Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FEM DISTAL VANGUARD 65 X 5

Facility

$6,090.00

Service Code	HCPCS C1776
Hospital Charge Code	270692338
Hospital Revenue Code	278
Min. Negotiated Rate	$172.96
Max. Negotiated Rate	$3,045.00
Rate for Payer: Aetna Commercial	$2,314.20
Rate for Payer: Aetna Medicare Advantage	$1,827.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,552.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,552.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,552.95
Rate for Payer: Cigna Commercial	$3,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.78
Rate for Payer: Qualcare PPO/HMO/WC	$913.50
Rate for Payer: UnitedHealthcare Community & State	$192.44
Rate for Payer: Wellpoint Medicaid Managed Care	$172.96

FEM DISTAL VANGUARD 65 X 5

Facility

$6,090.00

Service Code	HCPCS C1776
Hospital Charge Code	270692338
Hospital Revenue Code	278
Min. Negotiated Rate	$913.50
Max. Negotiated Rate	$1,473.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.78
Rate for Payer: Qualcare PPO/HMO/WC	$913.50

Femerol Head 28 medium

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677406
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

Femerol Head 28 medium

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677406
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

FEM HD ARTIC 28MM 12/14 TAP

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270657701
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

FEM HD ARTIC 28MM 12/14 TAP

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270657701
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

FEM HD TYP1 TAPER 3MM NECK

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695267
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

FEM HD TYP1 TAPER 3MM NECK

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695267
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

FEM. HEAD 36MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703611
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

FEM. HEAD 36MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703611
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

FEM HEAD 36MM +8MMREF397164795

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703599
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

FEM HEAD 36MM +8MMREF397164795

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703599
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

FEM HEAD BALL EZE 28MM 12/14

Facility

$2,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270698951
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

FEM HEAD BALL EZE 28MM 12/14

Facility

$2,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270698951
Hospital Revenue Code	278
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$82.95
Rate for Payer: Wellpoint Medicaid Managed Care	$74.55

FEM HEAD BIOLOX UNI TAPER SZ40

Facility

$4,686.15

Service Code	HCPCS C1776
Hospital Charge Code	270697194
Hospital Revenue Code	278
Min. Negotiated Rate	$702.92
Max. Negotiated Rate	$1,134.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$937.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,134.05
Rate for Payer: Qualcare PPO/HMO/WC	$702.92

FEM HEAD BIOLOX UNI TAPER SZ40

Facility

$4,686.15

Service Code	HCPCS C1776
Hospital Charge Code	270697194
Hospital Revenue Code	278
Min. Negotiated Rate	$133.09
Max. Negotiated Rate	$2,343.07
Rate for Payer: Aetna Commercial	$1,780.74
Rate for Payer: Aetna Medicare Advantage	$1,405.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,194.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,194.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$937.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,194.97
Rate for Payer: Cigna Commercial	$2,343.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,134.05
Rate for Payer: Qualcare PPO/HMO/WC	$702.92
Rate for Payer: UnitedHealthcare Community & State	$148.08
Rate for Payer: Wellpoint Medicaid Managed Care	$133.09

FEM HEAD CERAM C-TPR 2.5X36MM

Facility

$4,799.25

Service Code	HCPCS C1776
Hospital Charge Code	270693125
Hospital Revenue Code	278
Min. Negotiated Rate	$719.89
Max. Negotiated Rate	$1,161.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$959.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.42
Rate for Payer: Qualcare PPO/HMO/WC	$719.89

FEM HEAD CERAM C-TPR 2.5X36MM

Facility

$4,799.25

Service Code	HCPCS C1776
Hospital Charge Code	270693125
Hospital Revenue Code	278
Min. Negotiated Rate	$136.30
Max. Negotiated Rate	$2,399.62
Rate for Payer: Aetna Commercial	$1,823.71
Rate for Payer: Aetna Medicare Advantage	$1,439.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,223.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,223.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$959.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,223.81
Rate for Payer: Cigna Commercial	$2,399.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.42
Rate for Payer: Qualcare PPO/HMO/WC	$719.89
Rate for Payer: UnitedHealthcare Community & State	$151.66
Rate for Payer: Wellpoint Medicaid Managed Care	$136.30

FEM HEAD CER BIOLOX S TAP 28MM

Facility

$9,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270694816
Hospital Revenue Code	278
Min. Negotiated Rate	$283.72
Max. Negotiated Rate	$4,995.00
Rate for Payer: Aetna Commercial	$3,796.20
Rate for Payer: Aetna Medicare Advantage	$2,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,547.45
Rate for Payer: Cigna Commercial	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50
Rate for Payer: UnitedHealthcare Community & State	$315.68
Rate for Payer: Wellpoint Medicaid Managed Care	$283.72

FEM HEAD CER BIOLOX S TAP 28MM

Facility

$9,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270694816
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.50
Max. Negotiated Rate	$2,417.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50

FEM NAIL RETRO 10.5MM X 300MM

Facility

$7,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270681041
Hospital Revenue Code	278
Min. Negotiated Rate	$214.70
Max. Negotiated Rate	$3,780.00
Rate for Payer: Aetna Commercial	$2,872.80
Rate for Payer: Aetna Medicare Advantage	$2,268.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,927.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,927.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,927.80
Rate for Payer: Cigna Commercial	$3,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,829.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.00
Rate for Payer: UnitedHealthcare Community & State	$238.90
Rate for Payer: Wellpoint Medicaid Managed Care	$214.70

FEM NAIL RETRO 10.5MM X 300MM

Facility

$7,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270681041
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.00
Max. Negotiated Rate	$1,829.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,829.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.00

FEM NAIL RETRO 13.5MMX380MM

Facility

$8,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270691622
Hospital Revenue Code	278
Min. Negotiated Rate	$232.17
Max. Negotiated Rate	$4,087.50
Rate for Payer: Aetna Commercial	$3,106.50
Rate for Payer: Aetna Medicare Advantage	$2,452.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,084.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,084.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,084.62
Rate for Payer: Cigna Commercial	$4,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,978.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,226.25
Rate for Payer: UnitedHealthcare Community & State	$258.33
Rate for Payer: Wellpoint Medicaid Managed Care	$232.17

FEM NAIL RETRO 13.5MMX380MM

Facility

$8,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270691622
Hospital Revenue Code	278
Min. Negotiated Rate	$1,226.25
Max. Negotiated Rate	$1,978.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,978.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,226.25

FEMORAL ASYM POST STAB SZ 3 LF

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270670657
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

Know your out-of-pocket cost for care.

All Charges