Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT-FEMORAL HEAD GRAFT

Facility

$2,163.00

Hospital Charge Code	270338783
Hospital Revenue Code	278
Min. Negotiated Rate	$61.43
Max. Negotiated Rate	$1,081.50
Rate for Payer: Aetna Commercial	$821.94
Rate for Payer: Aetna Medicare Advantage	$648.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.57
Rate for Payer: Cigna Commercial	$1,081.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.45
Rate for Payer: Qualcare PPO/HMO/WC	$324.45
Rate for Payer: UnitedHealthcare Community & State	$68.35
Rate for Payer: Wellpoint Medicaid Managed Care	$61.43

IMPLANT-FEMORAL HEAD GRAFT

Facility

$2,163.00

Hospital Charge Code	270338783
Hospital Revenue Code	278
Min. Negotiated Rate	$324.45
Max. Negotiated Rate	$523.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.45
Rate for Payer: Qualcare PPO/HMO/WC	$324.45

IMPLANT FIBULOCK SYST

Facility

$3,500.00

Hospital Charge Code	270690433
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

IMPLANT FIBULOCK SYST

Facility

$3,500.00

Hospital Charge Code	270690433
Hospital Revenue Code	272
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$910.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$700.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

IMPLANT-HEEL FRACTURE

Facility

$4,717.00

Hospital Charge Code	270338781
Hospital Revenue Code	278
Min. Negotiated Rate	$707.55
Max. Negotiated Rate	$1,141.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$943.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,141.51
Rate for Payer: Qualcare PPO/HMO/WC	$707.55

IMPLANT-HEEL FRACTURE

Facility

$4,717.00

Hospital Charge Code	270338781
Hospital Revenue Code	278
Min. Negotiated Rate	$133.96
Max. Negotiated Rate	$2,358.50
Rate for Payer: Aetna Commercial	$1,792.46
Rate for Payer: Aetna Medicare Advantage	$1,415.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,202.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,202.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$943.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,202.84
Rate for Payer: Cigna Commercial	$2,358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,141.51
Rate for Payer: Qualcare PPO/HMO/WC	$707.55
Rate for Payer: UnitedHealthcare Community & State	$149.06
Rate for Payer: Wellpoint Medicaid Managed Care	$133.96

IMPLANT HEMI PHALANG CANN #1

Facility

$3,687.50

Service Code	HCPCS C1776
Hospital Charge Code	270676441
Hospital Revenue Code	278
Min. Negotiated Rate	$104.72
Max. Negotiated Rate	$1,843.75
Rate for Payer: Aetna Commercial	$1,401.25
Rate for Payer: Aetna Medicare Advantage	$1,106.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$940.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$940.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$940.31
Rate for Payer: Cigna Commercial	$1,843.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.38
Rate for Payer: Qualcare PPO/HMO/WC	$553.12
Rate for Payer: UnitedHealthcare Community & State	$116.53
Rate for Payer: Wellpoint Medicaid Managed Care	$104.72

IMPLANT HEMI PHALANG CANN #1

Facility

$3,687.50

Service Code	HCPCS C1776
Hospital Charge Code	270676441
Hospital Revenue Code	278
Min. Negotiated Rate	$553.12
Max. Negotiated Rate	$892.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.38
Rate for Payer: Qualcare PPO/HMO/WC	$553.12

IMPLANT HEMI PHALANG CANN #2

Facility

$7,375.00

Hospital Charge Code	270676442
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

IMPLANT HEMI PHALANG CANN #2

Facility

$7,375.00

Hospital Charge Code	270676442
Hospital Revenue Code	278
Min. Negotiated Rate	$209.45
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$233.05
Rate for Payer: Wellpoint Medicaid Managed Care	$209.45

IMPLANT HEMI PHALANG CANN #3

Facility

$7,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270670543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

IMPLANT HEMI PHALANG CANN #3

Facility

$7,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270670543
Hospital Revenue Code	278
Min. Negotiated Rate	$209.45
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$233.05
Rate for Payer: Wellpoint Medicaid Managed Care	$209.45

IMPLANT HEMI PHALANG CANN #4

Facility

$7,375.00

Hospital Charge Code	270676443
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

IMPLANT HEMI PHALANG CANN #4

Facility

$7,375.00

Hospital Charge Code	270676443
Hospital Revenue Code	278
Min. Negotiated Rate	$209.45
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$233.05
Rate for Payer: Wellpoint Medicaid Managed Care	$209.45

IMPLANT HEMI PHALANG CANN #5

Facility

$7,375.00

Hospital Charge Code	270676444
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

IMPLANT HEMI PHALANG CANN #5

Facility

$7,375.00

Hospital Charge Code	270676444
Hospital Revenue Code	278
Min. Negotiated Rate	$209.45
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,802.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25
Rate for Payer: UnitedHealthcare Community & State	$233.05
Rate for Payer: Wellpoint Medicaid Managed Care	$209.45

IMPLANT HIGH PROFILE 400cc

Facility

$3,750.00

Hospital Charge Code	270673553
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

IMPLANT HIGH PROFILE 400cc

Facility

$3,750.00

Hospital Charge Code	270673553
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

IMPLANT HIGH PROFILE 450cc

Facility

$3,750.00

Hospital Charge Code	270673554
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

IMPLANT HIGH PROFILE 450cc

Facility

$3,750.00

Hospital Charge Code	270673554
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

IMPLANT HIGH PROFILE 500CC

Facility

$3,750.00

Service Code	HCPCS C1789
Hospital Charge Code	270669961
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

IMPLANT HIGH PROFILE 500CC

Facility

$3,750.00

Service Code	HCPCS C1789
Hospital Charge Code	270669961
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

IMPLANT HIGH PROFILE 550CC

Facility

$3,750.00

Service Code	HCPCS C1789
Hospital Charge Code	270669962
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

IMPLANT HIGH PROFILE 550CC

Facility

$3,750.00

Service Code	HCPCS C1789
Hospital Charge Code	270669962
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

IMPLANT HIGH PROFILE 550CC

Facility

$4,635.00

Hospital Charge Code	669962
Hospital Revenue Code	278
Min. Negotiated Rate	$695.25
Max. Negotiated Rate	$1,121.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$927.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,121.67
Rate for Payer: Qualcare PPO/HMO/WC	$695.25

Know your out-of-pocket cost for care.

All Charges