Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTERBODY FUSION DEV 15X12X5MM

Facility

$15,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270705028
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

INTERBODY FUSION DEV 7DEG LORD

Facility

$20,000.00

Hospital Charge Code	270702367
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

INTERBODY FUSION DEV 7DEG LORD

Facility

$20,000.00

Hospital Charge Code	270702367
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

INTERBODY FUSION DEVICE

Facility

$20,000.00

Hospital Charge Code	270702963
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

INTERBODY FUSION DEVICE

Facility

$20,000.00

Hospital Charge Code	270702963
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

INTERBODY FUSION DEVICE 15WX12

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704521
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

INTERBODY FUSION DEVICE 15WX12

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704521
Hospital Revenue Code	278
Min. Negotiated Rate	$440.20
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$5,890.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00
Rate for Payer: UnitedHealthcare Community & State	$489.80
Rate for Payer: Wellpoint Medicaid Managed Care	$440.20

INTERBODY FUSION DEVICE 15WX12

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704520
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

INTERBODY FUSION DEVICE 15WX12

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704520
Hospital Revenue Code	278
Min. Negotiated Rate	$440.20
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$5,890.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00
Rate for Payer: UnitedHealthcare Community & State	$489.80
Rate for Payer: Wellpoint Medicaid Managed Care	$440.20

INTERBODY PROSTH 18X15X6MM 7D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694452
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

INTERBODY PROSTH 18X15X6MM 7D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694452
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

INTERBODY STANDALONE 12X17X7MM

Facility

$32,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270669220
Hospital Revenue Code	278
Min. Negotiated Rate	$4,893.75
Max. Negotiated Rate	$7,895.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,895.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,893.75

INTERBODY STANDALONE 12X17X7MM

Facility

$32,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270669220
Hospital Revenue Code	278
Min. Negotiated Rate	$926.55
Max. Negotiated Rate	$16,312.50
Rate for Payer: Aetna Commercial	$12,397.50
Rate for Payer: Aetna Medicare Advantage	$9,787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,319.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,319.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,319.38
Rate for Payer: Cigna Commercial	$16,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,895.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,893.75
Rate for Payer: UnitedHealthcare Community & State	$1,030.95
Rate for Payer: Wellpoint Medicaid Managed Care	$926.55

INTERCED 3X4 ABSORBABLE

Facility

$14,628.00

Hospital Charge Code	270656002
Hospital Revenue Code	278
Min. Negotiated Rate	$2,194.20
Max. Negotiated Rate	$3,539.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,925.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,539.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,194.20

INTERCED 3X4 ABSORBABLE

Facility

$14,628.00

Hospital Charge Code	270656002
Hospital Revenue Code	278
Min. Negotiated Rate	$415.44
Max. Negotiated Rate	$7,314.00
Rate for Payer: Aetna Commercial	$5,558.64
Rate for Payer: Aetna Medicare Advantage	$4,388.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,730.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,730.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,925.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,730.14
Rate for Payer: Cigna Commercial	$7,314.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,539.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,194.20
Rate for Payer: UnitedHealthcare Community & State	$462.24
Rate for Payer: Wellpoint Medicaid Managed Care	$415.44

INTERCEED 3X 4 ABSORBABLE

Facility

$1,201.00

Hospital Charge Code	270330789
Hospital Revenue Code	272
Min. Negotiated Rate	$34.11
Max. Negotiated Rate	$600.50
Rate for Payer: Aetna Commercial	$456.38
Rate for Payer: Aetna Medicare Advantage	$360.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.25
Rate for Payer: Cigna Commercial	$600.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.26
Rate for Payer: Oxford Commercial	$240.20
Rate for Payer: Qualcare PPO/HMO/WC	$180.15
Rate for Payer: UnitedHealthcare Commercial	$240.20
Rate for Payer: UnitedHealthcare Community & State	$37.95
Rate for Payer: Wellpoint Medicaid Managed Care	$34.11

INTERCEED 3X 4 ABSORBABLE

Facility

$1,201.00

Hospital Charge Code	270330789
Hospital Revenue Code	272
Min. Negotiated Rate	$180.15
Max. Negotiated Rate	$180.15
Rate for Payer: Qualcare PPO/HMO/WC	$180.15

INTERCEED ADHESION BARRIER 3x4

Facility

$1,630.42

Hospital Charge Code	270601039
Hospital Revenue Code	272
Min. Negotiated Rate	$244.56
Max. Negotiated Rate	$244.56
Rate for Payer: Qualcare PPO/HMO/WC	$244.56

INTERCEED ADHESION BARRIER 3x4

Facility

$1,630.42

Hospital Charge Code	270601039
Hospital Revenue Code	272
Min. Negotiated Rate	$46.30
Max. Negotiated Rate	$815.21
Rate for Payer: Aetna Commercial	$619.56
Rate for Payer: Aetna Medicare Advantage	$489.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$415.76
Rate for Payer: Cigna Commercial	$815.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.91
Rate for Payer: Oxford Commercial	$326.08
Rate for Payer: Qualcare PPO/HMO/WC	$244.56
Rate for Payer: UnitedHealthcare Commercial	$326.08
Rate for Payer: UnitedHealthcare Community & State	$51.52
Rate for Payer: Wellpoint Medicaid Managed Care	$46.30

INTERDISCAL PERQ ASPIR DX

Facility

$3,392.55

Service Code	HCPCS 62267
Hospital Charge Code	404362267
Hospital Revenue Code	361
Min. Negotiated Rate	$96.35
Max. Negotiated Rate	$3,629.00
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) NJ Health	$3,536.00
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	$882.06
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.88
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$107.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$96.35

INTERDISCAL PERQ ASPIR DX

Facility

$3,392.55

Service Code	HCPCS 62267
Hospital Charge Code	404362267
Hospital Revenue Code	361
Min. Negotiated Rate	$508.88
Max. Negotiated Rate	$508.88
Rate for Payer: Qualcare PPO/HMO/WC	$508.88

INTERFERANCE SCREW 10 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684924
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

INTERFERANCE SCREW 10 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684924
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

INTERFERANCE SCREW 9 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684925
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

INTERFERANCE SCREW 9 X 28

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684925
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

Know your out-of-pocket cost for care.

All Charges