Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FUSION IMPLANT PROXIMAL 2.8MM

Facility

$1,300.00

Hospital Charge Code	270669818
Hospital Revenue Code	278
Min. Negotiated Rate	$36.92
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$41.08
Rate for Payer: Wellpoint Medicaid Managed Care	$36.92

FUSION IMPLANT PROXIMAL 2.8MM

Facility

$1,300.00

Hospital Charge Code	270669818
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

FUSION IMP MID PHALANX 3.8X6MM

Facility

$1,300.00

Hospital Charge Code	270669817
Hospital Revenue Code	278
Min. Negotiated Rate	$36.92
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$41.08
Rate for Payer: Wellpoint Medicaid Managed Care	$36.92

FUSION IMP MID PHALANX 3.8X6MM

Facility

$1,300.00

Hospital Charge Code	270669817
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

FUSION IPJ

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270690330
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

FUSION IPJ

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270690330
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

FUSION OF STOMACH AND BOWEL

Facility

$7,177.00

Service Code	HCPCS 43820
Hospital Charge Code	1600000637
Hospital Revenue Code	360
Min. Negotiated Rate	$203.83
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,727.26
Rate for Payer: Aetna Medicare Advantage	$2,153.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,830.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,830.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,830.13
Rate for Payer: Cigna Commercial	$3,588.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.02
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,076.55
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$226.79
Rate for Payer: Wellpoint Medicaid Managed Care	$203.83

FUSION OF STOMACH AND BOWEL

Facility

$7,177.00

Service Code	HCPCS 43820
Hospital Charge Code	1600000637
Hospital Revenue Code	360
Min. Negotiated Rate	$1,076.55
Max. Negotiated Rate	$1,076.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,076.55

FX BRIDGE TUBEROSITY REPAIR

Facility

$4,000.00

Hospital Charge Code	270703189
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

FX BRIDGE TUBEROSITY REPAIR

Facility

$4,000.00

Hospital Charge Code	270703189
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

G-6-PD,RBC

Facility

$390.00

Service Code	HCPCS 82955
Hospital Charge Code	39900087
Hospital Revenue Code	301
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$26.38
Rate for Payer: Aetna Medicare Advantage	$31.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.70
Rate for Payer: Clover Medicare Advantage	$9.21
Rate for Payer: EmblemHealth Commercial	$29.10
Rate for Payer: Humana Medicare Advantage	$9.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.70
Rate for Payer: Wellcare Medicare Advantage	$9.70
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

G-6-PD,RBC

Facility

$390.00

Service Code	HCPCS 82955
Hospital Charge Code	39900087
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

G7 ACETABULAR LINER HIGH WALL

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685251
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

G7 ACETABULAR LINER HIGH WALL

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270685251
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

G7 DUAL MOBILITY LINER 44MM F

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680810
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

G7 DUAL MOBILITY LINER 44MM F

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680810
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

G7 DUAL MOBILITY LINER 46MM G

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686368
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

G7 DUAL MOBILITY LINER 46MM G

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686368
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

G7 FINNED 3 HOLE SHELL 48C

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688750
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

G7 FINNED 3 HOLE SHELL 48C

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688750
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

G7 FINNED 3 HOLE SHELL 50D Q

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684058
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

G7 FINNED 3 HOLE SHELL 50D Q

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684058
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

G7 FINNED 4 HOLE SHELL 54F

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680824
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

G7 FINNED 4 HOLE SHELL 54F

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680824
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

G7 FINNED 4 HOLE SHELL 56F

Facility

$6,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681899
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

Know your out-of-pocket cost for care.

All Charges