Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DEBR NECROTIZ ST-GENTLS&PENEUM

Facility

$6,416.20

Service Code	HCPCS 11004
Hospital Charge Code	1600000801
Hospital Revenue Code	360
Min. Negotiated Rate	$962.43
Max. Negotiated Rate	$962.43
Rate for Payer: Qualcare PPO/HMO/WC	$962.43

DEBR NECROTIZ ST-GENTLS&PENEUM

Facility

$6,416.20

Service Code	HCPCS 11004
Hospital Charge Code	1600000801
Hospital Revenue Code	360
Min. Negotiated Rate	$182.22
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,438.16
Rate for Payer: Aetna Medicare Advantage	$1,924.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,636.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,636.13
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	$1,636.13
Rate for Payer: Cigna Commercial	$3,208.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,668.21
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$962.43
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$202.75
Rate for Payer: Wellpoint Medicaid Managed Care	$182.22

DEB SKIN BONE AT FX SITE

Facility

$7,612.30

Service Code	HCPCS 11012
Hospital Charge Code	1600000540
Hospital Revenue Code	360
Min. Negotiated Rate	$240.55
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
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	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,979.20
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$240.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,775.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7,622.61

DEB SKIN BONE AT FX SITE

Facility

$7,612.30

Service Code	HCPCS 11012
Hospital Charge Code	1600000540
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

DEB SUBQ TISSUE 20 SQ CM/<

Facility

$1,498.20

Service Code	HCPCS 11042
Hospital Charge Code	16000156
Hospital Revenue Code	360
Min. Negotiated Rate	$47.34
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	$389.53
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.73
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$47.34
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	$1,037.98

DEB SUBQ TISSUE 20 SQ CM/<

Facility

$1,498.20

Service Code	HCPCS 11042
Hospital Charge Code	16000156
Hospital Revenue Code	360
Min. Negotiated Rate	$224.73
Max. Negotiated Rate	$224.73
Rate for Payer: Qualcare PPO/HMO/WC	$224.73

DECALCIFICATION

Facility

$390.00

Service Code	HCPCS 88311
Hospital Charge Code	38474058
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DECALCIFICATION

Facility

$390.00

Service Code	HCPCS 88311
Hospital Charge Code	38474058
Hospital Revenue Code	310
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DECALCIFICATION OF BONE

Facility

$390.00

Service Code	HCPCS 88311
Hospital Charge Code	3005221
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DECALCIFICATION OF BONE

Facility

$390.00

Service Code	HCPCS 88311
Hospital Charge Code	3005221
Hospital Revenue Code	310
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DECALCIFICATION OF BONE

Facility

$390.00

Service Code	HCPCS 88311
Hospital Charge Code	3005220
Hospital Revenue Code	310
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.38
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

DECALCIFICATION OF BONE

Facility

$390.00

Service Code	HCPCS 88311
Hospital Charge Code	3005220
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DECELL PLACENTAL MEMBRANE 5X5C

Facility

$6,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270704474
Hospital Revenue Code	278
Min. Negotiated Rate	$183.18
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Community & State	$203.82
Rate for Payer: Wellpoint Medicaid Managed Care	$183.18

DECELL PLACENTAL MEMBRANE 5X5C

Facility

$6,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270704474
Hospital Revenue Code	278
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$1,560.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.90
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

DECITABINE 50MG INJ

Facility

$13,756.44

Service Code	HCPCS J0894
Hospital Charge Code	6063943093
Hospital Revenue Code	636
Min. Negotiated Rate	$390.68
Max. Negotiated Rate	$6,878.22
Rate for Payer: Aetna Commercial	$5,227.45
Rate for Payer: Aetna Medicare Advantage	$4,126.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,507.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,507.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,507.89
Rate for Payer: Cigna Commercial	$6,878.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,329.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,063.47
Rate for Payer: UnitedHealthcare Community & State	$434.70
Rate for Payer: Wellpoint Medicaid Managed Care	$390.68

DECITABINE 50MG INJ

Facility

$13,756.44

Service Code	HCPCS J0894
Hospital Charge Code	6063943093
Hospital Revenue Code	636
Min. Negotiated Rate	$2,063.47
Max. Negotiated Rate	$3,329.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,329.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,063.47

DECLOMYCIN/300MG/TAB

Facility

$114.37

Service Code	NDC 65162055548
Hospital Charge Code	60634319
Hospital Revenue Code	250
Min. Negotiated Rate	$17.16
Max. Negotiated Rate	$17.16
Rate for Payer: Qualcare PPO/HMO/WC	$17.16

DECLOMYCIN/300MG/TAB

Facility

$114.37

Service Code	NDC 65162055548
Hospital Charge Code	60634319
Hospital Revenue Code	250
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$57.19
Rate for Payer: Aetna Commercial	$43.46
Rate for Payer: Aetna Medicare Advantage	$34.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.16
Rate for Payer: Cigna Commercial	$57.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.74
Rate for Payer: Oxford Commercial	$22.87
Rate for Payer: Qualcare PPO/HMO/WC	$17.16
Rate for Payer: UnitedHealthcare Commercial	$22.87
Rate for Payer: UnitedHealthcare Community & State	$3.61
Rate for Payer: Wellpoint Medicaid Managed Care	$3.25

DECLOT VASCULAR DEVICE

Facility

$1,814.20

Service Code	HCPCS 36593
Hospital Charge Code	350036593
Hospital Revenue Code	361
Min. Negotiated Rate	$51.52
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,067.36
Rate for Payer: Aetna Medicare Advantage	$1,271.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$392.41
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	$1,423.47
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: Cigna Medicare Advantage	$392.41
Rate for Payer: Clover Medicare Advantage	$372.79
Rate for Payer: EmblemHealth Commercial	$1,177.23
Rate for Payer: Humana Medicare Advantage	$404.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$392.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.69
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$272.13
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$57.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$392.41
Rate for Payer: Wellcare Medicare Advantage	$392.41
Rate for Payer: Wellpoint Medicaid Managed Care	$51.52

DECLOT VASCULAR DEVICE

Facility

$1,814.20

Service Code	HCPCS 36593
Hospital Charge Code	350036593
Hospital Revenue Code	361
Min. Negotiated Rate	$272.13
Max. Negotiated Rate	$272.13
Rate for Payer: Qualcare PPO/HMO/WC	$272.13

DECMPRES SPINAL CORD THORACIC

Facility

$71,323.35

Service Code	HCPCS 63055
Hospital Charge Code	1600000641
Hospital Revenue Code	360
Min. Negotiated Rate	$10,698.50
Max. Negotiated Rate	$10,698.50
Rate for Payer: Qualcare PPO/HMO/WC	$10,698.50

DECMPRES SPINAL CORD THORACIC

Facility

$71,323.35

Service Code	HCPCS 63055
Hospital Charge Code	1600000641
Hospital Revenue Code	360
Min. Negotiated Rate	$2,025.58
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18,544.07
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,698.50
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$2,253.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$2,025.58

DECOMPRES EPIDURAL NERVE ROOTS

Facility

$7,823.00

Service Code	HCPCS 64722
Hospital Charge Code	84506065
Hospital Revenue Code	361
Min. Negotiated Rate	$222.17
Max. Negotiated Rate	$8,415.40
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
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	$8,415.40
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,033.98
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,173.45
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$247.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$222.17

DECOMPRES EPIDURAL NERVE ROOTS

Facility

$7,823.00

Service Code	HCPCS 64722
Hospital Charge Code	84506065
Hospital Revenue Code	361
Min. Negotiated Rate	$1,173.45
Max. Negotiated Rate	$1,173.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,173.45

DECOMPRESS FOREARM 1 SPACE

Facility

$5,399.78

Service Code	HCPCS 25020
Hospital Charge Code	16000828
Hospital Revenue Code	360
Min. Negotiated Rate	$153.35
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,929.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,929.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,403.94
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$809.97
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$170.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$153.35

Know your out-of-pocket cost for care.

All Charges