Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL HEAD CERAMIC V40 36 MM

Facility

$4,154.40

Service Code	HCPCS C1776
Hospital Charge Code	270691026
Hospital Revenue Code	278
Min. Negotiated Rate	$117.98
Max. Negotiated Rate	$2,077.20
Rate for Payer: Aetna Commercial	$1,578.67
Rate for Payer: Aetna Medicare Advantage	$1,246.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,059.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,059.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$830.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,059.37
Rate for Payer: Cigna Commercial	$2,077.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.36
Rate for Payer: Qualcare PPO/HMO/WC	$623.16
Rate for Payer: UnitedHealthcare Community & State	$131.28
Rate for Payer: Wellpoint Medicaid Managed Care	$117.98

FEMORAL HEAD CERAMIC V40 36 MM

Facility

$4,154.40

Service Code	HCPCS C1776
Hospital Charge Code	270691026
Hospital Revenue Code	278
Min. Negotiated Rate	$623.16
Max. Negotiated Rate	$1,005.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$830.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.36
Rate for Payer: Qualcare PPO/HMO/WC	$623.16

FEMORAL HEAD COCR 28M/-3.5

Facility

$1,795.00

Hospital Charge Code	270669108
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 28M/-3.5

Facility

$1,795.00

Hospital Charge Code	270669108
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 28MM/0

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669104
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 28MM/0

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669104
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 28MM/+10.5

Facility

$1,795.00

Hospital Charge Code	270669107
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 28MM/+10.5

Facility

$1,795.00

Hospital Charge Code	270669107
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 28MM/+3.5

Facility

$1,795.00

Hospital Charge Code	270669105
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 28MM/+3.5

Facility

$1,795.00

Hospital Charge Code	270669105
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 28MM/+7

Facility

$1,795.00

Hospital Charge Code	270669106
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 28MM/+7

Facility

$1,795.00

Hospital Charge Code	270669106
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/0

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669109
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 32MM/0

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669109
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/+10.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669112
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/+10.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669112
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 32MM/+3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669110
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/+3.5

Facility

$1,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270669110
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 32MM/-3.5

Facility

$1,795.00

Hospital Charge Code	270669113
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR 32MM/-3.5

Facility

$1,795.00

Hospital Charge Code	270669113
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 32MM/+7

Facility

$1,795.00

Hospital Charge Code	270669111
Hospital Revenue Code	278
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Community & State	$56.72
Rate for Payer: Wellpoint Medicaid Managed Care	$50.98

FEMORAL HEAD COCR 32MM/+7

Facility

$1,795.00

Hospital Charge Code	270669111
Hospital Revenue Code	278
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$434.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$434.39
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

FEMORAL HEAD COCR -3.5MM 28MM

Facility

$2,175.00

Hospital Charge Code	270669543
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

FEMORAL HEAD COCR -3.5MM 28MM

Facility

$2,175.00

Hospital Charge Code	270669543
Hospital Revenue Code	278
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$68.73
Rate for Payer: Wellpoint Medicaid Managed Care	$61.77

FEMORAL HEAD COCR 3.5MM 36MM

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270669368
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

Know your out-of-pocket cost for care.

All Charges