Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HIGHWALL G7 LONGVI 32 MM SZ C

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691942
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

HIGHWALL G7 LONGVI 32 MM SZ C

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691942
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

HIGHWALL G7 LONGVITY 32 MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691567
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

HIGHWALL G7 LONGVITY 32 MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270691567
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

HIGH WALL LNR 36MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692412
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

HIGH WALL LNR 36MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692412
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

HINGED RODS

Facility

$2,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687812
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$707.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

HINGED RODS

Facility

$2,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687812
Hospital Revenue Code	278
Min. Negotiated Rate	$83.07
Max. Negotiated Rate	$1,462.50
Rate for Payer: Aetna Commercial	$1,111.50
Rate for Payer: Aetna Medicare Advantage	$877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.88
Rate for Payer: Cigna Commercial	$1,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75
Rate for Payer: UnitedHealthcare Community & State	$92.43
Rate for Payer: Wellpoint Medicaid Managed Care	$83.07

HINGE HALF HOFFMAN II EXT FIX

Facility

$936.35

Service Code	HCPCS C1713
Hospital Charge Code	270699517
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$226.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.60
Rate for Payer: Qualcare PPO/HMO/WC	$140.45

HINGE HALF HOFFMAN II EXT FIX

Facility

$936.35

Service Code	HCPCS C1713
Hospital Charge Code	270699517
Hospital Revenue Code	278
Min. Negotiated Rate	$26.59
Max. Negotiated Rate	$468.18
Rate for Payer: Aetna Commercial	$355.81
Rate for Payer: Aetna Medicare Advantage	$280.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.77
Rate for Payer: Cigna Commercial	$468.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.60
Rate for Payer: Qualcare PPO/HMO/WC	$140.45
Rate for Payer: UnitedHealthcare Community & State	$29.59
Rate for Payer: Wellpoint Medicaid Managed Care	$26.59

HIP/ANCA TIBIA W/SCREW 100mm

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270683440
Hospital Revenue Code	278
Min. Negotiated Rate	$3,937.50
Max. Negotiated Rate	$6,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50

HIP/ANCA TIBIA W/SCREW 100mm

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270683440
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$13,125.00
Rate for Payer: Aetna Commercial	$9,975.00
Rate for Payer: Aetna Medicare Advantage	$7,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,693.75
Rate for Payer: Cigna Commercial	$13,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50
Rate for Payer: UnitedHealthcare Community & State	$829.50
Rate for Payer: Wellpoint Medicaid Managed Care	$745.50

HIP AND FEMUR FRACTURE REPAIR

Facility

$22,763.62

Service Code	APR-DRG 3082
Min. Negotiated Rate	$22,317.27
Max. Negotiated Rate	$22,763.62
Rate for Payer: UnitedHealthcare Community & State	$22,317.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,763.62
Rate for Payer: Wellpoint Medicaid Managed Care	$22,317.27

HIP AND FEMUR FRACTURE REPAIR

Facility

$43,410.82

Service Code	APR-DRG 3084
Min. Negotiated Rate	$42,559.63
Max. Negotiated Rate	$43,410.82
Rate for Payer: UnitedHealthcare Community & State	$42,559.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$43,410.82
Rate for Payer: Wellpoint Medicaid Managed Care	$42,559.63

HIP AND FEMUR FRACTURE REPAIR

Facility

$29,230.81

Service Code	APR-DRG 3083
Min. Negotiated Rate	$28,657.66
Max. Negotiated Rate	$29,230.81
Rate for Payer: UnitedHealthcare Community & State	$28,657.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,230.81
Rate for Payer: Wellpoint Medicaid Managed Care	$28,657.66

HIP AND FEMUR FRACTURE REPAIR

Facility

$19,301.80

Service Code	APR-DRG 3081
Min. Negotiated Rate	$18,923.33
Max. Negotiated Rate	$19,301.80
Rate for Payer: UnitedHealthcare Community & State	$18,923.33
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,301.80
Rate for Payer: Wellpoint Medicaid Managed Care	$18,923.33

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC

Facility

$85,637.35

Service Code	MSDRG 481
Min. Negotiated Rate	$26,075.48
Max. Negotiated Rate	$85,637.35
Rate for Payer: Aetna Commercial	$62,850.41
Rate for Payer: Aetna Medicare Advantage	$85,637.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57,349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57,349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,447.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57,349.35
Rate for Payer: Cigna Commercial	$46,692.69
Rate for Payer: Cigna Medicare Advantage	$27,447.87
Rate for Payer: Clover Medicare Advantage	$26,075.48
Rate for Payer: EmblemHealth Commercial	$82,343.61
Rate for Payer: Humana Medicare Advantage	$28,271.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,447.87
Rate for Payer: Oxford Commercial	$36,905.09
Rate for Payer: UnitedHealthcare Commercial	$49,398.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,447.87
Rate for Payer: Wellcare Medicare Advantage	$27,447.87

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC

Facility

$111,474.60

Service Code	MSDRG 480
Min. Negotiated Rate	$33,942.59
Max. Negotiated Rate	$111,474.60
Rate for Payer: Aetna Commercial	$81,252.01
Rate for Payer: Aetna Medicare Advantage	$111,474.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81,729.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81,729.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35,729.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81,729.75
Rate for Payer: Cigna Commercial	$64,923.90
Rate for Payer: Cigna Medicare Advantage	$35,729.04
Rate for Payer: Clover Medicare Advantage	$33,942.59
Rate for Payer: EmblemHealth Commercial	$107,187.12
Rate for Payer: Humana Medicare Advantage	$36,800.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35,729.04
Rate for Payer: Oxford Commercial	$51,314.73
Rate for Payer: UnitedHealthcare Commercial	$68,686.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$35,729.04
Rate for Payer: Wellcare Medicare Advantage	$35,729.04

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

Facility

$70,993.73

Service Code	MSDRG 482
Min. Negotiated Rate	$21,616.68
Max. Negotiated Rate	$70,993.73
Rate for Payer: Aetna Commercial	$52,421.04
Rate for Payer: Aetna Medicare Advantage	$70,993.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,754.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,050.95
Rate for Payer: Cigna Commercial	$36,359.88
Rate for Payer: Cigna Medicare Advantage	$22,754.40
Rate for Payer: Clover Medicare Advantage	$21,616.68
Rate for Payer: EmblemHealth Commercial	$68,263.20
Rate for Payer: Humana Medicare Advantage	$23,437.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,754.40
Rate for Payer: Oxford Commercial	$28,738.22
Rate for Payer: UnitedHealthcare Commercial	$38,467.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,754.40
Rate for Payer: Wellcare Medicare Advantage	$22,754.40

HIP ARTHRO ACETEBULOPLASTY

Facility

$22,425.68

Service Code	HCPCS 29915
Hospital Charge Code	16000578
Hospital Revenue Code	360
Min. Negotiated Rate	$636.89
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,830.68
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$708.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$636.89

HIP ARTHRO ACETEBULOPLASTY

Facility

$22,425.68

Service Code	HCPCS 29915
Hospital Charge Code	16000578
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

HIP ARTHRO W/FEMOROPLASTY

Facility

$22,425.68

Service Code	HCPCS 29914
Hospital Charge Code	16000638
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

HIP ARTHRO W/FEMOROPLASTY

Facility

$22,425.68

Service Code	HCPCS 29914
Hospital Charge Code	16000638
Hospital Revenue Code	360
Min. Negotiated Rate	$636.89
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,830.68
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$708.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$636.89

HIP ARTHRO W/LABRAL REPAIR

Facility

$22,425.68

Service Code	HCPCS 29916
Hospital Charge Code	16000579
Hospital Revenue Code	360
Min. Negotiated Rate	$3,363.85
Max. Negotiated Rate	$3,363.85
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85

HIP ARTHRO W/LABRAL REPAIR

Facility

$22,425.68

Service Code	HCPCS 29916
Hospital Charge Code	16000579
Hospital Revenue Code	360
Min. Negotiated Rate	$636.89
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,830.68
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$708.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$636.89

Know your out-of-pocket cost for care.

All Charges