Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALLOGRAFT AMNIOTIC MEMBRANE4X4

Facility

$9,330.00

Service Code	HCPCS Q4100
Hospital Charge Code	270660633W
Hospital Revenue Code	636
Min. Negotiated Rate	$264.97
Max. Negotiated Rate	$4,665.00
Rate for Payer: Aetna Commercial	$3,545.40
Rate for Payer: Aetna Medicare Advantage	$2,799.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,379.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,379.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,379.15
Rate for Payer: Cigna Commercial	$4,665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,257.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,399.50
Rate for Payer: UnitedHealthcare Community & State	$294.83
Rate for Payer: Wellpoint Medicaid Managed Care	$264.97

ALLOGRAFT AMNIOTIC MENBRANE

Facility

$9,170.00

Service Code	HCPCS Q4100
Hospital Charge Code	270664960
Hospital Revenue Code	636
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$2,219.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

ALLOGRAFT AMNIOTIC MENBRANE

Facility

$9,170.00

Service Code	HCPCS Q4100
Hospital Charge Code	270664960
Hospital Revenue Code	636
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

ALLOGRAFTBIOVANCEAMNMEM2X3CM

Facility

$5,750.00

Service Code	HCPCS Q4154
Hospital Charge Code	270698089
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

ALLOGRAFTBIOVANCEAMNMEM2X3CM

Facility

$5,750.00

Service Code	HCPCS Q4154
Hospital Charge Code	270698089
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,391.50
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
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	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
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: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

ALLOGRAFTBIOVANCEAMNMEM2X4CM

Facility

$7,000.00

Service Code	HCPCS Q4154
Hospital Charge Code	270698090
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

ALLOGRAFTBIOVANCEAMNMEM2X4CM

Facility

$7,000.00

Service Code	HCPCS Q4154
Hospital Charge Code	270698090
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,694.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$221.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$198.80

ALLOGRAFT BONE MARTIX LG

Facility

$28,425.00

Service Code	HCPCS C1762
Hospital Charge Code	270667320
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.75
Max. Negotiated Rate	$6,878.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,878.85
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.75

ALLOGRAFT BONE MARTIX LG

Facility

$28,425.00

Service Code	HCPCS C1762
Hospital Charge Code	270667320
Hospital Revenue Code	278
Min. Negotiated Rate	$807.27
Max. Negotiated Rate	$14,212.50
Rate for Payer: Aetna Commercial	$10,801.50
Rate for Payer: Aetna Medicare Advantage	$8,527.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,248.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,248.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,248.38
Rate for Payer: Cigna Commercial	$14,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,878.85
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.75
Rate for Payer: UnitedHealthcare Community & State	$898.23
Rate for Payer: Wellpoint Medicaid Managed Care	$807.27

ALLOGRAFT BONUS TRIAD 5CC

Facility

$14,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270689827
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

ALLOGRAFT BONUS TRIAD 5CC

Facility

$14,750.00

Service Code	HCPCS C1762
Hospital Charge Code	270689827
Hospital Revenue Code	278
Min. Negotiated Rate	$418.90
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$5,605.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50
Rate for Payer: UnitedHealthcare Community & State	$466.10
Rate for Payer: Wellpoint Medicaid Managed Care	$418.90

ALLOGRAFT CANC CRUSHED 30CC

Facility

$3,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270700444
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

ALLOGRAFT CANC CRUSHED 30CC

Facility

$3,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270700444
Hospital Revenue Code	278
Min. Negotiated Rate	$109.34
Max. Negotiated Rate	$1,925.00
Rate for Payer: Aetna Commercial	$1,463.00
Rate for Payer: Aetna Medicare Advantage	$1,155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$981.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$981.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$981.75
Rate for Payer: Cigna Commercial	$1,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50
Rate for Payer: UnitedHealthcare Community & State	$121.66
Rate for Payer: Wellpoint Medicaid Managed Care	$109.34

ALLOGRAFT DBM+CCC 10CC

Facility

$12,006.25

Service Code	HCPCS C1762
Hospital Charge Code	270670544
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.94
Max. Negotiated Rate	$2,905.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,401.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,905.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.94

ALLOGRAFT DBM+CCC 10CC

Facility

$12,006.25

Service Code	HCPCS C1762
Hospital Charge Code	270670544
Hospital Revenue Code	278
Min. Negotiated Rate	$340.98
Max. Negotiated Rate	$6,003.12
Rate for Payer: Aetna Commercial	$4,562.38
Rate for Payer: Aetna Medicare Advantage	$3,601.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,061.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,061.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,401.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,061.59
Rate for Payer: Cigna Commercial	$6,003.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,905.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.94
Rate for Payer: UnitedHealthcare Community & State	$379.40
Rate for Payer: Wellpoint Medicaid Managed Care	$340.98

ALLOGRAFT EVANS WEDGE 10X22X20

Facility

$12,705.00

Service Code	HCPCS C1713
Hospital Charge Code	270678562
Hospital Revenue Code	278
Min. Negotiated Rate	$360.82
Max. Negotiated Rate	$6,352.50
Rate for Payer: Aetna Commercial	$4,827.90
Rate for Payer: Aetna Medicare Advantage	$3,811.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,239.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,239.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,239.78
Rate for Payer: Cigna Commercial	$6,352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,074.61
Rate for Payer: Qualcare PPO/HMO/WC	$1,905.75
Rate for Payer: UnitedHealthcare Community & State	$401.48
Rate for Payer: Wellpoint Medicaid Managed Care	$360.82

ALLOGRAFT EVANS WEDGE 10X22X20

Facility

$12,705.00

Service Code	HCPCS C1713
Hospital Charge Code	270678562
Hospital Revenue Code	278
Min. Negotiated Rate	$1,905.75
Max. Negotiated Rate	$3,074.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,541.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,074.61
Rate for Payer: Qualcare PPO/HMO/WC	$1,905.75

ALLOGRAFT EVANS WEDGE 12X22X20

Facility

$8,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270681217
Hospital Revenue Code	278
Min. Negotiated Rate	$237.42
Max. Negotiated Rate	$4,180.00
Rate for Payer: Aetna Commercial	$3,176.80
Rate for Payer: Aetna Medicare Advantage	$2,508.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,131.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,131.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,131.80
Rate for Payer: Cigna Commercial	$4,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,023.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,254.00
Rate for Payer: UnitedHealthcare Community & State	$264.18
Rate for Payer: Wellpoint Medicaid Managed Care	$237.42

ALLOGRAFT EVANS WEDGE 12X22X20

Facility

$8,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270681217
Hospital Revenue Code	278
Min. Negotiated Rate	$1,254.00
Max. Negotiated Rate	$2,023.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,672.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,023.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,254.00

ALLOGRAFT EVANS WEDGE 8X22X20m

Facility

$7,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270674060
Hospital Revenue Code	278
Min. Negotiated Rate	$1,155.00
Max. Negotiated Rate	$1,863.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00

ALLOGRAFT EVANS WEDGE 8X22X20m

Facility

$7,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270674060
Hospital Revenue Code	278
Min. Negotiated Rate	$218.68
Max. Negotiated Rate	$3,850.00
Rate for Payer: Aetna Commercial	$2,926.00
Rate for Payer: Aetna Medicare Advantage	$2,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,963.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,963.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,963.50
Rate for Payer: Cigna Commercial	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,863.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,155.00
Rate for Payer: UnitedHealthcare Community & State	$243.32
Rate for Payer: Wellpoint Medicaid Managed Care	$218.68

ALLOGRAFTFEMCNDYLEHEMILFMEDFSH

Facility

$56,209.50

Service Code	HCPCS C1762
Hospital Charge Code	270695271
Hospital Revenue Code	278
Min. Negotiated Rate	$8,431.42
Max. Negotiated Rate	$13,602.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,241.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,602.70
Rate for Payer: Qualcare PPO/HMO/WC	$8,431.42

ALLOGRAFTFEMCNDYLEHEMILFMEDFSH

Facility

$56,209.50

Service Code	HCPCS C1762
Hospital Charge Code	270695271
Hospital Revenue Code	278
Min. Negotiated Rate	$1,596.35
Max. Negotiated Rate	$28,104.75
Rate for Payer: Aetna Commercial	$21,359.61
Rate for Payer: Aetna Medicare Advantage	$16,862.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,333.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,333.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,241.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,333.42
Rate for Payer: Cigna Commercial	$28,104.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,602.70
Rate for Payer: Qualcare PPO/HMO/WC	$8,431.42
Rate for Payer: UnitedHealthcare Community & State	$1,776.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1,596.35

ALLOGRAFT FLOW 10CC FD

Facility

$4,025.00

Hospital Charge Code	270671269
Hospital Revenue Code	278
Min. Negotiated Rate	$114.31
Max. Negotiated Rate	$2,012.50
Rate for Payer: Aetna Commercial	$1,529.50
Rate for Payer: Aetna Medicare Advantage	$1,207.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,026.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,026.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,026.38
Rate for Payer: Cigna Commercial	$2,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$974.05
Rate for Payer: Qualcare PPO/HMO/WC	$603.75
Rate for Payer: UnitedHealthcare Community & State	$127.19
Rate for Payer: Wellpoint Medicaid Managed Care	$114.31

ALLOGRAFT FLOW 10CC FD

Facility

$4,025.00

Hospital Charge Code	270671269
Hospital Revenue Code	278
Min. Negotiated Rate	$603.75
Max. Negotiated Rate	$974.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$974.05
Rate for Payer: Qualcare PPO/HMO/WC	$603.75

Know your out-of-pocket cost for care.

All Charges