAB 10 mg

Facility

$742.16

Service Code	HCPCS J9355
Hospital Charge Code	60628881
Hospital Revenue Code	636
Min. Negotiated Rate	$21.08
Max. Negotiated Rate	$266.37
Rate for Payer: Aetna Commercial	$199.73
Rate for Payer: Aetna Medicare Advantage	$237.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.37
Rate for Payer: Cigna Medicare Advantage	$73.43
Rate for Payer: Clover Medicare Advantage	$69.76
Rate for Payer: EmblemHealth Commercial	$220.29
Rate for Payer: Humana Medicare Advantage	$75.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$73.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.60
Rate for Payer: Qualcare PPO/HMO/WC	$111.32
Rate for Payer: UnitedHealthcare Community & State	$23.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$73.43
Rate for Payer: Wellcare Medicare Advantage	$73.43
Rate for Payer: Wellpoint Medicaid Managed Care	$21.08

TRASTUZUMAB 10 mg

Facility

$742.16

Service Code	HCPCS J9355
Hospital Charge Code	60628881
Hospital Revenue Code	636
Min. Negotiated Rate	$111.32
Max. Negotiated Rate	$179.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.60
Rate for Payer: Qualcare PPO/HMO/WC	$111.32

TRASTUZUMAB-DKST 150MG

Facility

$4,018.86

Service Code	HCPCS Q5114
Hospital Charge Code	606390427
Hospital Revenue Code	636
Min. Negotiated Rate	$602.83
Max. Negotiated Rate	$972.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$972.56
Rate for Payer: Qualcare PPO/HMO/WC	$602.83

TRASTUZUMAB-DKST 150MG

Facility

$4,018.86

Service Code	HCPCS Q5114
Hospital Charge Code	606390427
Hospital Revenue Code	636
Min. Negotiated Rate	$33.99
Max. Negotiated Rate	$972.56
Rate for Payer: Aetna Commercial	$97.32
Rate for Payer: Aetna Medicare Advantage	$115.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.79
Rate for Payer: Cigna Medicare Advantage	$35.78
Rate for Payer: Clover Medicare Advantage	$33.99
Rate for Payer: EmblemHealth Commercial	$107.34
Rate for Payer: Humana Medicare Advantage	$36.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$972.56
Rate for Payer: Qualcare PPO/HMO/WC	$602.83
Rate for Payer: UnitedHealthcare Community & State	$127.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.78
Rate for Payer: Wellcare Medicare Advantage	$35.78
Rate for Payer: Wellpoint Medicaid Managed Care	$114.14

TRASTUZUMAB-DKST 420MG

Facility

$11,245.15

Service Code	HCPCS Q5114
Hospital Charge Code	606390426
Hospital Revenue Code	636
Min. Negotiated Rate	$1,686.77
Max. Negotiated Rate	$2,721.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,721.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,686.77

TRASTUZUMAB-DKST 420MG

Facility

$11,245.15

Service Code	HCPCS Q5114
Hospital Charge Code	606390426
Hospital Revenue Code	636
Min. Negotiated Rate	$33.99
Max. Negotiated Rate	$2,721.33
Rate for Payer: Aetna Commercial	$97.32
Rate for Payer: Aetna Medicare Advantage	$115.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.79
Rate for Payer: Cigna Medicare Advantage	$35.78
Rate for Payer: Clover Medicare Advantage	$33.99
Rate for Payer: EmblemHealth Commercial	$107.34
Rate for Payer: Humana Medicare Advantage	$36.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,721.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,686.77
Rate for Payer: UnitedHealthcare Community & State	$355.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.78
Rate for Payer: Wellcare Medicare Advantage	$35.78
Rate for Payer: Wellpoint Medicaid Managed Care	$319.36

TRAUMATIC INJURY WITH MCC

Facility

$71,107.48

Service Code	MSDRG 913
Min. Negotiated Rate	$21,651.32
Max. Negotiated Rate	$71,107.48
Rate for Payer: Aetna Commercial	$52,502.08
Rate for Payer: Aetna Medicare Advantage	$71,107.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,280.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,280.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,790.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,280.45
Rate for Payer: Cigna Commercial	$36,440.14
Rate for Payer: Cigna Medicare Advantage	$22,790.86
Rate for Payer: Clover Medicare Advantage	$21,651.32
Rate for Payer: EmblemHealth Commercial	$68,372.58
Rate for Payer: Humana Medicare Advantage	$23,474.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,790.86
Rate for Payer: Oxford Commercial	$28,801.65
Rate for Payer: UnitedHealthcare Commercial	$38,552.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,790.86
Rate for Payer: Wellcare Medicare Advantage	$22,790.86

TRAUMATIC INJURY WITHOUT MCC

Facility

$47,440.75

Service Code	MSDRG 914
Min. Negotiated Rate	$14,445.10
Max. Negotiated Rate	$47,440.75
Rate for Payer: Aetna Commercial	$35,646.33
Rate for Payer: Aetna Medicare Advantage	$47,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,205.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,211.55
Rate for Payer: Cigna Commercial	$19,740.45
Rate for Payer: Cigna Medicare Advantage	$15,205.37
Rate for Payer: Clover Medicare Advantage	$14,445.10
Rate for Payer: EmblemHealth Commercial	$45,616.11
Rate for Payer: Humana Medicare Advantage	$15,661.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,205.37
Rate for Payer: Oxford Commercial	$15,602.51
Rate for Payer: UnitedHealthcare Commercial	$20,884.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,205.37
Rate for Payer: Wellcare Medicare Advantage	$15,205.37

TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC

Facility

$60,621.54

Service Code	MSDRG 086
Min. Negotiated Rate	$18,458.48
Max. Negotiated Rate	$60,621.54
Rate for Payer: Aetna Medicare Advantage	$60,621.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36,570.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36,570.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,429.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36,570.60
Rate for Payer: Cigna Commercial	$29,041.09
Rate for Payer: Cigna Medicare Advantage	$19,429.98
Rate for Payer: Clover Medicare Advantage	$18,458.48
Rate for Payer: EmblemHealth Commercial	$58,289.94
Rate for Payer: Humana Medicare Advantage	$20,012.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,429.98
Rate for Payer: Oxford Commercial	$22,953.57
Rate for Payer: UnitedHealthcare Commercial	$30,724.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,429.98
Rate for Payer: Wellcare Medicare Advantage	$19,429.98

TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC

Facility

$63,562.89

Service Code	MSDRG 083
Min. Negotiated Rate	$19,354.08
Max. Negotiated Rate	$63,562.89
Rate for Payer: Aetna Medicare Advantage	$63,562.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,372.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,678.80
Rate for Payer: Cigna Commercial	$31,116.57
Rate for Payer: Cigna Medicare Advantage	$20,372.72
Rate for Payer: Clover Medicare Advantage	$19,354.08
Rate for Payer: EmblemHealth Commercial	$61,118.16
Rate for Payer: Humana Medicare Advantage	$20,983.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,372.72
Rate for Payer: Oxford Commercial	$24,594.00
Rate for Payer: UnitedHealthcare Commercial	$32,919.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,372.72
Rate for Payer: Wellcare Medicare Advantage	$20,372.72

TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC

Facility

$91,242.12

Service Code	MSDRG 085
Min. Negotiated Rate	$27,782.06
Max. Negotiated Rate	$91,242.12
Rate for Payer: Aetna Medicare Advantage	$91,242.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62,890.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62,890.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,244.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62,890.35
Rate for Payer: Cigna Commercial	$50,647.47
Rate for Payer: Cigna Medicare Advantage	$29,244.27
Rate for Payer: Clover Medicare Advantage	$27,782.06
Rate for Payer: EmblemHealth Commercial	$87,732.81
Rate for Payer: Humana Medicare Advantage	$30,121.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29,244.27
Rate for Payer: Oxford Commercial	$40,030.88
Rate for Payer: UnitedHealthcare Commercial	$53,582.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,244.27
Rate for Payer: Wellcare Medicare Advantage	$29,244.27

TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC

Facility

$91,674.90

Service Code	MSDRG 082
Min. Negotiated Rate	$27,913.83
Max. Negotiated Rate	$91,674.90
Rate for Payer: Aetna Medicare Advantage	$91,674.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63,167.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63,167.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,382.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63,167.40
Rate for Payer: Cigna Commercial	$50,952.88
Rate for Payer: Cigna Medicare Advantage	$29,382.98
Rate for Payer: Clover Medicare Advantage	$27,913.83
Rate for Payer: EmblemHealth Commercial	$88,148.94
Rate for Payer: Humana Medicare Advantage	$30,264.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29,382.98
Rate for Payer: Oxford Commercial	$40,272.27
Rate for Payer: UnitedHealthcare Commercial	$53,905.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,382.98
Rate for Payer: Wellcare Medicare Advantage	$29,382.98

TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC

Facility

$48,363.31

Service Code	MSDRG 087
Min. Negotiated Rate	$14,726.01
Max. Negotiated Rate	$48,363.31
Rate for Payer: Aetna Medicare Advantage	$48,363.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,657.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,657.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,501.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,657.45
Rate for Payer: Cigna Commercial	$20,391.41
Rate for Payer: Cigna Medicare Advantage	$15,501.06
Rate for Payer: Clover Medicare Advantage	$14,726.01
Rate for Payer: EmblemHealth Commercial	$46,503.18
Rate for Payer: Humana Medicare Advantage	$15,966.09
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,501.06
Rate for Payer: Oxford Commercial	$16,117.01
Rate for Payer: UnitedHealthcare Commercial	$21,573.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,501.06
Rate for Payer: Wellcare Medicare Advantage	$15,501.06

TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC

Facility

$49,661.79

Service Code	MSDRG 084
Min. Negotiated Rate	$15,121.38
Max. Negotiated Rate	$49,661.79
Rate for Payer: Aetna Medicare Advantage	$49,661.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,488.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,917.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,488.60
Rate for Payer: Cigna Commercial	$21,307.65
Rate for Payer: Cigna Medicare Advantage	$15,917.24
Rate for Payer: Clover Medicare Advantage	$15,121.38
Rate for Payer: EmblemHealth Commercial	$47,751.72
Rate for Payer: Humana Medicare Advantage	$16,394.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,917.24
Rate for Payer: Oxford Commercial	$16,841.20
Rate for Payer: UnitedHealthcare Commercial	$22,542.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,917.24
Rate for Payer: Wellcare Medicare Advantage	$15,917.24

TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC

Facility

$65,973.55

Service Code	MSDRG 604
Min. Negotiated Rate	$20,088.10
Max. Negotiated Rate	$65,973.55
Rate for Payer: Aetna Commercial	$48,845.61
Rate for Payer: Aetna Medicare Advantage	$65,973.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,834.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,834.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,145.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,834.55
Rate for Payer: Cigna Commercial	$32,817.53
Rate for Payer: Cigna Medicare Advantage	$21,145.37
Rate for Payer: Clover Medicare Advantage	$20,088.10
Rate for Payer: EmblemHealth Commercial	$63,436.11
Rate for Payer: Humana Medicare Advantage	$21,779.73
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,145.37
Rate for Payer: Oxford Commercial	$25,938.40
Rate for Payer: UnitedHealthcare Commercial	$34,719.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,145.37
Rate for Payer: Wellcare Medicare Advantage	$21,145.37

TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC

Facility

$48,404.37

Service Code	MSDRG 605
Min. Negotiated Rate	$14,738.51
Max. Negotiated Rate	$48,404.37
Rate for Payer: Aetna Commercial	$36,332.63
Rate for Payer: Aetna Medicare Advantage	$48,404.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,211.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,514.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,211.55
Rate for Payer: Cigna Commercial	$20,420.39
Rate for Payer: Cigna Medicare Advantage	$15,514.22
Rate for Payer: Clover Medicare Advantage	$14,738.51
Rate for Payer: EmblemHealth Commercial	$46,542.66
Rate for Payer: Humana Medicare Advantage	$15,979.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,514.22
Rate for Payer: Oxford Commercial	$16,139.92
Rate for Payer: UnitedHealthcare Commercial	$21,603.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,514.22
Rate for Payer: Wellcare Medicare Advantage	$15,514.22

TRAXLTON SNARE HEXAGONAL

Facility

$125.00

Hospital Charge Code	270664465
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

Know your out-of-pocket cost for care.

All Charges