Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL POSTERIOR STAB. SZ3 RT

Facility

$9,475.20

Hospital Charge Code	270670881
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.28
Max. Negotiated Rate	$2,293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,293.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.28

FEMORAL POSTERIOR STAB. SZ3 RT

Facility

$9,475.20

Hospital Charge Code	270670881
Hospital Revenue Code	278
Min. Negotiated Rate	$269.10
Max. Negotiated Rate	$4,737.60
Rate for Payer: Aetna Commercial	$3,600.58
Rate for Payer: Aetna Medicare Advantage	$2,842.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.18
Rate for Payer: Cigna Commercial	$4,737.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,293.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.28
Rate for Payer: UnitedHealthcare Community & State	$299.42
Rate for Payer: Wellpoint Medicaid Managed Care	$269.10

FEMORAL POSTERIOR SZ3 5MM SRW

Facility

$5,445.00

Service Code	HCPCS C1776
Hospital Charge Code	270668741
Hospital Revenue Code	278
Min. Negotiated Rate	$816.75
Max. Negotiated Rate	$1,317.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,089.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,317.69
Rate for Payer: Qualcare PPO/HMO/WC	$816.75

FEMORAL POSTERIOR SZ3 5MM SRW

Facility

$5,445.00

Service Code	HCPCS C1776
Hospital Charge Code	270668741
Hospital Revenue Code	278
Min. Negotiated Rate	$154.64
Max. Negotiated Rate	$2,722.50
Rate for Payer: Aetna Commercial	$2,069.10
Rate for Payer: Aetna Medicare Advantage	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,388.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,388.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,388.47
Rate for Payer: Cigna Commercial	$2,722.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,317.69
Rate for Payer: Qualcare PPO/HMO/WC	$816.75
Rate for Payer: UnitedHealthcare Community & State	$172.06
Rate for Payer: Wellpoint Medicaid Managed Care	$154.64

FEMORAL POSTERIOR SZ 7 PS

Facility

$7,524.55

Service Code	HCPCS C1776
Hospital Charge Code	270681040
Hospital Revenue Code	278
Min. Negotiated Rate	$213.70
Max. Negotiated Rate	$3,762.28
Rate for Payer: Aetna Commercial	$2,859.33
Rate for Payer: Aetna Medicare Advantage	$2,257.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,918.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,918.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,504.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,918.76
Rate for Payer: Cigna Commercial	$3,762.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,820.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,128.68
Rate for Payer: UnitedHealthcare Community & State	$237.78
Rate for Payer: Wellpoint Medicaid Managed Care	$213.70

FEMORAL POSTERIOR SZ 7 PS

Facility

$7,524.55

Service Code	HCPCS C1776
Hospital Charge Code	270681040
Hospital Revenue Code	278
Min. Negotiated Rate	$1,128.68
Max. Negotiated Rate	$1,820.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,504.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,820.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,128.68

FEMORAL POST STAB SZ 2 LT

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270675278
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

FEMORAL POST STAB SZ 2 LT

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270675278
Hospital Revenue Code	278
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

FEMORAL POST STAB SZ 4 LF

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673793
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

FEMORAL POST STAB SZ 4 LF

Facility

$5,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673793
Hospital Revenue Code	278
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

FEMORAL POST STAB. SZ4 RIGHT

Facility

$8,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270669599
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,966.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

FEMORAL POST STAB. SZ4 RIGHT

Facility

$8,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270669599
Hospital Revenue Code	278
Min. Negotiated Rate	$230.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$3,087.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Community & State	$256.75
Rate for Payer: Wellpoint Medicaid Managed Care	$230.75

FEMORAL PREP KIT SZ4 CR

Facility

$2,340.00

Hospital Charge Code	270698200
Hospital Revenue Code	272
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$351.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

FEMORAL PREP KIT SZ4 CR

Facility

$2,340.00

Hospital Charge Code	270698200
Hospital Revenue Code	272
Min. Negotiated Rate	$66.46
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$889.20
Rate for Payer: Aetna Medicare Advantage	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$596.70
Rate for Payer: Cigna Commercial	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.40
Rate for Payer: Oxford Commercial	$468.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00
Rate for Payer: UnitedHealthcare Commercial	$468.00
Rate for Payer: UnitedHealthcare Community & State	$73.94
Rate for Payer: Wellpoint Medicaid Managed Care	$66.46

FEMORAL PREP KIT SZ5 CR

Facility

$2,340.00

Hospital Charge Code	270698202
Hospital Revenue Code	272
Min. Negotiated Rate	$66.46
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$889.20
Rate for Payer: Aetna Medicare Advantage	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$596.70
Rate for Payer: Cigna Commercial	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.40
Rate for Payer: Oxford Commercial	$468.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00
Rate for Payer: UnitedHealthcare Commercial	$468.00
Rate for Payer: UnitedHealthcare Community & State	$73.94
Rate for Payer: Wellpoint Medicaid Managed Care	$66.46

FEMORAL PREP KIT SZ5 CR

Facility

$2,340.00

Hospital Charge Code	270698202
Hospital Revenue Code	272
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$351.00
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

FEMORAL PROXIMAL HIGH OFFSET

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270690936
Hospital Revenue Code	278
Min. Negotiated Rate	$5,431.50
Max. Negotiated Rate	$8,762.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50

FEMORAL PROXIMAL HIGH OFFSET

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270690936
Hospital Revenue Code	278
Min. Negotiated Rate	$1,028.36
Max. Negotiated Rate	$18,105.00
Rate for Payer: Aetna Commercial	$13,759.80
Rate for Payer: Aetna Medicare Advantage	$10,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,233.55
Rate for Payer: Cigna Commercial	$18,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50
Rate for Payer: UnitedHealthcare Community & State	$1,144.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1,028.36

FEMORAL P/S 67.5mm LEFT

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270642378
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

FEMORAL P/S 67.5mm LEFT

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270642378
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FEMORAL PS 67.5RIGHT 183110

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270636754
Hospital Revenue Code	278
Min. Negotiated Rate	$489.33
Max. Negotiated Rate	$8,615.00
Rate for Payer: Aetna Commercial	$6,547.40
Rate for Payer: Aetna Medicare Advantage	$5,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,393.65
Rate for Payer: Cigna Commercial	$8,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50
Rate for Payer: UnitedHealthcare Community & State	$544.47
Rate for Payer: Wellpoint Medicaid Managed Care	$489.33

FEMORAL PS 67.5RIGHT 183110

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270636754
Hospital Revenue Code	278
Min. Negotiated Rate	$2,584.50
Max. Negotiated Rate	$4,169.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50

FEMORAL PS 72.5mm RIGHT

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270667611
Hospital Revenue Code	278
Min. Negotiated Rate	$2,584.50
Max. Negotiated Rate	$4,169.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50

FEMORAL PS 72.5mm RIGHT

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270667611
Hospital Revenue Code	278
Min. Negotiated Rate	$489.33
Max. Negotiated Rate	$8,615.00
Rate for Payer: Aetna Commercial	$6,547.40
Rate for Payer: Aetna Medicare Advantage	$5,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,393.65
Rate for Payer: Cigna Commercial	$8,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50
Rate for Payer: UnitedHealthcare Community & State	$544.47
Rate for Payer: Wellpoint Medicaid Managed Care	$489.33

FEMORAL PS ATTUNE 52 MM 7 RT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686059
Hospital Revenue Code	278
Min. Negotiated Rate	$326.60
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$363.40
Rate for Payer: Wellpoint Medicaid Managed Care	$326.60

Know your out-of-pocket cost for care.

All Charges