Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HIP RETRACTOR SINGLR PRONG

Facility

$2,941.85

Hospital Charge Code	270678487
Hospital Revenue Code	272
Min. Negotiated Rate	$83.55
Max. Negotiated Rate	$1,470.92
Rate for Payer: Aetna Commercial	$1,117.90
Rate for Payer: Aetna Medicare Advantage	$882.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$750.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$750.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$750.17
Rate for Payer: Cigna Commercial	$1,470.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.88
Rate for Payer: Oxford Commercial	$588.37
Rate for Payer: Qualcare PPO/HMO/WC	$441.28
Rate for Payer: UnitedHealthcare Commercial	$588.37
Rate for Payer: UnitedHealthcare Community & State	$92.96
Rate for Payer: Wellpoint Medicaid Managed Care	$83.55

HIP RETRACTOR SINGLR PRONG

Facility

$2,941.85

Hospital Charge Code	270678487
Hospital Revenue Code	272
Min. Negotiated Rate	$441.28
Max. Negotiated Rate	$441.28
Rate for Payer: Qualcare PPO/HMO/WC	$441.28

HIPS BILATERAL WITH PELVIS

Facility

$521.00

Hospital Charge Code	2002665
Hospital Revenue Code	320
Min. Negotiated Rate	$78.15
Max. Negotiated Rate	$78.15
Rate for Payer: Qualcare PPO/HMO/WC	$78.15

HIPS BILATERAL WITH PELVIS

Facility

$521.00

Hospital Charge Code	2002665
Hospital Revenue Code	320
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$197.98
Rate for Payer: Aetna Medicare Advantage	$156.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.85
Rate for Payer: Cigna Commercial	$260.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.46
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.15
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$16.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$593.26

Service Code	HCPCS 73521
Hospital Charge Code	75190635
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$593.26

Service Code	HCPCS 73521
Hospital Charge Code	2011596
Hospital Revenue Code	320
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.25
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$16.85

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$593.26

Service Code	HCPCS 73521
Hospital Charge Code	94270260
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$5,100.00

Service Code	HCPCS 73521
Hospital Charge Code	94061480
Hospital Revenue Code	320
Min. Negotiated Rate	$36.22
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
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: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$5,100.00

Service Code	HCPCS 73521
Hospital Charge Code	94061480
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$593.26

Service Code	HCPCS 73521
Hospital Charge Code	2011596
Hospital Revenue Code	320
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Qualcare PPO/HMO/WC	$88.99

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$593.26

Service Code	HCPCS 73521
Hospital Charge Code	94270260
Hospital Revenue Code	320
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.25
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$16.85

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$6,601.19

Service Code	HCPCS 73521
Hospital Charge Code	2011560
Hospital Revenue Code	320
Min. Negotiated Rate	$36.22
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$6,601.19

Service Code	HCPCS 73521
Hospital Charge Code	2011560
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

HIPS BIL W/WO PELVIS 2 VIEWS

Facility

$593.26

Service Code	HCPCS 73521
Hospital Charge Code	75190635
Hospital Revenue Code	320
Min. Negotiated Rate	$16.85
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.25
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.99
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$18.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$16.85

HIP SPICA WITH PELVIC BAND

Facility

$3,046.45

Service Code	HCPCS L1686
Hospital Charge Code	270610655
Hospital Revenue Code	274
Min. Negotiated Rate	$456.97
Max. Negotiated Rate	$737.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$609.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$737.24
Rate for Payer: Qualcare PPO/HMO/WC	$456.97

HIP SPICA WITH PELVIC BAND

Facility

$3,046.45

Service Code	HCPCS L1686
Hospital Charge Code	270610655
Hospital Revenue Code	274
Min. Negotiated Rate	$86.52
Max. Negotiated Rate	$1,523.22
Rate for Payer: Aetna Commercial	$1,157.65
Rate for Payer: Aetna Medicare Advantage	$913.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$776.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$776.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$609.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$776.84
Rate for Payer: Cigna Commercial	$1,523.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$737.24
Rate for Payer: Qualcare PPO/HMO/WC	$456.97
Rate for Payer: UnitedHealthcare Community & State	$96.27
Rate for Payer: Wellpoint Medicaid Managed Care	$86.52

HIP STEM CEMENTED

Facility

$2,743.60

Hospital Charge Code	270660304
Hospital Revenue Code	278
Min. Negotiated Rate	$77.92
Max. Negotiated Rate	$1,371.80
Rate for Payer: Aetna Commercial	$1,042.57
Rate for Payer: Aetna Medicare Advantage	$823.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$699.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$699.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$548.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$699.62
Rate for Payer: Cigna Commercial	$1,371.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.95
Rate for Payer: Qualcare PPO/HMO/WC	$411.54
Rate for Payer: UnitedHealthcare Community & State	$86.70
Rate for Payer: Wellpoint Medicaid Managed Care	$77.92

HIP STEM CEMENTED

Facility

$2,743.60

Hospital Charge Code	270660304
Hospital Revenue Code	278
Min. Negotiated Rate	$411.54
Max. Negotiated Rate	$663.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$548.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.95
Rate for Payer: Qualcare PPO/HMO/WC	$411.54

HIP STEM C-TPR 127DEG 35x160MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270672946
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

HIP STEM C-TPR 127DEG 35x160MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270672946
Hospital Revenue Code	278
Min. Negotiated Rate	$421.74
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$5,643.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50
Rate for Payer: UnitedHealthcare Community & State	$469.26
Rate for Payer: Wellpoint Medicaid Managed Care	$421.74

HIP STEM-LEFT HIP

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270677234
Hospital Revenue Code	278
Min. Negotiated Rate	$878.05
Max. Negotiated Rate	$15,458.62
Rate for Payer: Aetna Commercial	$11,748.56
Rate for Payer: Aetna Medicare Advantage	$9,275.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,883.90
Rate for Payer: Cigna Commercial	$15,458.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59
Rate for Payer: UnitedHealthcare Community & State	$976.99
Rate for Payer: Wellpoint Medicaid Managed Care	$878.05

HIP STEM-LEFT HIP

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270677234
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$7,481.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

HIP STEM NECK ANGLE SZ 0

Facility

$17,491.50

Hospital Charge Code	270676688
Hospital Revenue Code	278
Min. Negotiated Rate	$2,623.72
Max. Negotiated Rate	$4,232.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,498.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,232.94
Rate for Payer: Qualcare PPO/HMO/WC	$2,623.72

HIP STEM NECK ANGLE SZ 0

Facility

$17,491.50

Hospital Charge Code	270676688
Hospital Revenue Code	278
Min. Negotiated Rate	$496.76
Max. Negotiated Rate	$8,745.75
Rate for Payer: Aetna Commercial	$6,646.77
Rate for Payer: Aetna Medicare Advantage	$5,247.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,460.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,460.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,498.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,460.33
Rate for Payer: Cigna Commercial	$8,745.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,232.94
Rate for Payer: Qualcare PPO/HMO/WC	$2,623.72
Rate for Payer: UnitedHealthcare Community & State	$552.73
Rate for Payer: Wellpoint Medicaid Managed Care	$496.76

HIP STEM NECK ANGLE SZ4

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270671315
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

Know your out-of-pocket cost for care.

All Charges