Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WC COLLAGEN DRSSNG 16SQ IN OR

Facility

$13.00

Service Code	HCPCS A6022
Hospital Charge Code	9808070
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

WC COM REP TRUNK 2.6CM-7.5CM

Facility

$2,370.40

Service Code	HCPCS 13101
Hospital Charge Code	9808325
Hospital Revenue Code	510
Min. Negotiated Rate	$67.32
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.30
Rate for Payer: Qualcare PPO/HMO/WC	$355.56
Rate for Payer: UnitedHealthcare Community & State	$74.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$67.32

WC COM REP TRUNK 2.6CM-7.5CM

Facility

$2,370.40

Service Code	HCPCS 13101
Hospital Charge Code	9808325
Hospital Revenue Code	510
Min. Negotiated Rate	$355.56
Max. Negotiated Rate	$355.56
Rate for Payer: Qualcare PPO/HMO/WC	$355.56

WC CUL ALL DER SUB/1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800270
Hospital Revenue Code	510
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.83
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$37.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.62

WC CUL ALL DER SUB/1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800270
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTD ALLO DERM SUB/1ST 100

Facility

$1,183.95

Hospital Charge Code	9800265
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTD ALLO DERM SUB/1ST 100

Facility

$1,183.95

Hospital Charge Code	9800265
Hospital Revenue Code	510
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.83
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$37.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.62

WC CULTURD ALL SKIN SUB<25 ADD

Facility

$1,183.95

Hospital Charge Code	9800240
Hospital Revenue Code	510
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.83
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$37.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.62

WC CULTURD ALL SKIN SUB<25 ADD

Facility

$1,183.95

Hospital Charge Code	9800240
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTURED ALLOGN SKIN SUB<25

Facility

$1,183.95

Hospital Charge Code	9800235
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTURED ALLOGN SKIN SUB<25

Facility

$1,183.95

Hospital Charge Code	9800235
Hospital Revenue Code	510
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.83
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$37.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.62

WC DEBRID BONE ADDL 20 SQCM

Facility

$1,833.25

Service Code	HCPCS 11047
Hospital Charge Code	9800098
Hospital Revenue Code	510
Min. Negotiated Rate	$52.06
Max. Negotiated Rate	$916.62
Rate for Payer: Aetna Commercial	$696.63
Rate for Payer: Aetna Medicare Advantage	$549.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.48
Rate for Payer: Cigna Commercial	$916.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.64
Rate for Payer: Qualcare PPO/HMO/WC	$274.99
Rate for Payer: UnitedHealthcare Community & State	$57.93
Rate for Payer: Wellpoint Medicaid Managed Care	$52.06

WC DEBRID BONE ADDL 20 SQCM

Facility

$1,833.25

Service Code	HCPCS 11047
Hospital Charge Code	9800098
Hospital Revenue Code	510
Min. Negotiated Rate	$274.99
Max. Negotiated Rate	$274.99
Rate for Payer: Qualcare PPO/HMO/WC	$274.99

WC DEBRIDEMENT EX ECZEMATOUS 1

Facility

$1,117.00

Service Code	HCPCS 11000
Hospital Charge Code	9808001
Hospital Revenue Code	361
Min. Negotiated Rate	$167.55
Max. Negotiated Rate	$167.55
Rate for Payer: Qualcare PPO/HMO/WC	$167.55

WC DEBRIDEMENT EX ECZEMATOUS 1

Facility

$1,117.00

Service Code	HCPCS 11000
Hospital Charge Code	9808001
Hospital Revenue Code	361
Min. Negotiated Rate	$35.30
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.42
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.55
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$35.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,607.24

WC DEBRIDEMENT SKIN FULL THICK

Facility

$843.05

Hospital Charge Code	9800080
Hospital Revenue Code	510
Min. Negotiated Rate	$23.94
Max. Negotiated Rate	$421.52
Rate for Payer: Aetna Commercial	$320.36
Rate for Payer: Aetna Medicare Advantage	$252.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.98
Rate for Payer: Cigna Commercial	$421.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.19
Rate for Payer: Qualcare PPO/HMO/WC	$126.46
Rate for Payer: UnitedHealthcare Community & State	$26.64
Rate for Payer: Wellpoint Medicaid Managed Care	$23.94

WC DEBRIDEMENT SKIN FULL THICK

Facility

$843.05

Hospital Charge Code	9800080
Hospital Revenue Code	510
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

WC DEBRIDEMENT SKIN PART THICK

Facility

$843.05

Hospital Charge Code	9800075
Hospital Revenue Code	510
Min. Negotiated Rate	$23.94
Max. Negotiated Rate	$421.52
Rate for Payer: Aetna Commercial	$320.36
Rate for Payer: Aetna Medicare Advantage	$252.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.98
Rate for Payer: Cigna Commercial	$421.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.19
Rate for Payer: Qualcare PPO/HMO/WC	$126.46
Rate for Payer: UnitedHealthcare Community & State	$26.64
Rate for Payer: Wellpoint Medicaid Managed Care	$23.94

WC DEBRIDEMENT SKIN PART THICK

Facility

$843.05

Hospital Charge Code	9800075
Hospital Revenue Code	510
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

WC DEBRIDEMENT SKIN&SQTIS/BONE

Facility

$7,943.37

Service Code	HCPCS 11044
Hospital Charge Code	9800095
Hospital Revenue Code	510
Min. Negotiated Rate	$224.20
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,065.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.51
Rate for Payer: UnitedHealthcare Community & State	$251.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$394.27
Rate for Payer: Wellpoint Medicaid Managed Care	$225.59

WC DEBRIDEMENT SKIN&SQTIS/BONE

Facility

$7,943.37

Service Code	HCPCS 11044
Hospital Charge Code	9800095
Hospital Revenue Code	510
Min. Negotiated Rate	$1,191.51
Max. Negotiated Rate	$1,191.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,191.51

WC DEBRIDEMENT SKIN&SQ TIS,MUS

Facility

$2,788.64

Service Code	HCPCS 11043
Hospital Charge Code	9800090
Hospital Revenue Code	510
Min. Negotiated Rate	$418.30
Max. Negotiated Rate	$418.30
Rate for Payer: Qualcare PPO/HMO/WC	$418.30

WC DEBRIDEMENT SKIN&SQ TIS,MUS

Facility

$2,788.64

Service Code	HCPCS 11043
Hospital Charge Code	9800090
Hospital Revenue Code	510
Min. Negotiated Rate	$79.20
Max. Negotiated Rate	$3,185.09
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$725.05
Rate for Payer: Qualcare PPO/HMO/WC	$418.30
Rate for Payer: UnitedHealthcare Community & State	$88.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$79.20

WC DEBRIDEMENT SKIN&SUBCU TISS

Facility

$1,485.00

Service Code	HCPCS 11042
Hospital Charge Code	9800085
Hospital Revenue Code	510
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.10
Rate for Payer: Qualcare PPO/HMO/WC	$222.75
Rate for Payer: UnitedHealthcare Community & State	$46.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$42.17

WC DEBRIDEMENT SKIN&SUBCU TISS

Facility

$1,485.00

Service Code	HCPCS 11042
Hospital Charge Code	9800085
Hospital Revenue Code	510
Min. Negotiated Rate	$222.75
Max. Negotiated Rate	$222.75
Rate for Payer: Qualcare PPO/HMO/WC	$222.75

Know your out-of-pocket cost for care.

All Charges