Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL TAPERED STEM STD-SZ 11

Facility

$7,170.00

Hospital Charge Code	270669090
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 11

Facility

$7,170.00

Hospital Charge Code	270669090
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 12

Facility

$7,170.00

Hospital Charge Code	270669091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 12

Facility

$7,170.00

Hospital Charge Code	270669091
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 2

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669081
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 2

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669081
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 3

Facility

$7,170.00

Hospital Charge Code	270669082
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 3

Facility

$7,170.00

Hospital Charge Code	270669082
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 4

Facility

$7,170.00

Hospital Charge Code	270669083
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 4

Facility

$7,170.00

Hospital Charge Code	270669083
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 5

Facility

$7,170.00

Hospital Charge Code	270669084
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 5

Facility

$7,170.00

Hospital Charge Code	270669084
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 6

Facility

$7,170.00

Hospital Charge Code	270669085
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 6

Facility

$7,170.00

Hospital Charge Code	270669085
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 7

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 7

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669086
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 8

Facility

$7,170.00

Hospital Charge Code	270669087
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAPERED STEM STD-SZ 8

Facility

$7,170.00

Hospital Charge Code	270669087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 9

Facility

$7,170.00

Hospital Charge Code	270669088
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAPERED STEM STD-SZ 9

Facility

$7,170.00

Hospital Charge Code	270669088
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAP STEM EXT OFF-SZ 1

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669092
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAP STEM EXT OFF-SZ 1

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669092
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAP STEM EXT OFF-SZ 10

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669101
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

FEMORAL TAP STEM EXT OFF-SZ 10

Facility

$7,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270669101
Hospital Revenue Code	278
Min. Negotiated Rate	$203.63
Max. Negotiated Rate	$3,585.00
Rate for Payer: Aetna Commercial	$2,724.60
Rate for Payer: Aetna Medicare Advantage	$2,151.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,828.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,828.35
Rate for Payer: Cigna Commercial	$3,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50
Rate for Payer: UnitedHealthcare Community & State	$226.57
Rate for Payer: Wellpoint Medicaid Managed Care	$203.63

FEMORAL TAP STEM EXT OFF-SZ 11

Facility

$7,170.00

Hospital Charge Code	270669102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,075.50
Max. Negotiated Rate	$1,735.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,434.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,075.50

Know your out-of-pocket cost for care.

All Charges