Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TR BAND LONG W INFLATR XXRF06L

Facility

$1,150.00

Hospital Charge Code	270643741
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

TR BAND STD W/INFLATOR XXRF06

Facility

$1,150.00

Hospital Charge Code	270643105
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

TR BAND STD W/INFLATOR XXRF06

Facility

$1,150.00

Hospital Charge Code	270643105
Hospital Revenue Code	272
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.00
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$230.00
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

TR BAND STD W/INFLATOR XXRF06

Facility

$210.00

Hospital Charge Code	270643105S
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

TR BAND STD W/INFLATOR XXRF06

Facility

$175.00

Hospital Charge Code	270643105N
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

TR BAND STD W/INFLATOR XXRF06

Facility

$175.00

Hospital Charge Code	270643105N
Hospital Revenue Code	272
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

TR BAND STD W/INFLATOR XXRF06

Facility

$210.00

Hospital Charge Code	270643105S
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

TR BAND STD W INFTR XX RF06

Facility

$210.00

Hospital Charge Code	270643105C
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

TR BAND STD W INFTR XX RF06

Facility

$210.00

Hospital Charge Code	270643105C
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$6.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

TRCOR2 UROBIOP NDL18x20

Facility

$235.00

Hospital Charge Code	270643164
Hospital Revenue Code	272
Min. Negotiated Rate	$6.67
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.10
Rate for Payer: Oxford Commercial	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$47.00
Rate for Payer: UnitedHealthcare Community & State	$7.43
Rate for Payer: Wellpoint Medicaid Managed Care	$6.67

TRCOR2 UROBIOP NDL18x20

Facility

$235.00

Hospital Charge Code	270643164
Hospital Revenue Code	272
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

TREANDA 100MG/20ML

Facility

$23,893.27

Service Code	HCPCS J9033
Hospital Charge Code	60630209
Hospital Revenue Code	636
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$5,782.17
Rate for Payer: Aetna Commercial	$5.88
Rate for Payer: Aetna Medicare Advantage	$7.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.84
Rate for Payer: Cigna Medicare Advantage	$2.16
Rate for Payer: Clover Medicare Advantage	$2.05
Rate for Payer: EmblemHealth Commercial	$6.48
Rate for Payer: Humana Medicare Advantage	$2.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,782.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,583.99
Rate for Payer: UnitedHealthcare Community & State	$755.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.16
Rate for Payer: Wellcare Medicare Advantage	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$678.57

TREANDA 100MG/20ML

Facility

$23,893.27

Service Code	HCPCS J9033
Hospital Charge Code	60630209
Hospital Revenue Code	636
Min. Negotiated Rate	$3,583.99
Max. Negotiated Rate	$5,782.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,782.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,583.99

TREANDA 25MG/1ML

Facility

$5,973.32

Service Code	HCPCS J9033
Hospital Charge Code	60630210
Hospital Revenue Code	636
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$1,445.54
Rate for Payer: Aetna Commercial	$5.88
Rate for Payer: Aetna Medicare Advantage	$7.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.84
Rate for Payer: Cigna Medicare Advantage	$2.16
Rate for Payer: Clover Medicare Advantage	$2.05
Rate for Payer: EmblemHealth Commercial	$6.48
Rate for Payer: Humana Medicare Advantage	$2.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.54
Rate for Payer: Qualcare PPO/HMO/WC	$896.00
Rate for Payer: UnitedHealthcare Community & State	$188.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.16
Rate for Payer: Wellcare Medicare Advantage	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$169.64

TREANDA 25MG/1ML

Facility

$5,973.32

Service Code	HCPCS J9033
Hospital Charge Code	60630210
Hospital Revenue Code	636
Min. Negotiated Rate	$896.00
Max. Negotiated Rate	$1,445.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.54
Rate for Payer: Qualcare PPO/HMO/WC	$896.00

Treat Ankle Dislocation

Facility

$28,225.00

Service Code	HCPCS 27848
Hospital Charge Code	16000715
Hospital Revenue Code	360
Min. Negotiated Rate	$801.59
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	$7,338.50
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,233.75
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$891.91
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	$801.59

Treat Ankle Dislocation

Facility

$28,225.00

Service Code	HCPCS 27848
Hospital Charge Code	16000715
Hospital Revenue Code	360
Min. Negotiated Rate	$4,233.75
Max. Negotiated Rate	$4,233.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,233.75

TREAT ANKLE FRACTURE

Facility

$63,197.33

Service Code	HCPCS 28445
Hospital Charge Code	16000573
Hospital Revenue Code	360
Min. Negotiated Rate	$9,479.60
Max. Negotiated Rate	$9,479.60
Rate for Payer: Qualcare PPO/HMO/WC	$9,479.60

TREAT ANKLE FRACTURE

Facility

$63,197.33

Service Code	HCPCS 28445
Hospital Charge Code	16000573
Hospital Revenue Code	360
Min. Negotiated Rate	$1,794.80
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	$16,431.31
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,479.60
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,997.04
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	$1,794.80

TREAT BIG TOE FRACTURE TA

Facility

$12,406.91

Service Code	HCPCS 28505
Hospital Charge Code	16000517
Hospital Revenue Code	360
Min. Negotiated Rate	$1,861.04
Max. Negotiated Rate	$1,861.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,861.04

TREAT BIG TOE FRACTURE TA

Facility

$12,406.91

Service Code	HCPCS 28505
Hospital Charge Code	16000517
Hospital Revenue Code	360
Min. Negotiated Rate	$352.36
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	$3,225.80
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,861.04
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$392.06
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	$352.36

TREAT DISLOCATION/FRACTURE

Facility

$22,425.68

Service Code	HCPCS 23670
Hospital Charge Code	16000819
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

TREAT DISLOCATION/FRACTURE

Facility

$9,423.70

Service Code	HCPCS 23665
Hospital Charge Code	1600000772
Hospital Revenue Code	360
Min. Negotiated Rate	$1,413.56
Max. Negotiated Rate	$1,413.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.56

TREAT DISLOCATION/FRACTURE

Facility

$22,425.68

Service Code	HCPCS 23670
Hospital Charge Code	16000819
Hospital Revenue Code	360
Min. Negotiated Rate	$636.89
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	$5,830.68
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$708.65
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	$636.89

TREAT DISLOCATION/FRACTURE

Facility

$9,423.70

Service Code	HCPCS 23665
Hospital Charge Code	1600000772
Hospital Revenue Code	360
Min. Negotiated Rate	$267.63
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	$2,450.16
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.56
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$297.79
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	$267.63

Know your out-of-pocket cost for care.

All Charges