Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HIP FRACTURE NAIL LAG SCREW

Facility

$2,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270683106
Hospital Revenue Code	278
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$638.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$528.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

HIP IMPLANT TOTAL REPLACEMENT

Facility

$20,331.00

Hospital Charge Code	270339081
Hospital Revenue Code	278
Min. Negotiated Rate	$577.40
Max. Negotiated Rate	$10,165.50
Rate for Payer: Aetna Commercial	$7,725.78
Rate for Payer: Aetna Medicare Advantage	$6,099.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,184.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,184.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,066.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,184.40
Rate for Payer: Cigna Commercial	$10,165.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,920.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,049.65
Rate for Payer: UnitedHealthcare Community & State	$642.46
Rate for Payer: Wellpoint Medicaid Managed Care	$577.40

HIP IMPLANT TOTAL REPLACEMENT

Facility

$20,331.00

Hospital Charge Code	270339081
Hospital Revenue Code	278
Min. Negotiated Rate	$3,049.65
Max. Negotiated Rate	$4,920.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,066.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,920.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,049.65

HIP INSTRUMENTATION SYSTEM

Facility

$2,500.00

Hospital Charge Code	270670489
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

HIP INSTRUMENTATION SYSTEM

Facility

$2,500.00

Hospital Charge Code	270670489
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

HIP INSTRUMENT USAGE FEE

Facility

$6,450.00

Hospital Charge Code	270698191
Hospital Revenue Code	279
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

HIP INSTRUMENT USAGE FEE

Facility

$6,450.00

Hospital Charge Code	270698191
Hospital Revenue Code	279
Min. Negotiated Rate	$183.18
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,677.00
Rate for Payer: Oxford Commercial	$1,290.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$1,290.00
Rate for Payer: UnitedHealthcare Community & State	$203.82
Rate for Payer: Wellpoint Medicaid Managed Care	$183.18

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	94061485
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP I VIEW W/WO PELVIS 1V LT

Facility

$358.23

Service Code	HCPCS 73501LT
Hospital Charge Code	94270265
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

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	2011550
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	94061485
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	2011550
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP I VIEW W/WO PELVIS 1V LT

Facility

$358.23

Service Code	HCPCS 73501LT
Hospital Charge Code	94270265
Hospital Revenue Code	320
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$53.73
Rate for Payer: Qualcare PPO/HMO/WC	$53.73

HIP I VIEW W/WO PELVIS 1V RT

Facility

$358.23

Service Code	HCPCS 73501RT
Hospital Charge Code	94270266
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

HIP I VIEW W/WO PELVIS 1V RT

Facility

$5,100.00

Service Code	HCPCS 73501RT
Hospital Charge Code	2011551
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HIP I VIEW W/WO PELVIS 1V RT

Facility

$5,100.00

Service Code	HCPCS 73501RT
Hospital Charge Code	2011551
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP I VIEW W/WO PELVIS 1V RT

Facility

$358.23

Service Code	HCPCS 73501RT
Hospital Charge Code	94270266
Hospital Revenue Code	320
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$53.73
Rate for Payer: Qualcare PPO/HMO/WC	$53.73

HIP I VIEW W/WO PELVIS 1V RT

Facility

$5,100.00

Service Code	HCPCS 73501RT
Hospital Charge Code	94061486
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HIP I VIEW W/WO PELVIS 1V RT

Facility

$5,100.00

Service Code	HCPCS 73501RT
Hospital Charge Code	94061486
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP MAP 3105.001.000

Facility

$2,060.00

Hospital Charge Code	270698390
Hospital Revenue Code	270
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$1,030.00
Rate for Payer: Aetna Commercial	$782.80
Rate for Payer: Aetna Medicare Advantage	$618.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$525.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$525.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$525.30
Rate for Payer: Cigna Commercial	$1,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.60
Rate for Payer: Oxford Commercial	$412.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00
Rate for Payer: UnitedHealthcare Commercial	$412.00
Rate for Payer: UnitedHealthcare Community & State	$65.10
Rate for Payer: Wellpoint Medicaid Managed Care	$58.50

HIP MAP 3105.001.000

Facility

$2,060.00

Hospital Charge Code	270698390
Hospital Revenue Code	270
Min. Negotiated Rate	$309.00
Max. Negotiated Rate	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00

HIP PUSHLOCK 2.9MM

Facility

$1,475.00

Hospital Charge Code	270681575
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

HIP PUSHLOCK 2.9MM

Facility

$1,475.00

Hospital Charge Code	270681575
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC

Facility

$110,144.52

Service Code	MSDRG 521
Min. Negotiated Rate	$33,537.59
Max. Negotiated Rate	$110,144.52
Rate for Payer: Aetna Commercial	$80,304.69
Rate for Payer: Aetna Medicare Advantage	$110,144.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82,837.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82,837.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35,302.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82,837.95
Rate for Payer: Cigna Commercial	$63,985.37
Rate for Payer: Cigna Medicare Advantage	$35,302.73
Rate for Payer: Clover Medicare Advantage	$33,537.59
Rate for Payer: EmblemHealth Commercial	$105,908.19
Rate for Payer: Humana Medicare Advantage	$36,361.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35,302.73
Rate for Payer: Oxford Commercial	$50,572.92
Rate for Payer: UnitedHealthcare Commercial	$67,693.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$35,302.73
Rate for Payer: Wellcare Medicare Advantage	$35,302.73

HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC

Facility

$86,370.34

Service Code	MSDRG 522
Min. Negotiated Rate	$26,298.66
Max. Negotiated Rate	$86,370.34
Rate for Payer: Aetna Commercial	$63,372.43
Rate for Payer: Aetna Medicare Advantage	$86,370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58,457.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58,457.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,682.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58,457.55
Rate for Payer: Cigna Commercial	$47,209.89
Rate for Payer: Cigna Medicare Advantage	$27,682.80
Rate for Payer: Clover Medicare Advantage	$26,298.66
Rate for Payer: EmblemHealth Commercial	$83,048.40
Rate for Payer: Humana Medicare Advantage	$28,513.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,682.80
Rate for Payer: Oxford Commercial	$37,313.87
Rate for Payer: UnitedHealthcare Commercial	$49,945.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,682.80
Rate for Payer: Wellcare Medicare Advantage	$27,682.80

Know your out-of-pocket cost for care.

All Charges