Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	160000227
Hospital Revenue Code	360
Min. Negotiated Rate	$795.55
Max. Negotiated Rate	$27,464.85
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
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	$27,464.85
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,283.23
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$885.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$795.55

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	160000227
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	1600000291
Hospital Revenue Code	360
Min. Negotiated Rate	$795.55
Max. Negotiated Rate	$27,464.85
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
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	$27,464.85
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,283.23
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$885.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$795.55

IMPLANT NEUROELECTRODES

Facility

$39,614.51

Service Code	HCPCS 63650
Hospital Charge Code	321563650
Hospital Revenue Code	361
Min. Negotiated Rate	$1,125.05
Max. Negotiated Rate	$27,464.85
Rate for Payer: Aetna Commercial	$20,593.91
Rate for Payer: Aetna Medicare Advantage	$24,530.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,464.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,571.29
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	$27,464.85
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: Cigna Medicare Advantage	$7,571.29
Rate for Payer: Clover Medicare Advantage	$7,192.73
Rate for Payer: EmblemHealth Commercial	$22,713.87
Rate for Payer: Humana Medicare Advantage	$7,798.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,571.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,299.77
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,942.18
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,251.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,571.29
Rate for Payer: Wellcare Medicare Advantage	$7,571.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1,125.05

IMPLANT NEUROELECTRODES

Facility

$25,012.45

Service Code	HCPCS 64581
Hospital Charge Code	16001043
Hospital Revenue Code	360
Min. Negotiated Rate	$3,751.87
Max. Negotiated Rate	$3,751.87
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.87

IMPLANT PEEK MED CONTOUR

Facility

$42,000.00

Hospital Charge Code	270677110
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$10,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

IMPLANT PEEK MED CONTOUR

Facility

$42,000.00

Hospital Charge Code	270677110
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.80
Max. Negotiated Rate	$21,000.00
Rate for Payer: Aetna Commercial	$15,960.00
Rate for Payer: Aetna Medicare Advantage	$12,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,710.00
Rate for Payer: Cigna Commercial	$21,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00
Rate for Payer: UnitedHealthcare Community & State	$1,327.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,192.80

IMPLANT-PENILE (AML)

Facility

$6,141.00

Hospital Charge Code	270335450
Hospital Revenue Code	278
Min. Negotiated Rate	$174.40
Max. Negotiated Rate	$3,070.50
Rate for Payer: Aetna Commercial	$2,333.58
Rate for Payer: Aetna Medicare Advantage	$1,842.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,565.95
Rate for Payer: Cigna Commercial	$3,070.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.12
Rate for Payer: Qualcare PPO/HMO/WC	$921.15
Rate for Payer: UnitedHealthcare Community & State	$194.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.40

IMPLANT-PENILE (AML)

Facility

$6,141.00

Hospital Charge Code	270335450
Hospital Revenue Code	278
Min. Negotiated Rate	$921.15
Max. Negotiated Rate	$1,486.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.12
Rate for Payer: Qualcare PPO/HMO/WC	$921.15

IMPLANT - PENILE (MENTOR)

Facility

$6,141.00

Hospital Charge Code	270335145
Hospital Revenue Code	278
Min. Negotiated Rate	$174.40
Max. Negotiated Rate	$3,070.50
Rate for Payer: Aetna Commercial	$2,333.58
Rate for Payer: Aetna Medicare Advantage	$1,842.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,565.95
Rate for Payer: Cigna Commercial	$3,070.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.12
Rate for Payer: Qualcare PPO/HMO/WC	$921.15
Rate for Payer: UnitedHealthcare Community & State	$194.06
Rate for Payer: Wellpoint Medicaid Managed Care	$174.40

IMPLANT - PENILE (MENTOR)

Facility

$6,141.00

Hospital Charge Code	270335145
Hospital Revenue Code	278
Min. Negotiated Rate	$921.15
Max. Negotiated Rate	$1,486.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.12
Rate for Payer: Qualcare PPO/HMO/WC	$921.15

IMPLANT PRODISC-C VIVO MED 5MM

Facility

$42,500.00

Service Code	HCPCS L8699
Hospital Charge Code	270698936
Hospital Revenue Code	278
Min. Negotiated Rate	$1,207.00
Max. Negotiated Rate	$21,250.00
Rate for Payer: Aetna Commercial	$16,150.00
Rate for Payer: Aetna Medicare Advantage	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,837.50
Rate for Payer: Cigna Commercial	$21,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00
Rate for Payer: UnitedHealthcare Community & State	$1,343.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,207.00

IMPLANT PRODISC-C VIVO MED 5MM

Facility

$42,500.00

Service Code	HCPCS L8699
Hospital Charge Code	270698936
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

IMPLANT-RECONSTRTN KNEE(A.C.L)

Facility

$2,654.00

Hospital Charge Code	270335453
Hospital Revenue Code	278
Min. Negotiated Rate	$398.10
Max. Negotiated Rate	$642.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.27
Rate for Payer: Qualcare PPO/HMO/WC	$398.10

IMPLANT-RECONSTRTN KNEE(A.C.L)

Facility

$2,654.00

Hospital Charge Code	270335453
Hospital Revenue Code	278
Min. Negotiated Rate	$75.37
Max. Negotiated Rate	$1,327.00
Rate for Payer: Aetna Commercial	$1,008.52
Rate for Payer: Aetna Medicare Advantage	$796.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.77
Rate for Payer: Cigna Commercial	$1,327.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.27
Rate for Payer: Qualcare PPO/HMO/WC	$398.10
Rate for Payer: UnitedHealthcare Community & State	$83.87
Rate for Payer: Wellpoint Medicaid Managed Care	$75.37

IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	87502595
Hospital Revenue Code	761
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$3,051.74
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$541.06
Rate for Payer: Oxford Commercial	$416.20
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$416.20
Rate for Payer: UnitedHealthcare Community & State	$65.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$59.10

IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	87502595
Hospital Revenue Code	761
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

IMPLANT REMVL W REINSERTION

Facility

$2,081.00

Hospital Charge Code	83652067
Hospital Revenue Code	360
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$790.78
Rate for Payer: Aetna Medicare Advantage	$624.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.65
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	$530.65
Rate for Payer: Cigna Commercial	$1,040.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$541.06
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Community & State	$65.76
Rate for Payer: Wellpoint Medicaid Managed Care	$59.10

IMPLANT REMVL W REINSERTION

Facility

$2,081.00

Hospital Charge Code	83652067
Hospital Revenue Code	360
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

IMPLANT REPAIR DEVICE MENISCAL

Facility

$3,037.50

Service Code	HCPCS C1776
Hospital Charge Code	270663297
Hospital Revenue Code	278
Min. Negotiated Rate	$86.27
Max. Negotiated Rate	$1,518.75
Rate for Payer: Aetna Commercial	$1,154.25
Rate for Payer: Aetna Medicare Advantage	$911.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$774.56
Rate for Payer: Cigna Commercial	$1,518.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.08
Rate for Payer: Qualcare PPO/HMO/WC	$455.62
Rate for Payer: UnitedHealthcare Community & State	$95.98
Rate for Payer: Wellpoint Medicaid Managed Care	$86.27

IMPLANT REPAIR DEVICE MENISCAL

Facility

$3,037.50

Service Code	HCPCS C1776
Hospital Charge Code	270663297
Hospital Revenue Code	278
Min. Negotiated Rate	$455.62
Max. Negotiated Rate	$735.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.08
Rate for Payer: Qualcare PPO/HMO/WC	$455.62

IMPLANT ROI-C LORDOSE 12 X 15.

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270684352
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

IMPLANT ROI-C LORDOSE 12 X 15.

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270684352
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

IMPLANT SCLERA QUARTER

Facility

$1,500.00

Hospital Charge Code	270683332
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

IMPLANT SCLERA QUARTER

Facility

$1,500.00

Hospital Charge Code	270683332
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges