Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HUMERAL BODYLONG

Facility

$20,000.00

Hospital Charge Code	270669577
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

HUMERAL BODY SMR SHOULDER HUME

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270678402
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$4,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY SMR SHOULDER HUME

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270678402
Hospital Revenue Code	278
Min. Negotiated Rate	$488.76
Max. Negotiated Rate	$8,605.00
Rate for Payer: Aetna Commercial	$6,539.80
Rate for Payer: Aetna Medicare Advantage	$5,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,388.55
Rate for Payer: Cigna Commercial	$8,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50
Rate for Payer: UnitedHealthcare Community & State	$543.84
Rate for Payer: Wellpoint Medicaid Managed Care	$488.76

HUMERAL BODY TRAUMA MEDIUM

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270666201
Hospital Revenue Code	278
Min. Negotiated Rate	$416.63
Max. Negotiated Rate	$7,335.00
Rate for Payer: Aetna Commercial	$5,574.60
Rate for Payer: Aetna Medicare Advantage	$4,401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,740.85
Rate for Payer: Cigna Commercial	$7,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50
Rate for Payer: UnitedHealthcare Community & State	$463.57
Rate for Payer: Wellpoint Medicaid Managed Care	$416.63

HUMERAL BODY TRAUMA MEDIUM

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270666201
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$3,550.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODY TRAY STD 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693795
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

HUMERAL BODY TRAY STD 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693795
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

HUMERAL CUP RVRS SZ 3/4 36MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700531
Hospital Revenue Code	278
Min. Negotiated Rate	$3,105.00
Max. Negotiated Rate	$5,009.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,009.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,105.00

HUMERAL CUP RVRS SZ 3/4 36MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700531
Hospital Revenue Code	278
Min. Negotiated Rate	$587.88
Max. Negotiated Rate	$10,350.00
Rate for Payer: Aetna Commercial	$7,866.00
Rate for Payer: Aetna Medicare Advantage	$6,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,278.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,278.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,278.50
Rate for Payer: Cigna Commercial	$10,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,009.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,105.00
Rate for Payer: UnitedHealthcare Community & State	$654.12
Rate for Payer: Wellpoint Medicaid Managed Care	$587.88

HUMERAL CUP RVRS SZ3/4 6X42MM

Facility

$25,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270700524
Hospital Revenue Code	278
Min. Negotiated Rate	$3,881.25
Max. Negotiated Rate	$6,261.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,261.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,881.25

HUMERAL CUP RVRS SZ3/4 6X42MM

Facility

$25,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270700524
Hospital Revenue Code	278
Min. Negotiated Rate	$734.85
Max. Negotiated Rate	$12,937.50
Rate for Payer: Aetna Commercial	$9,832.50
Rate for Payer: Aetna Medicare Advantage	$7,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,598.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,598.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,598.12
Rate for Payer: Cigna Commercial	$12,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,261.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,881.25
Rate for Payer: UnitedHealthcare Community & State	$817.65
Rate for Payer: Wellpoint Medicaid Managed Care	$734.85

HUMERAL EXTENSION +9MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672166
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

HUMERAL EXTENSION +9MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672166
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

HUMERAL FRACTURE STEM 6MMX122M

Facility

$24,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270705443
Hospital Revenue Code	278
Min. Negotiated Rate	$698.92
Max. Negotiated Rate	$12,305.00
Rate for Payer: Aetna Commercial	$9,351.80
Rate for Payer: Aetna Medicare Advantage	$7,383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,275.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,275.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,922.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,275.55
Rate for Payer: Cigna Commercial	$12,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,955.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,691.50
Rate for Payer: UnitedHealthcare Community & State	$777.68
Rate for Payer: Wellpoint Medicaid Managed Care	$698.92

HUMERAL FRACTURE STEM 6MMX122M

Facility

$24,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270705443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,691.50
Max. Negotiated Rate	$5,955.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,955.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,691.50

HUMERAL GUIDE PIN 3.5 NON

Facility

$865.00

Hospital Charge Code	270703972
Hospital Revenue Code	279
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$432.50
Rate for Payer: Aetna Commercial	$328.70
Rate for Payer: Aetna Medicare Advantage	$259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.57
Rate for Payer: Cigna Commercial	$432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.90
Rate for Payer: Oxford Commercial	$173.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.75
Rate for Payer: UnitedHealthcare Commercial	$173.00
Rate for Payer: UnitedHealthcare Community & State	$27.33
Rate for Payer: Wellpoint Medicaid Managed Care	$24.57

HUMERAL GUIDE PIN 3.5 NON

Facility

$865.00

Hospital Charge Code	270703972
Hospital Revenue Code	279
Min. Negotiated Rate	$129.75
Max. Negotiated Rate	$129.75
Rate for Payer: Qualcare PPO/HMO/WC	$129.75

HUMERAL HD CENTR GLENO 36MM

Facility

$6,982.50

Service Code	HCPCS C1776
Hospital Charge Code	270695303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.38
Max. Negotiated Rate	$1,689.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.38

HUMERAL HD CENTR GLENO 36MM

Facility

$6,982.50

Service Code	HCPCS C1776
Hospital Charge Code	270695303
Hospital Revenue Code	278
Min. Negotiated Rate	$198.30
Max. Negotiated Rate	$3,491.25
Rate for Payer: Aetna Commercial	$2,653.35
Rate for Payer: Aetna Medicare Advantage	$2,094.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.54
Rate for Payer: Cigna Commercial	$3,491.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.38
Rate for Payer: UnitedHealthcare Community & State	$220.65
Rate for Payer: Wellpoint Medicaid Managed Care	$198.30

HUMERAL HEAD 40X14MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700459
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

HUMERAL HEAD 40X14MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700459
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

HUMERAL HEAD 45MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270669576
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$1,415.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

HUMERAL HEAD 45MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270669576
Hospital Revenue Code	278
Min. Negotiated Rate	$166.14
Max. Negotiated Rate	$2,925.00
Rate for Payer: Aetna Commercial	$2,223.00
Rate for Payer: Aetna Medicare Advantage	$1,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.75
Rate for Payer: Cigna Commercial	$2,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50
Rate for Payer: UnitedHealthcare Community & State	$184.86
Rate for Payer: Wellpoint Medicaid Managed Care	$166.14

HUMERAL HEAD 52x20MM STERILE

Facility

$8,750.00

Hospital Charge Code	270675694
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

HUMERAL HEAD 52x20MM STERILE

Facility

$8,750.00

Hospital Charge Code	270675694
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

Know your out-of-pocket cost for care.

All Charges