Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

UNLISTED HYSTEROSCOPY UTERUS

Facility

$778.40

Service Code	HCPCS 58579
Hospital Charge Code	16001008
Hospital Revenue Code	360
Min. Negotiated Rate	$116.76
Max. Negotiated Rate	$116.76
Rate for Payer: Qualcare PPO/HMO/WC	$116.76

UNLISTED JNT ARTHROSC

Facility

$11,779.44

Service Code	HCPCS 29999
Hospital Charge Code	16000247
Hospital Revenue Code	360
Min. Negotiated Rate	$278.40
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
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	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,062.65
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,766.92
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$372.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$334.54

UNLISTED JNT ARTHROSC

Facility

$11,779.44

Service Code	HCPCS 29999
Hospital Charge Code	16000247
Hospital Revenue Code	360
Min. Negotiated Rate	$1,766.92
Max. Negotiated Rate	$1,766.92
Rate for Payer: Qualcare PPO/HMO/WC	$1,766.92

UNLISTED LAPAROSCOPY ABD PERIT

Facility

$26,932.08

Service Code	HCPCS 49329
Hospital Charge Code	16000488
Hospital Revenue Code	360
Min. Negotiated Rate	$764.87
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,002.34
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,039.81
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$851.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$764.87

UNLISTED LAPAROSCOPY ABD PERIT

Facility

$26,932.08

Service Code	HCPCS 49329
Hospital Charge Code	16000488
Hospital Revenue Code	360
Min. Negotiated Rate	$4,039.81
Max. Negotiated Rate	$4,039.81
Rate for Payer: Qualcare PPO/HMO/WC	$4,039.81

UNLISTED LAPAROSCOPY BILIARY

Facility

$23,722.52

Service Code	HCPCS 47579
Hospital Charge Code	160000186
Hospital Revenue Code	360
Min. Negotiated Rate	$3,558.38
Max. Negotiated Rate	$3,558.38
Rate for Payer: Qualcare PPO/HMO/WC	$3,558.38

UNLISTED LAPAROSCOPY BILIARY

Facility

$23,722.52

Service Code	HCPCS 47579
Hospital Charge Code	160000186
Hospital Revenue Code	360
Min. Negotiated Rate	$673.72
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,167.86
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,558.38
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$749.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$673.72

UNLISTED LAPAROSCOPY PROCEDURE

Facility

$43,334.60

Service Code	HCPCS 58679
Hospital Charge Code	1600000411
Hospital Revenue Code	360
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,267.00
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,369.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1,230.70

UNLISTED LAPAROSCOPY PROCEDURE

Facility

$43,334.60

Service Code	HCPCS 58679
Hospital Charge Code	1600000411
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

UNLISTED LAPAROSCOPY PROCEDURE, SPLEEN

Facility

$26,053.61

Service Code	CPT 38129
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25

UNLISTED LAPAROSCOPY STOMACH

Facility

$25,659.60

Service Code	HCPCS 43659
Hospital Charge Code	1600000601
Hospital Revenue Code	360
Min. Negotiated Rate	$3,848.94
Max. Negotiated Rate	$3,848.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,848.94

UNLISTED LAPAROSCOPY STOMACH

Facility

$25,659.60

Service Code	HCPCS 43659
Hospital Charge Code	1600000601
Hospital Revenue Code	360
Min. Negotiated Rate	$728.73
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,671.50
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,848.94
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$810.84
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$728.73

UNLISTED LAPAROSCOPY UTERUS

Facility

$34,350.00

Service Code	HCPCS 58578
Hospital Charge Code	1600000734
Hospital Revenue Code	360
Min. Negotiated Rate	$5,152.50
Max. Negotiated Rate	$5,152.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,152.50

UNLISTED LAPAROSCOPY UTERUS

Facility

$34,350.00

Service Code	HCPCS 58578
Hospital Charge Code	1600000734
Hospital Revenue Code	360
Min. Negotiated Rate	$975.54
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,931.00
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,152.50
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,085.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$975.54

UNLISTED LAPS PX APPENDIX

Facility

$34,354.45

Service Code	HCPCS 44979
Hospital Charge Code	1600000773
Hospital Revenue Code	360
Min. Negotiated Rate	$975.67
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,932.16
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,153.17
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,085.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$975.67

UNLISTED LAPS PX APPENDIX

Facility

$34,354.45

Service Code	HCPCS 44979
Hospital Charge Code	1600000773
Hospital Revenue Code	360
Min. Negotiated Rate	$5,153.17
Max. Negotiated Rate	$5,153.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,153.17

UNLISTED LAPS PX BLADDER

Facility

$34,354.45

Service Code	HCPCS 51999
Hospital Charge Code	1600000671
Hospital Revenue Code	360
Min. Negotiated Rate	$5,153.17
Max. Negotiated Rate	$5,153.17
Rate for Payer: Qualcare PPO/HMO/WC	$5,153.17

UNLISTED LAPS PX BLADDER

Facility

$34,354.45

Service Code	HCPCS 51999
Hospital Charge Code	1600000671
Hospital Revenue Code	360
Min. Negotiated Rate	$975.67
Max. Negotiated Rate	$26,053.61
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,053.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$26,053.61
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,932.16
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,153.17
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,085.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$975.67

UNLISTED PROCEDURE BILIARY TRA

Facility

$3,684.28

Service Code	HCPCS 47999
Hospital Charge Code	1600000364
Hospital Revenue Code	360
Min. Negotiated Rate	$552.64
Max. Negotiated Rate	$552.64
Rate for Payer: Qualcare PPO/HMO/WC	$552.64

UNLISTED PROCEDURE BILIARY TRA

Facility

$3,684.28

Service Code	HCPCS 47999
Hospital Charge Code	1600000364
Hospital Revenue Code	360
Min. Negotiated Rate	$104.63
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,908.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,908.70
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.91
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$552.64
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$116.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$104.63

UNLISTED PROCEDURE FOOT OR TOE

Facility

$859.60

Service Code	HCPCS 28899
Hospital Charge Code	16000271
Hospital Revenue Code	360
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
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	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.50
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.94
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$27.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$24.41

UNLISTED PROCEDURE FOOT OR TOE

Facility

$859.60

Service Code	HCPCS 28899
Hospital Charge Code	16000271
Hospital Revenue Code	360
Min. Negotiated Rate	$128.94
Max. Negotiated Rate	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.94

UNLISTED PROCEDURE HAND/FINGER

Facility

$1,241.80

Service Code	HCPCS 26989
Hospital Charge Code	323026989
Hospital Revenue Code	450
Min. Negotiated Rate	$35.27
Max. Negotiated Rate	$1,063.04
Rate for Payer: Aetna Commercial	$797.10
Rate for Payer: Aetna Medicare Advantage	$949.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,063.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$293.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,063.04
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: Cigna Medicare Advantage	$293.05
Rate for Payer: Clover Medicare Advantage	$278.40
Rate for Payer: EmblemHealth Commercial	$879.15
Rate for Payer: Humana Medicare Advantage	$301.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$293.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.27
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$35.27

UNLISTED PROCEDURE HAND/FINGER

Facility

$1,241.80

Service Code	HCPCS 26989
Hospital Charge Code	323026989
Hospital Revenue Code	450
Min. Negotiated Rate	$186.27
Max. Negotiated Rate	$186.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.27

UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM

Facility

$3,536.00

Service Code	CPT 38999
Hospital Revenue Code	360
Min. Negotiated Rate	$497.92
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,425.63
Rate for Payer: Aetna Medicare Advantage	$1,698.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,901.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$524.13
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	$1,901.28
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: Cigna Medicare Advantage	$524.13
Rate for Payer: Clover Medicare Advantage	$497.92
Rate for Payer: EmblemHealth Commercial	$1,572.39
Rate for Payer: Humana Medicare Advantage	$539.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$524.13
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$524.13
Rate for Payer: Wellcare Medicare Advantage	$524.13

Know your out-of-pocket cost for care.

All Charges