Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HEAD HUMERAL 54MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676518
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

HEAD HUMERAL 54x21MM

Facility

$8,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270672693
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

HEAD HUMERAL 54x21MM

Facility

$8,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270672693
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

HEAD HUMERAL SHORT 41 x 16MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270681774
Hospital Revenue Code	278
Min. Negotiated Rate	$219.39
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,935.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75
Rate for Payer: UnitedHealthcare Community & State	$244.11
Rate for Payer: Wellpoint Medicaid Managed Care	$219.39

HEAD HUMERAL SHORT 41 x 16MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270681774
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HEAD HUMERAL SHORT 41 x 17MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270682810
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HEAD HUMERAL SHORT 41 x 17MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270682810
Hospital Revenue Code	278
Min. Negotiated Rate	$219.39
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,935.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75
Rate for Payer: UnitedHealthcare Community & State	$244.11
Rate for Payer: Wellpoint Medicaid Managed Care	$219.39

HEAD HUMERAL SHORT 50 x19 MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270686662
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HEAD HUMERAL SHORT 50 x19 MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270686662
Hospital Revenue Code	278
Min. Negotiated Rate	$219.39
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,935.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75
Rate for Payer: UnitedHealthcare Community & State	$244.11
Rate for Payer: Wellpoint Medicaid Managed Care	$219.39

HEAD HUM VERADIAL 38X19X39MM

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687324
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

HEAD HUM VERADIAL 38X19X39MM

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687324
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

HEAD HUM VERSA DIAL COMP 54MM

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692397
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

HEAD HUM VERSA DIAL COMP 54MM

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692397
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

HEAD IMPACTOR

Facility

$1,600.00

Hospital Charge Code	270688837
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

HEAD IMPACTOR

Facility

$1,600.00

Hospital Charge Code	270688837
Hospital Revenue Code	278
Min. Negotiated Rate	$45.44
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$50.56
Rate for Payer: Wellpoint Medicaid Managed Care	$45.44

HEAD LEFT 24 MM TR

Facility

$17,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270682763
Hospital Revenue Code	278
Min. Negotiated Rate	$504.81
Max. Negotiated Rate	$8,887.50
Rate for Payer: Aetna Commercial	$6,754.50
Rate for Payer: Aetna Medicare Advantage	$5,332.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,532.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,532.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,532.62
Rate for Payer: Cigna Commercial	$8,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,301.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,666.25
Rate for Payer: UnitedHealthcare Community & State	$561.69
Rate for Payer: Wellpoint Medicaid Managed Care	$504.81

HEAD LEFT 24 MM TR

Facility

$17,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270682763
Hospital Revenue Code	278
Min. Negotiated Rate	$2,666.25
Max. Negotiated Rate	$4,301.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,301.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,666.25

HEADLESS BIPOLAR 32 MM

Facility

$8,286.00

Service Code	HCPCS C1776
Hospital Charge Code	270689637
Hospital Revenue Code	278
Min. Negotiated Rate	$1,242.90
Max. Negotiated Rate	$2,005.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,657.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,005.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.90

HEADLESS BIPOLAR 32 MM

Facility

$8,286.00

Service Code	HCPCS C1776
Hospital Charge Code	270689637
Hospital Revenue Code	278
Min. Negotiated Rate	$235.32
Max. Negotiated Rate	$4,143.00
Rate for Payer: Aetna Commercial	$3,148.68
Rate for Payer: Aetna Medicare Advantage	$2,485.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,112.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,112.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,657.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,112.93
Rate for Payer: Cigna Commercial	$4,143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,005.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.90
Rate for Payer: UnitedHealthcare Community & State	$261.84
Rate for Payer: Wellpoint Medicaid Managed Care	$235.32

HEADLESS COMPRES SCRW 4.3X46MM

Facility

$1,931.25

Service Code	HCPCS C1713
Hospital Charge Code	270702071
Hospital Revenue Code	278
Min. Negotiated Rate	$289.69
Max. Negotiated Rate	$467.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.36
Rate for Payer: Qualcare PPO/HMO/WC	$289.69

HEADLESS COMPRES SCRW 4.3X46MM

Facility

$1,931.25

Service Code	HCPCS C1713
Hospital Charge Code	270702071
Hospital Revenue Code	278
Min. Negotiated Rate	$54.85
Max. Negotiated Rate	$965.62
Rate for Payer: Aetna Commercial	$733.88
Rate for Payer: Aetna Medicare Advantage	$579.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.47
Rate for Payer: Cigna Commercial	$965.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.36
Rate for Payer: Qualcare PPO/HMO/WC	$289.69
Rate for Payer: UnitedHealthcare Community & State	$61.03
Rate for Payer: Wellpoint Medicaid Managed Care	$54.85

HEADLESS COMPRESS SRW 6.5X85MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686472
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

HEADLESS COMPRESS SRW 6.5X85MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686472
Hospital Revenue Code	278
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

HEADLESS COMPR SCREW 4.0MMXL32

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700426
Hospital Revenue Code	278
Min. Negotiated Rate	$320.25
Max. Negotiated Rate	$516.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: Qualcare PPO/HMO/WC	$320.25

HEADLESS COMPR SCREW 4.0MMXL32

Facility

$2,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700426
Hospital Revenue Code	278
Min. Negotiated Rate	$60.63
Max. Negotiated Rate	$1,067.50
Rate for Payer: Aetna Commercial	$811.30
Rate for Payer: Aetna Medicare Advantage	$640.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$544.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$544.42
Rate for Payer: Cigna Commercial	$1,067.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.67
Rate for Payer: Qualcare PPO/HMO/WC	$320.25
Rate for Payer: UnitedHealthcare Community & State	$67.47
Rate for Payer: Wellpoint Medicaid Managed Care	$60.63

Know your out-of-pocket cost for care.

All Charges