Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WC UNNA BOOT LEFT

Facility

$512.25

Service Code	HCPCS 29580LT
Hospital Charge Code	9800172
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 UNNA BOOT LEFT

Facility

$512.25

Service Code	HCPCS 29580LT
Hospital Charge Code	9800172
Hospital Revenue Code	510
Min. Negotiated Rate	$76.84
Max. Negotiated Rate	$76.84
Rate for Payer: Qualcare PPO/HMO/WC	$76.84

WC UNNA BOOT RIGHT

Facility

$515.25

Service Code	HCPCS 29580RT
Hospital Charge Code	9800171
Hospital Revenue Code	510
Min. Negotiated Rate	$14.63
Max. Negotiated Rate	$257.62
Rate for Payer: Aetna Commercial	$195.79
Rate for Payer: Aetna Medicare Advantage	$154.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.39
Rate for Payer: Cigna Commercial	$257.62
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: Wellpoint Medicaid Managed Care	$14.63

WC UNNA BOOT RIGHT

Facility

$515.25

Service Code	HCPCS 29580RT
Hospital Charge Code	9800171
Hospital Revenue Code	510
Min. Negotiated Rate	$77.29
Max. Negotiated Rate	$77.29
Rate for Payer: Qualcare PPO/HMO/WC	$77.29

WC UNNA FLEX 4X10

Facility

$458.00

Service Code	HCPCS A6456
Hospital Charge Code	9808195
Hospital Revenue Code	272
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

WC UNNA FLEX 4X10

Facility

$458.00

Service Code	HCPCS A6456
Hospital Charge Code	9808195
Hospital Revenue Code	272
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$229.00
Rate for Payer: Aetna Commercial	$174.04
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.08
Rate for Payer: Oxford Commercial	$91.60
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$91.60
Rate for Payer: UnitedHealthcare Community & State	$14.47
Rate for Payer: Wellpoint Medicaid Managed Care	$13.01

WC US,PREGNT UTERUS,LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	83652271
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

WC US,PREGNT UTERUS,LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	83652271
Hospital Revenue Code	402
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

WC WEDGE EXCISION NAIL

Facility

$545.00

Service Code	HCPCS 11765
Hospital Charge Code	9800072
Hospital Revenue Code	361
Min. Negotiated Rate	$15.48
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	$141.70
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$17.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$15.48

WC WEDGE EXCISION NAIL

Facility

$545.00

Service Code	HCPCS 11765
Hospital Charge Code	9800072
Hospital Revenue Code	361
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	87502505
Hospital Revenue Code	761
Min. Negotiated Rate	$36.72
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	$69.30
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	$336.18
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$40.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$36.72

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	87502505
Hospital Revenue Code	761
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	83652071
Hospital Revenue Code	761
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	83652071
Hospital Revenue Code	761
Min. Negotiated Rate	$36.72
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	$69.30
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	$336.18
Rate for Payer: Oxford Commercial	$258.60
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$258.60
Rate for Payer: UnitedHealthcare Community & State	$40.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$36.72

WEANING PARAMETERS

Facility

$6,100.00

Service Code	HCPCS 94150
Hospital Charge Code	9500050
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

WEANING PARAMETERS

Facility

$6,100.00

Service Code	HCPCS 94150
Hospital Charge Code	9500050
Hospital Revenue Code	460
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.54
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.00
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$192.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$173.24

WEDGE 2 0X 20 X 8

Facility

$10,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687065
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$2,655.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25

WEDGE 2 0X 20 X 8

Facility

$10,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687065
Hospital Revenue Code	278
Min. Negotiated Rate	$311.69
Max. Negotiated Rate	$5,487.50
Rate for Payer: Aetna Commercial	$4,170.50
Rate for Payer: Aetna Medicare Advantage	$3,292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,798.62
Rate for Payer: Cigna Commercial	$5,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25
Rate for Payer: UnitedHealthcare Community & State	$346.81
Rate for Payer: Wellpoint Medicaid Managed Care	$311.69

WEDGE ALLOGRAFT LAPIDUS 5MM 5D

Facility

$14,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699356
Hospital Revenue Code	278
Min. Negotiated Rate	$418.90
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$5,605.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50
Rate for Payer: UnitedHealthcare Community & State	$466.10
Rate for Payer: Wellpoint Medicaid Managed Care	$418.90

WEDGE ALLOGRAFT LAPIDUS 5MM 5D

Facility

$14,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

WEDGE AVITRAC MTP CORE 11 MM

Facility

$6,632.50

Hospital Charge Code	270701752
Hospital Revenue Code	278
Min. Negotiated Rate	$188.36
Max. Negotiated Rate	$3,316.25
Rate for Payer: Aetna Commercial	$2,520.35
Rate for Payer: Aetna Medicare Advantage	$1,989.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,691.29
Rate for Payer: Cigna Commercial	$3,316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88
Rate for Payer: UnitedHealthcare Community & State	$209.59
Rate for Payer: Wellpoint Medicaid Managed Care	$188.36

WEDGE AVITRAC MTP CORE 11 MM

Facility

$6,632.50

Hospital Charge Code	270701752
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$1,605.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 13 MM

Facility

$6,632.50

Hospital Charge Code	270701751
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$1,605.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 13 MM

Facility

$6,632.50

Hospital Charge Code	270701751
Hospital Revenue Code	278
Min. Negotiated Rate	$188.36
Max. Negotiated Rate	$3,316.25
Rate for Payer: Aetna Commercial	$2,520.35
Rate for Payer: Aetna Medicare Advantage	$1,989.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,691.29
Rate for Payer: Cigna Commercial	$3,316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88
Rate for Payer: UnitedHealthcare Community & State	$209.59
Rate for Payer: Wellpoint Medicaid Managed Care	$188.36

WEDGE BIOCORTICAL COTTON 6MM

Facility

$7,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270684863
Hospital Revenue Code	278
Min. Negotiated Rate	$203.20
Max. Negotiated Rate	$3,577.50
Rate for Payer: Aetna Commercial	$2,718.90
Rate for Payer: Aetna Medicare Advantage	$2,146.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,431.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.53
Rate for Payer: Cigna Commercial	$3,577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.25
Rate for Payer: UnitedHealthcare Community & State	$226.10
Rate for Payer: Wellpoint Medicaid Managed Care	$203.20

Know your out-of-pocket cost for care.

All Charges