Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DHS PLATE

Facility

$785.00

Hospital Charge Code	270335052
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

DHS PLATE

Facility

$785.00

Hospital Charge Code	270335052
Hospital Revenue Code	278
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Community & State	$24.81
Rate for Payer: Wellpoint Medicaid Managed Care	$22.29

DHS PLATE135/2HOLE/46MM

Facility

$2,555.70

Service Code	HCPCS C1713
Hospital Charge Code	270682725
Hospital Revenue Code	278
Min. Negotiated Rate	$383.36
Max. Negotiated Rate	$618.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.48
Rate for Payer: Qualcare PPO/HMO/WC	$383.36

DHS PLATE135/2HOLE/46MM

Facility

$2,555.70

Service Code	HCPCS C1713
Hospital Charge Code	270682725
Hospital Revenue Code	278
Min. Negotiated Rate	$72.58
Max. Negotiated Rate	$1,277.85
Rate for Payer: Aetna Commercial	$971.17
Rate for Payer: Aetna Medicare Advantage	$766.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$651.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$651.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$651.70
Rate for Payer: Cigna Commercial	$1,277.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.48
Rate for Payer: Qualcare PPO/HMO/WC	$383.36
Rate for Payer: UnitedHealthcare Community & State	$80.76
Rate for Payer: Wellpoint Medicaid Managed Care	$72.58

DHSREAMING HEAD STANDARD

Facility

$2,934.45

Hospital Charge Code	270683136
Hospital Revenue Code	272
Min. Negotiated Rate	$440.17
Max. Negotiated Rate	$440.17
Rate for Payer: Qualcare PPO/HMO/WC	$440.17

DHSREAMING HEAD STANDARD

Facility

$2,934.45

Hospital Charge Code	270683136
Hospital Revenue Code	272
Min. Negotiated Rate	$83.34
Max. Negotiated Rate	$1,467.22
Rate for Payer: Aetna Commercial	$1,115.09
Rate for Payer: Aetna Medicare Advantage	$880.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.28
Rate for Payer: Cigna Commercial	$1,467.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.96
Rate for Payer: Oxford Commercial	$586.89
Rate for Payer: Qualcare PPO/HMO/WC	$440.17
Rate for Payer: UnitedHealthcare Commercial	$586.89
Rate for Payer: UnitedHealthcare Community & State	$92.73
Rate for Payer: Wellpoint Medicaid Managed Care	$83.34

DIABETES

Facility

$23,322.54

Service Code	APR-DRG 4204
Min. Negotiated Rate	$22,865.24
Max. Negotiated Rate	$23,322.54
Rate for Payer: UnitedHealthcare Community & State	$22,865.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,322.54
Rate for Payer: Wellpoint Medicaid Managed Care	$22,865.24

DIABETES

Facility

$7,672.12

Service Code	APR-DRG 4202
Min. Negotiated Rate	$7,521.69
Max. Negotiated Rate	$7,672.12
Rate for Payer: UnitedHealthcare Community & State	$7,521.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,672.12
Rate for Payer: Wellpoint Medicaid Managed Care	$7,521.69

DIABETES

Facility

$11,406.42

Service Code	APR-DRG 4203
Min. Negotiated Rate	$11,182.76
Max. Negotiated Rate	$11,406.42
Rate for Payer: UnitedHealthcare Community & State	$11,182.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,406.42
Rate for Payer: Wellpoint Medicaid Managed Care	$11,182.76

DIABETES

Facility

$6,083.78

Service Code	APR-DRG 4201
Min. Negotiated Rate	$5,964.49
Max. Negotiated Rate	$6,083.78
Rate for Payer: UnitedHealthcare Community & State	$5,964.49
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,083.78
Rate for Payer: Wellpoint Medicaid Managed Care	$5,964.49

DIABETES WITH CC

Facility

$47,778.81

Service Code	MSDRG 638
Min. Negotiated Rate	$14,548.03
Max. Negotiated Rate	$47,778.81
Rate for Payer: Aetna Commercial	$35,887.12
Rate for Payer: Aetna Medicare Advantage	$47,778.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,934.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,934.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,313.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,934.50
Rate for Payer: Cigna Commercial	$19,978.99
Rate for Payer: Cigna Medicare Advantage	$15,313.72
Rate for Payer: Clover Medicare Advantage	$14,548.03
Rate for Payer: EmblemHealth Commercial	$45,941.16
Rate for Payer: Humana Medicare Advantage	$15,773.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,313.72
Rate for Payer: Oxford Commercial	$15,791.04
Rate for Payer: UnitedHealthcare Commercial	$21,136.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,313.72
Rate for Payer: Wellcare Medicare Advantage	$15,313.72

DIABETES WITH MCC

Facility

$64,855.10

Service Code	MSDRG 637
Min. Negotiated Rate	$19,747.55
Max. Negotiated Rate	$64,855.10
Rate for Payer: Aetna Commercial	$48,049.04
Rate for Payer: Aetna Medicare Advantage	$64,855.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40,172.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40,172.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,786.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40,172.25
Rate for Payer: Cigna Commercial	$32,028.35
Rate for Payer: Cigna Medicare Advantage	$20,786.89
Rate for Payer: Clover Medicare Advantage	$19,747.55
Rate for Payer: EmblemHealth Commercial	$62,360.67
Rate for Payer: Humana Medicare Advantage	$21,410.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,786.89
Rate for Payer: Oxford Commercial	$25,314.65
Rate for Payer: UnitedHealthcare Commercial	$33,884.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,786.89
Rate for Payer: Wellcare Medicare Advantage	$20,786.89

DIABETES WITHOUT CC/MCC

Facility

$39,090.57

Service Code	MSDRG 639
Min. Negotiated Rate	$10,945.54
Max. Negotiated Rate	$39,090.57
Rate for Payer: Aetna Commercial	$29,699.26
Rate for Payer: Aetna Medicare Advantage	$39,090.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,177.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,177.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,529.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,177.10
Rate for Payer: Cigna Commercial	$13,848.41
Rate for Payer: Cigna Medicare Advantage	$12,529.03
Rate for Payer: Clover Medicare Advantage	$11,902.58
Rate for Payer: EmblemHealth Commercial	$37,587.09
Rate for Payer: Humana Medicare Advantage	$12,904.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,529.03
Rate for Payer: Oxford Commercial	$10,945.54
Rate for Payer: UnitedHealthcare Commercial	$14,651.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,529.03
Rate for Payer: Wellcare Medicare Advantage	$12,529.03

DIAB MGMT F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200017
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

DIAB MGMT F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200017
Hospital Revenue Code	942
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$85.32
Rate for Payer: Wellpoint Medicaid Managed Care	$76.68

DIAB MGMT PATHOPHYSIOLOGY

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200016
Hospital Revenue Code	942
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$85.32
Rate for Payer: Wellpoint Medicaid Managed Care	$76.68

DIAB MGMT PATHOPHYSIOLOGY

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200016
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

DIAB NUTRITION COUNSEL EST PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200031
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

DIAB NUTRITION COUNSEL EST PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200031
Hospital Revenue Code	942
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$85.32
Rate for Payer: Wellpoint Medicaid Managed Care	$76.68

DIAB NUTRITION COUNSEL EST PT

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9300004
Hospital Revenue Code	942
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

DIAB NUTRITION COUNSEL EST PT

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9300004
Hospital Revenue Code	942
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$1,203.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

DIAB NUTRITION COUNSEL F/U PT

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9300005
Hospital Revenue Code	942
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

DIAB NUTRITION COUNSEL F/U PT

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9300005
Hospital Revenue Code	942
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$1,203.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

DIAB NUTRITION COUNSEL F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200032
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

DIAB NUTRITION COUNSEL F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200032
Hospital Revenue Code	942
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$702.00
Rate for Payer: Oxford Commercial	$1,060.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,203.00
Rate for Payer: UnitedHealthcare Community & State	$85.32
Rate for Payer: Wellpoint Medicaid Managed Care	$76.68

Know your out-of-pocket cost for care.

All Charges