Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WC PARING > 4 LESIONS

Facility

$1,291.00

Service Code	HCPCS 11057
Hospital Charge Code	9800110
Hospital Revenue Code	510
Min. Negotiated Rate	$193.65
Max. Negotiated Rate	$193.65
Rate for Payer: Qualcare PPO/HMO/WC	$193.65

WC PARING SKIN LESION

Facility

$747.00

Service Code	HCPCS 11055
Hospital Charge Code	9800100
Hospital Revenue Code	510
Min. Negotiated Rate	$112.05
Max. Negotiated Rate	$112.05
Rate for Payer: Qualcare PPO/HMO/WC	$112.05

WC PARING SKIN LESION

Facility

$747.00

Service Code	HCPCS 11055
Hospital Charge Code	9800100
Hospital Revenue Code	510
Min. Negotiated Rate	$21.21
Max. Negotiated Rate	$864.65
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.22
Rate for Payer: Qualcare PPO/HMO/WC	$112.05
Rate for Payer: UnitedHealthcare Community & State	$23.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.21

WC PELVIC EXAM UNDER ANESTHES

Facility

$232.00

Service Code	HCPCS 57410
Hospital Charge Code	83652135
Hospital Revenue Code	761
Min. Negotiated Rate	$34.80
Max. Negotiated Rate	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.80

WC PELVIC EXAM UNDER ANESTHES

Facility

$232.00

Service Code	HCPCS 57410
Hospital Charge Code	83652135
Hospital Revenue Code	761
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.32
Rate for Payer: Oxford Commercial	$46.40
Rate for Payer: Qualcare PPO/HMO/WC	$34.80
Rate for Payer: UnitedHealthcare Commercial	$46.40
Rate for Payer: UnitedHealthcare Community & State	$7.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$6.59

WC PERMANENT NAIL REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	9800070
Hospital Revenue Code	510
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

WC PERMANENT NAIL REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	9800070
Hospital Revenue Code	510
Min. Negotiated Rate	$59.10
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	$134.87
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	$541.06
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Community & State	$65.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$59.10

WC PHAL CLSD TX W/MANIPULATION

Facility

$728.40

Service Code	HCPCS 26755
Hospital Charge Code	9800535
Hospital Revenue Code	510
Min. Negotiated Rate	$20.69
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) NJ Health	$103.45
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	$189.38
Rate for Payer: Qualcare PPO/HMO/WC	$109.26
Rate for Payer: UnitedHealthcare Community & State	$23.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$293.05
Rate for Payer: Wellcare Medicare Advantage	$293.05
Rate for Payer: Wellpoint Medicaid Managed Care	$20.69

WC PHAL CLSD TX W/MANIPULATION

Facility

$728.40

Service Code	HCPCS 26755
Hospital Charge Code	9800535
Hospital Revenue Code	510
Min. Negotiated Rate	$109.26
Max. Negotiated Rate	$109.26
Rate for Payer: Qualcare PPO/HMO/WC	$109.26

WC POLYMEM ISLAND DRESSING 4X5

Facility

$19.00

Service Code	HCPCS A6212
Hospital Charge Code	9808150
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$7.22
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$3.80
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

WC POLYMEM ISLAND DRESSING 4X5

Facility

$19.00

Service Code	HCPCS A6212
Hospital Charge Code	9808150
Hospital Revenue Code	272
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

WC POLYMEM SILVER 4X4

Facility

$40.00

Service Code	HCPCS A6210
Hospital Charge Code	9808120
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

WC POLYMEM SILVER 4X4

Facility

$40.00

Service Code	HCPCS A6210
Hospital Charge Code	9808120
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

WC PRENATAL >7 VISITS

Facility

$139.00

Service Code	HCPCS 59426
Hospital Charge Code	83652227
Hospital Revenue Code	514
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

WC PRENATAL >7 VISITS

Facility

$139.00

Service Code	HCPCS 59426
Hospital Charge Code	83652227
Hospital Revenue Code	514
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$69.50
Rate for Payer: Aetna Commercial	$52.82
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.45
Rate for Payer: Cigna Commercial	$69.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.14
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

WC PRIMATRIX - PER SQ CM

Facility

$197.70

Service Code	HCPCS Q4110
Hospital Charge Code	9800230
Hospital Revenue Code	636
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$536.29
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Qualcare PPO/HMO/WC	$29.66
Rate for Payer: UnitedHealthcare Community & State	$6.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.61

WC PRIMATRIX - PER SQ CM

Facility

$197.70

Service Code	HCPCS Q4110
Hospital Charge Code	9800230
Hospital Revenue Code	636
Min. Negotiated Rate	$29.66
Max. Negotiated Rate	$47.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Qualcare PPO/HMO/WC	$29.66

WC PRIMATRIX - PER SQ CM JW

Facility

$197.70

Service Code	HCPCS Q4110JW
Hospital Charge Code	9800230W
Hospital Revenue Code	636
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$98.85
Rate for Payer: Aetna Commercial	$75.13
Rate for Payer: Aetna Medicare Advantage	$59.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.41
Rate for Payer: Cigna Commercial	$98.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Qualcare PPO/HMO/WC	$29.66
Rate for Payer: UnitedHealthcare Community & State	$6.25
Rate for Payer: Wellpoint Medicaid Managed Care	$5.61

WC PRIMATRIX - PER SQ CM JW

Facility

$197.70

Service Code	HCPCS Q4110JW
Hospital Charge Code	9800230W
Hospital Revenue Code	636
Min. Negotiated Rate	$29.66
Max. Negotiated Rate	$47.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Qualcare PPO/HMO/WC	$29.66

WC PROMOGRAN MATRIX WD 4.34 SQ

Facility

$29.00

Service Code	HCPCS A6021
Hospital Charge Code	9808075
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

WC PROMOGRAN MATRIX WD 4.34 SQ

Facility

$29.00

Service Code	HCPCS A6021
Hospital Charge Code	9808075
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$14.50
Rate for Payer: Aetna Commercial	$11.02
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.39
Rate for Payer: Cigna Commercial	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$5.80
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

WC REMOVAL OF CAST

Facility

$515.25

Service Code	HCPCS 29700
Hospital Charge Code	9800165
Hospital Revenue Code	510
Min. Negotiated Rate	$14.63
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	$28.63
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	$133.97
Rate for Payer: Qualcare PPO/HMO/WC	$77.29
Rate for Payer: UnitedHealthcare Community & State	$16.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$332.28
Rate for Payer: Wellcare Medicare Advantage	$332.28
Rate for Payer: Wellpoint Medicaid Managed Care	$14.63

WC REMOVAL OF CAST

Facility

$515.25

Service Code	HCPCS 29700
Hospital Charge Code	9800165
Hospital Revenue Code	510
Min. Negotiated Rate	$77.29
Max. Negotiated Rate	$77.29
Rate for Payer: Qualcare PPO/HMO/WC	$77.29

WC REMOVAL OF FB, SUBQ FOOT

Facility

$1,403.00

Service Code	HCPCS 28190
Hospital Charge Code	9800135
Hospital Revenue Code	510
Min. Negotiated Rate	$210.45
Max. Negotiated Rate	$210.45
Rate for Payer: Qualcare PPO/HMO/WC	$210.45

WC REMOVAL OF FB, SUBQ FOOT

Facility

$1,403.00

Service Code	HCPCS 28190
Hospital Charge Code	9800135
Hospital Revenue Code	510
Min. Negotiated Rate	$39.85
Max. Negotiated Rate	$3,051.74
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.78
Rate for Payer: Qualcare PPO/HMO/WC	$210.45
Rate for Payer: UnitedHealthcare Community & State	$44.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$39.85

Know your out-of-pocket cost for care.

All Charges