Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WC REMOVE NAIL PLATE

Facility

$440.00

Service Code	HCPCS 11730
Hospital Charge Code	9800060
Hospital Revenue Code	510
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

WC REMOVE NAIL PLATE

Facility

$440.00

Service Code	HCPCS 11730
Hospital Charge Code	9800060
Hospital Revenue Code	510
Min. Negotiated Rate	$12.50
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	$59.48
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	$114.40
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Community & State	$13.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$12.50

WC REMOVE NAIL PLATE ADDL

Facility

$372.00

Service Code	HCPCS 11732
Hospital Charge Code	9800065
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

WC REMOVE NAIL PLATE ADDL

Facility

$372.00

Service Code	HCPCS 11732
Hospital Charge Code	9800065
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) NJ Health	$22.07
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 REST CNTC LAYR W/SILVER 4X

Facility

$20.00

Service Code	HCPCS A6207
Hospital Charge Code	9808100
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

WC REST CNTC LAYR W/SILVER 4X

Facility

$20.00

Service Code	HCPCS A6207
Hospital Charge Code	9808100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

WC REST NONADHERENT 4X5-CONT

Facility

$30.90

Service Code	HCPCS A6207
Hospital Charge Code	9808095
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$15.45
Rate for Payer: Aetna Commercial	$11.74
Rate for Payer: Aetna Medicare Advantage	$9.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.88
Rate for Payer: Cigna Commercial	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.03
Rate for Payer: Oxford Commercial	$6.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.63
Rate for Payer: UnitedHealthcare Commercial	$6.18
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

WC REST NONADHERENT 4X5-CONT

Facility

$30.90

Service Code	HCPCS A6207
Hospital Charge Code	9808095
Hospital Revenue Code	272
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$4.63
Rate for Payer: Qualcare PPO/HMO/WC	$4.63

WC RHO D IMM GLOB IV 100 IU

Facility

$499.00

Hospital Charge Code	83652619
Hospital Revenue Code	636
Min. Negotiated Rate	$74.85
Max. Negotiated Rate	$120.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.76
Rate for Payer: Qualcare PPO/HMO/WC	$74.85

WC RHO D IMM GLOB IV 100 IU

Facility

$499.00

Hospital Charge Code	83652619
Hospital Revenue Code	636
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$249.50
Rate for Payer: Aetna Commercial	$189.62
Rate for Payer: Aetna Medicare Advantage	$149.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.25
Rate for Payer: Cigna Commercial	$249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.76
Rate for Payer: Qualcare PPO/HMO/WC	$74.85
Rate for Payer: UnitedHealthcare Community & State	$15.77
Rate for Payer: Wellpoint Medicaid Managed Care	$14.17

WC SALPINGECTOMY,COMP/UNI/BIL

Professional

Both

$22,067.72

Service Code	HCPCS 58700
Hospital Charge Code	83652187
Hospital Revenue Code	960
Min. Negotiated Rate	$1,270.30
Max. Negotiated Rate	$1,270.30
Rate for Payer: Aetna Medicare Advantage	$1,270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,270.30

WC SEPTIC ABORT,SURG CMPLTD

Professional

Both

$9,789.90

Service Code	HCPCS 59830
Hospital Charge Code	83652255
Hospital Revenue Code	960
Min. Negotiated Rate	$1,453.05
Max. Negotiated Rate	$1,453.05
Rate for Payer: Aetna Medicare Advantage	$1,453.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,453.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,453.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.05

WC SILVERCEL 4 1/4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808090
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

WC SILVERCEL 4 1/4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808090
Hospital Revenue Code	272
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

WC SILVERCEL 4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808085
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

WC SILVERCEL 4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808085
Hospital Revenue Code	272
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

WC SILVERCEL ANTIMCB DRESNG 2X

Facility

$12.00

Service Code	HCPCS A6196
Hospital Charge Code	9808080
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

WC SILVERCEL ANTIMCB DRESNG 2X

Facility

$12.00

Service Code	HCPCS A6196
Hospital Charge Code	9808080
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

WC SKIN SUB HD/FT/DG ADD 100

Facility

$1,257.40

Service Code	HCPCS 15278
Hospital Charge Code	9800215
Hospital Revenue Code	510
Min. Negotiated Rate	$35.71
Max. Negotiated Rate	$628.70
Rate for Payer: Aetna Commercial	$477.81
Rate for Payer: Aetna Medicare Advantage	$377.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.64
Rate for Payer: Cigna Commercial	$628.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.92
Rate for Payer: Qualcare PPO/HMO/WC	$188.61
Rate for Payer: UnitedHealthcare Community & State	$39.73
Rate for Payer: Wellpoint Medicaid Managed Care	$35.71

WC SKIN SUB HD/FT/DG ADD 100

Facility

$1,257.40

Service Code	HCPCS 15278
Hospital Charge Code	9800215
Hospital Revenue Code	510
Min. Negotiated Rate	$188.61
Max. Negotiated Rate	$188.61
Rate for Payer: Qualcare PPO/HMO/WC	$188.61

WC SKIN SUB HD/FT/DG ADD 25C

Facility

$467.35

Service Code	HCPCS 15276KX
Hospital Charge Code	9800515
Hospital Revenue Code	510
Min. Negotiated Rate	$70.10
Max. Negotiated Rate	$70.10
Rate for Payer: Qualcare PPO/HMO/WC	$70.10

WC SKIN SUB HD/FT/DG ADD 25C

Facility

$467.35

Service Code	HCPCS 15276KX
Hospital Charge Code	9800515
Hospital Revenue Code	510
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$233.68
Rate for Payer: Aetna Commercial	$177.59
Rate for Payer: Aetna Medicare Advantage	$140.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.17
Rate for Payer: Cigna Commercial	$233.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.51
Rate for Payer: Qualcare PPO/HMO/WC	$70.10
Rate for Payer: UnitedHealthcare Community & State	$14.77
Rate for Payer: Wellpoint Medicaid Managed Care	$13.27

WC SKIN SUB HD/FT/DG FIRST 100

Facility

$1,257.40

Service Code	HCPCS 15277
Hospital Charge Code	9800210
Hospital Revenue Code	510
Min. Negotiated Rate	$188.61
Max. Negotiated Rate	$188.61
Rate for Payer: Qualcare PPO/HMO/WC	$188.61

WC SKIN SUB HD/FT/DG FIRST 100

Facility

$1,257.40

Service Code	HCPCS 15277
Hospital Charge Code	9800210
Hospital Revenue Code	510
Min. Negotiated Rate	$35.71
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$326.92
Rate for Payer: Qualcare PPO/HMO/WC	$188.61
Rate for Payer: UnitedHealthcare Community & State	$39.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$35.71

WC SKIN SUB HD/FT/DG FIRST 25C

Facility

$1,370.55

Service Code	HCPCS 15275KX
Hospital Charge Code	9800510
Hospital Revenue Code	510
Min. Negotiated Rate	$38.92
Max. Negotiated Rate	$685.27
Rate for Payer: Aetna Commercial	$520.81
Rate for Payer: Aetna Medicare Advantage	$411.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.49
Rate for Payer: Cigna Commercial	$685.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.34
Rate for Payer: Qualcare PPO/HMO/WC	$205.58
Rate for Payer: UnitedHealthcare Community & State	$43.31
Rate for Payer: Wellpoint Medicaid Managed Care	$38.92

Know your out-of-pocket cost for care.

All Charges