Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FEMUR MIN 2 VIEWS LT

Facility

$6,601.19

Service Code	HCPCS 73552LT
Hospital Charge Code	2011552
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FEMUR MIN 2 VIEWS LT

Facility

$358.23

Service Code	HCPCS 73552LT
Hospital Charge Code	75190644
Hospital Revenue Code	320
Min. Negotiated Rate	$10.17
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$136.13
Rate for Payer: Aetna Medicare Advantage	$107.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.35
Rate for Payer: Cigna Commercial	$179.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.73
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$11.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.17

FEMUR MIN 2 VIEWS LT

Facility

$6,601.19

Service Code	HCPCS 73552LT
Hospital Charge Code	94061491
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FEMUR MIN 2 VIEWS LT

Facility

$358.23

Service Code	HCPCS 73552LT
Hospital Charge Code	94270271
Hospital Revenue Code	320
Min. Negotiated Rate	$10.17
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$136.13
Rate for Payer: Aetna Medicare Advantage	$107.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.35
Rate for Payer: Cigna Commercial	$179.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.73
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$11.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.17

FEMUR MIN 2 VIEWS LT

Facility

$6,601.19

Service Code	HCPCS 73552LT
Hospital Charge Code	2011552
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FEMUR MIN 2 VIEWS RT

Facility

$358.23

Service Code	HCPCS 73552RT
Hospital Charge Code	75190646
Hospital Revenue Code	320
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$53.73
Rate for Payer: Qualcare PPO/HMO/WC	$53.73

FEMUR MIN 2 VIEWS RT

Facility

$358.23

Service Code	HCPCS 73552RT
Hospital Charge Code	75190646
Hospital Revenue Code	320
Min. Negotiated Rate	$10.17
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$136.13
Rate for Payer: Aetna Medicare Advantage	$107.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.35
Rate for Payer: Cigna Commercial	$179.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.73
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$11.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.17

FEMUR MIN 2 VIEWS RT

Facility

$6,601.19

Service Code	HCPCS 73552RT
Hospital Charge Code	2011554
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FEMUR MIN 2 VIEWS RT

Facility

$6,601.19

Service Code	HCPCS 73552RT
Hospital Charge Code	2011554
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FEMUR MIN 2 VIEWS RT

Facility

$6,601.19

Service Code	HCPCS 73552RT
Hospital Charge Code	94061493
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

FEMUR MIN 2 VIEWS RT

Facility

$358.23

Service Code	HCPCS 73552RT
Hospital Charge Code	94270273
Hospital Revenue Code	320
Min. Negotiated Rate	$10.17
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$136.13
Rate for Payer: Aetna Medicare Advantage	$107.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.35
Rate for Payer: Cigna Commercial	$179.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.14
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.73
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$11.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.17

FEMUR MIN 2 VIEWS RT

Facility

$6,601.19

Service Code	HCPCS 73552RT
Hospital Charge Code	94061493
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

FEMUR MIN 2 VIEWS RT

Facility

$358.23

Service Code	HCPCS 73552RT
Hospital Charge Code	94270273
Hospital Revenue Code	320
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$53.73
Rate for Payer: Qualcare PPO/HMO/WC	$53.73

FEMUR MOD AVENIR CMP HA SZ1

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270696897
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

FEMUR MOD AVENIR CMP HA SZ1

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270696897
Hospital Revenue Code	278
Min. Negotiated Rate	$419.97
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$467.29
Rate for Payer: Wellpoint Medicaid Managed Care	$419.97

FEMUR NONPOR CEMENTED SZ2 RT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697280
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

FEMUR NONPOR CEMENTED SZ2 RT

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697280
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

FEMUR NONPOROUS SZ 1

Facility

$6,000.00

Hospital Charge Code	270672547
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

FEMUR NONPOROUS SZ 1

Facility

$6,000.00

Hospital Charge Code	270672547
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMUR NONPOROUS SZ 2

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672548
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

FEMUR NONPOROUS SZ 2

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672548
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMUR NONPOROUS SZ 3

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672549
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

FEMUR NONPOROUS SZ 3

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672549
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMUR NONPOROUS SZ 4

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672550
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

FEMUR NONPOROUS SZ 4

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672550
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