Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WC APLIGRAF PER SQ CM - WASTE

Facility

$205.10

Hospital Charge Code	9800245WM
Hospital Revenue Code	636
Min. Negotiated Rate	$30.77
Max. Negotiated Rate	$49.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.63
Rate for Payer: Qualcare PPO/HMO/WC	$30.77

WC APLIGRAF PER SQ CM - WASTE

Facility

$205.10

Hospital Charge Code	9800245WM
Hospital Revenue Code	636
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$102.55
Rate for Payer: Aetna Commercial	$77.94
Rate for Payer: Aetna Medicare Advantage	$61.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.30
Rate for Payer: Cigna Commercial	$102.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.63
Rate for Payer: Qualcare PPO/HMO/WC	$30.77
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$5.82

WC APLIGRAFT TISS ALLOGEN

Facility

$1,293.00

Service Code	HCPCS 15340
Hospital Charge Code	9808200
Hospital Revenue Code	519
Min. Negotiated Rate	$36.72
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Community & State	$40.86
Rate for Payer: Wellpoint Medicaid Managed Care	$36.72

WC APLIGRAFT TISS ALLOGEN

Facility

$1,293.00

Service Code	HCPCS 15340
Hospital Charge Code	9808200
Hospital Revenue Code	519
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WC APLIGRAFT TISS CULT

Facility

$1,293.00

Service Code	HCPCS 15341
Hospital Charge Code	9808205
Hospital Revenue Code	519
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WC APLIGRAFT TISS CULT

Facility

$1,293.00

Service Code	HCPCS 15341
Hospital Charge Code	9808205
Hospital Revenue Code	519
Min. Negotiated Rate	$36.72
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Community & State	$40.86
Rate for Payer: Wellpoint Medicaid Managed Care	$36.72

WC APLIGRAFT TISS CULT ALLOGEN

Facility

$1,293.00

Service Code	HCPCS 15340
Hospital Charge Code	9808185
Hospital Revenue Code	519
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WC APLIGRAFT TISS CULT ALLOGEN

Facility

$1,293.00

Service Code	HCPCS 15340
Hospital Charge Code	9808185
Hospital Revenue Code	519
Min. Negotiated Rate	$36.72
Max. Negotiated Rate	$646.50
Rate for Payer: Aetna Commercial	$491.34
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$646.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Community & State	$40.86
Rate for Payer: Wellpoint Medicaid Managed Care	$36.72

WC APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	9800162
Hospital Revenue Code	510
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

WC APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	9800162
Hospital Revenue Code	510
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$1,205.35
Rate for Payer: Aetna Commercial	$903.80
Rate for Payer: Aetna Medicare Advantage	$1,076.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,205.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$332.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,205.35
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: Cigna Medicare Advantage	$332.28
Rate for Payer: Clover Medicare Advantage	$315.67
Rate for Payer: EmblemHealth Commercial	$996.84
Rate for Payer: Humana Medicare Advantage	$342.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$332.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.72
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Community & State	$42.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$38.64

WC ASPIRATION/INJ INT JT/BURSA

Facility

$1,091.00

Service Code	HCPCS 20605
Hospital Charge Code	9800130
Hospital Revenue Code	510
Min. Negotiated Rate	$28.03
Max. Negotiated Rate	$1,322.84
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,322.84
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.66
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Community & State	$34.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$30.98

WC ASPIRATION/INJ INT JT/BURSA

Facility

$1,091.00

Service Code	HCPCS 20605
Hospital Charge Code	9800130
Hospital Revenue Code	510
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

WC ASPIRATION/INJ SM JT/BURSA

Facility

$1,091.00

Service Code	HCPCS 20600
Hospital Charge Code	9800125
Hospital Revenue Code	510
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

WC ASPIRATION/INJ SM JT/BURSA

Facility

$1,091.00

Service Code	HCPCS 20600
Hospital Charge Code	9800125
Hospital Revenue Code	510
Min. Negotiated Rate	$30.98
Max. Negotiated Rate	$1,322.84
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,322.84
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.66
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Community & State	$34.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$30.98

WC BILATERAL UNNA BOOT

Facility

$512.25

Service Code	HCPCS 2958050
Hospital Charge Code	9800175
Hospital Revenue Code	510
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$256.12
Rate for Payer: Aetna Commercial	$194.66
Rate for Payer: Aetna Medicare Advantage	$153.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.62
Rate for Payer: Cigna Commercial	$256.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.19
Rate for Payer: Qualcare PPO/HMO/WC	$76.84
Rate for Payer: UnitedHealthcare Community & State	$16.19
Rate for Payer: Wellpoint Medicaid Managed Care	$14.55

WC BILATERAL UNNA BOOT

Facility

$512.25

Service Code	HCPCS 2958050
Hospital Charge Code	9800175
Hospital Revenue Code	510
Min. Negotiated Rate	$76.84
Max. Negotiated Rate	$76.84
Rate for Payer: Qualcare PPO/HMO/WC	$76.84

WC BX OF VULVA PERINEUM 1 LESI

Facility

$469.00

Service Code	HCPCS 56605
Hospital Charge Code	83652127
Hospital Revenue Code	361
Min. Negotiated Rate	$70.35
Max. Negotiated Rate	$70.35
Rate for Payer: Qualcare PPO/HMO/WC	$70.35

WC BX OF VULVA PERINEUM 1 LESI

Facility

$469.00

Service Code	HCPCS 56605
Hospital Charge Code	83652127
Hospital Revenue Code	361
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$3,969.32
Rate for Payer: Aetna Commercial	$2,976.31
Rate for Payer: Aetna Medicare Advantage	$3,545.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,969.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,969.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,094.23
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	$3,969.32
Rate for Payer: Cigna Commercial	$2,193.38
Rate for Payer: Cigna Medicare Advantage	$1,094.23
Rate for Payer: Clover Medicare Advantage	$1,039.52
Rate for Payer: EmblemHealth Commercial	$3,282.69
Rate for Payer: Humana Medicare Advantage	$1,127.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,094.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.94
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.35
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$14.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,094.23
Rate for Payer: Wellcare Medicare Advantage	$1,094.23
Rate for Payer: Wellpoint Medicaid Managed Care	$13.32

WC BX SKIN, SQ TIS ADDL LESION

Facility

$372.00

Service Code	HCPCS 11101
Hospital Charge Code	9800120
Hospital Revenue Code	510
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$141.36
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: Wellpoint Medicaid Managed Care	$10.56

WC BX SKIN, SQ TIS ADDL LESION

Facility

$372.00

Service Code	HCPCS 11101
Hospital Charge Code	9800120
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

WC BX SKIN, SQ TISSUE 1 LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	9800115
Hospital Revenue Code	510
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.12
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

WC BX SKIN, SQ TISSUE 1 LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	9800115
Hospital Revenue Code	510
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

WC CIRCUMC CLAMP/DEV WDP/R-BLC

Facility

$2,768.00

Service Code	HCPCS 54150
Hospital Charge Code	83652115
Hospital Revenue Code	361
Min. Negotiated Rate	$415.20
Max. Negotiated Rate	$415.20
Rate for Payer: Qualcare PPO/HMO/WC	$415.20

WC CIRCUMC CLAMP/DEV WDP/R-BLC

Facility

$2,768.00

Service Code	HCPCS 54150
Hospital Charge Code	83652115
Hospital Revenue Code	361
Min. Negotiated Rate	$78.61
Max. Negotiated Rate	$9,008.64
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,008.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
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	$9,008.64
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.68
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$415.20
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$87.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$78.61

WC COLLAGEN DRSSNG 16SQ IN OR

Facility

$13.00

Service Code	HCPCS A6022
Hospital Charge Code	9808070
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

Know your out-of-pocket cost for care.

All Charges