Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INS PICC DEVICE W PORT 5 YRS/>

Facility

$22,851.90

Service Code	HCPCS 36571
Hospital Charge Code	16000736
Hospital Revenue Code	360
Min. Negotiated Rate	$3,427.78
Max. Negotiated Rate	$3,427.78
Rate for Payer: Qualcare PPO/HMO/WC	$3,427.78

INS/RPLC SPI NPG/RCVR POCKET

Facility

$179,437.65

Service Code	HCPCS 63685
Hospital Charge Code	1600000514
Hospital Revenue Code	360
Min. Negotiated Rate	$3,536.00
Max. Negotiated Rate	$132,983.28
Rate for Payer: Aetna Commercial	$99,714.55
Rate for Payer: Aetna Medicare Advantage	$118,777.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132,983.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132,983.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,659.76
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	$132,983.28
Rate for Payer: Cigna Commercial	$73,484.37
Rate for Payer: Cigna Medicare Advantage	$36,659.76
Rate for Payer: Clover Medicare Advantage	$34,826.77
Rate for Payer: EmblemHealth Commercial	$109,979.28
Rate for Payer: Humana Medicare Advantage	$37,759.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$36,659.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46,653.79
Rate for Payer: Oxford Commercial	$18,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$26,915.65
Rate for Payer: UnitedHealthcare Commercial	$20,109.00
Rate for Payer: UnitedHealthcare Community & State	$5,670.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,659.76
Rate for Payer: Wellcare Medicare Advantage	$36,659.76
Rate for Payer: Wellpoint Medicaid Managed Care	$5,096.03

INS/RPLC SPI NPG/RCVR POCKET

Facility

$179,437.65

Service Code	HCPCS 63685
Hospital Charge Code	1600000514
Hospital Revenue Code	360
Min. Negotiated Rate	$26,915.65
Max. Negotiated Rate	$26,915.65
Rate for Payer: Qualcare PPO/HMO/WC	$26,915.65

INS/RPL PRHP SAC/GASTR NPG/R

Facility

$38,477.00

Service Code	HCPCS 64590
Hospital Charge Code	160000228
Hospital Revenue Code	360
Min. Negotiated Rate	$1,092.75
Max. Negotiated Rate	$83,606.08
Rate for Payer: Aetna Commercial	$62,690.15
Rate for Payer: Aetna Medicare Advantage	$74,675.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83,606.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83,606.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,047.85
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	$83,606.08
Rate for Payer: Cigna Commercial	$46,199.32
Rate for Payer: Cigna Medicare Advantage	$23,047.85
Rate for Payer: Clover Medicare Advantage	$21,895.46
Rate for Payer: EmblemHealth Commercial	$69,143.55
Rate for Payer: Humana Medicare Advantage	$23,739.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,047.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,004.02
Rate for Payer: Oxford Commercial	$18,024.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,771.55
Rate for Payer: UnitedHealthcare Commercial	$20,109.00
Rate for Payer: UnitedHealthcare Community & State	$1,215.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,047.85
Rate for Payer: Wellcare Medicare Advantage	$23,047.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1,092.75

INS/RPL PRHP SAC/GASTR NPG/R

Facility

$38,477.00

Service Code	HCPCS 64590
Hospital Charge Code	160000228
Hospital Revenue Code	360
Min. Negotiated Rate	$5,771.55
Max. Negotiated Rate	$5,771.55
Rate for Payer: Qualcare PPO/HMO/WC	$5,771.55

INSRT MDM LINER 22.2/38MM 38D

Facility

$4,465.10

Service Code	HCPCS C1776
Hospital Charge Code	270681299
Hospital Revenue Code	278
Min. Negotiated Rate	$669.76
Max. Negotiated Rate	$1,080.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.55
Rate for Payer: Qualcare PPO/HMO/WC	$669.76

INSRT MDM LINER 22.2/38MM 38D

Facility

$4,465.10

Service Code	HCPCS C1776
Hospital Charge Code	270681299
Hospital Revenue Code	278
Min. Negotiated Rate	$126.81
Max. Negotiated Rate	$2,232.55
Rate for Payer: Aetna Commercial	$1,696.74
Rate for Payer: Aetna Medicare Advantage	$1,339.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.60
Rate for Payer: Cigna Commercial	$2,232.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.55
Rate for Payer: Qualcare PPO/HMO/WC	$669.76
Rate for Payer: UnitedHealthcare Community & State	$141.10
Rate for Payer: Wellpoint Medicaid Managed Care	$126.81

INSRTR THRD SHAFT STR G7

Facility

$2,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270693276
Hospital Revenue Code	278
Min. Negotiated Rate	$73.84
Max. Negotiated Rate	$1,300.00
Rate for Payer: Aetna Commercial	$988.00
Rate for Payer: Aetna Medicare Advantage	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$663.00
Rate for Payer: Cigna Commercial	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.20
Rate for Payer: Qualcare PPO/HMO/WC	$390.00
Rate for Payer: UnitedHealthcare Community & State	$82.16
Rate for Payer: Wellpoint Medicaid Managed Care	$73.84

INSRTR THRD SHAFT STR G7

Facility

$2,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270693276
Hospital Revenue Code	278
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$629.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.20
Rate for Payer: Qualcare PPO/HMO/WC	$390.00

INSRT SPHERE FLEX LEFT 11MM S4

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681130
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

INSRT SPHERE FLEX LEFT 11MM S4

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681130
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

INSRT SPINE FIXATION DVC POSTR

Facility

$23,774.45

Service Code	HCPCS 22840
Hospital Charge Code	16000360
Hospital Revenue Code	360
Min. Negotiated Rate	$3,566.17
Max. Negotiated Rate	$3,566.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17

INSRT SPINE FIXATION DVC POSTR

Facility

$23,774.45

Service Code	HCPCS 22840
Hospital Charge Code	16000360
Hospital Revenue Code	360
Min. Negotiated Rate	$751.27
Max. Negotiated Rate	$11,887.23
Rate for Payer: Aetna Commercial	$9,034.29
Rate for Payer: Aetna Medicare Advantage	$7,132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,062.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,062.48
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	$6,062.48
Rate for Payer: Cigna Commercial	$11,887.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$751.27

INSRT SPINE FXTN DVC4-7SEGMNTS

Facility

$25,282.63

Service Code	HCPCS 22846
Hospital Charge Code	16000808
Hospital Revenue Code	360
Min. Negotiated Rate	$798.93
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$9,607.40
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$12,641.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,573.48
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$798.93

INSRT SPINE FXTN DVC4-7SEGMNTS

Facility

$25,282.63

Service Code	HCPCS 22846
Hospital Charge Code	16000808
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSRT SPN FIXATION DVC7-12SEGS

Facility

$25,282.63

Service Code	HCPCS 22845
Hospital Charge Code	16000375
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSRT SPN FIXATION DVC7-12SEGS

Facility

$25,282.63

Service Code	HCPCS 22845
Hospital Charge Code	16000375
Hospital Revenue Code	360
Min. Negotiated Rate	$798.93
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$9,607.40
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$12,641.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,573.48
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$798.93

INSRT SPN FXTN DVC 7-12SEGMNTS

Facility

$20,846.25

Service Code	HCPCS 22843
Hospital Charge Code	16000807
Hospital Revenue Code	360
Min. Negotiated Rate	$3,126.94
Max. Negotiated Rate	$3,126.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,126.94

INSRT SPN FXTN DVC 7-12SEGMNTS

Facility

$20,846.25

Service Code	HCPCS 22843
Hospital Charge Code	16000807
Hospital Revenue Code	360
Min. Negotiated Rate	$658.74
Max. Negotiated Rate	$10,423.12
Rate for Payer: Aetna Commercial	$7,921.57
Rate for Payer: Aetna Medicare Advantage	$6,253.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,315.79
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	$5,315.79
Rate for Payer: Cigna Commercial	$10,423.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,420.02
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,126.94
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$658.74

INS TEMP BALDDER CATH

Facility

$1,167.00

Service Code	HCPCS 51702
Hospital Charge Code	1600000435
Hospital Revenue Code	360
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
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	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.42
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$36.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$33.14

INS TEMP BALDDER CATH

Facility

$1,167.00

Service Code	HCPCS 51702
Hospital Charge Code	1600000435
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

INSTIBPSNREVARTSURFVE16MM

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270694285
Hospital Revenue Code	278
Min. Negotiated Rate	$514.75
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$6,887.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Community & State	$572.75
Rate for Payer: Wellpoint Medicaid Managed Care	$514.75

INSTIBPSNREVARTSURFVE16MM

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270694285
Hospital Revenue Code	278
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$4,386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

INST. KIT,INFERIOR,GLENOID

Facility

$3,265.00

Hospital Charge Code	270687344
Hospital Revenue Code	272
Min. Negotiated Rate	$92.73
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$1,240.70
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$848.90
Rate for Payer: Oxford Commercial	$653.00
Rate for Payer: Qualcare PPO/HMO/WC	$489.75
Rate for Payer: UnitedHealthcare Commercial	$653.00
Rate for Payer: UnitedHealthcare Community & State	$103.17
Rate for Payer: Wellpoint Medicaid Managed Care	$92.73

INST. KIT,INFERIOR,GLENOID

Facility

$3,265.00

Hospital Charge Code	270687344
Hospital Revenue Code	272
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$489.75
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

Know your out-of-pocket cost for care.

All Charges