Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTERLOCK OCLUSION SYSTEM 8 MM

Facility

$1,885.75

Hospital Charge Code	270679434
Hospital Revenue Code	272
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$942.88
Rate for Payer: Aetna Commercial	$716.59
Rate for Payer: Aetna Medicare Advantage	$565.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.87
Rate for Payer: Cigna Commercial	$942.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.30
Rate for Payer: Oxford Commercial	$377.15
Rate for Payer: Qualcare PPO/HMO/WC	$282.86
Rate for Payer: UnitedHealthcare Commercial	$377.15
Rate for Payer: UnitedHealthcare Community & State	$59.59
Rate for Payer: Wellpoint Medicaid Managed Care	$53.56

INTERLOCK OCLUSION SYSTEM 8 MM

Facility

$1,885.75

Hospital Charge Code	270679434
Hospital Revenue Code	272
Min. Negotiated Rate	$282.86
Max. Negotiated Rate	$282.86
Rate for Payer: Qualcare PPO/HMO/WC	$282.86

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662474
Hospital Revenue Code	272
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,044.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662544
Hospital Revenue Code	278
Min. Negotiated Rate	$197.81
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,646.70
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,685.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75
Rate for Payer: UnitedHealthcare Community & State	$220.09
Rate for Payer: Wellpoint Medicaid Managed Care	$197.81

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662474
Hospital Revenue Code	272
Min. Negotiated Rate	$197.81
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,646.70
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,810.90
Rate for Payer: Oxford Commercial	$1,393.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75
Rate for Payer: UnitedHealthcare Commercial	$1,393.00
Rate for Payer: UnitedHealthcare Community & State	$220.09
Rate for Payer: Wellpoint Medicaid Managed Care	$197.81

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662544
Hospital Revenue Code	278
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,685.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,393.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,685.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

INTERNAL BRACE IMPLANT SYSTEM

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270680614
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

INTERNAL BRACE IMPLANT SYSTEM

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270680614
Hospital Revenue Code	278
Min. Negotiated Rate	$169.69
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$2,270.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Community & State	$188.81
Rate for Payer: Wellpoint Medicaid Managed Care	$169.69

INTERP CERV MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72240
Hospital Charge Code	84506070
Hospital Revenue Code	320
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$3,378.36
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.36
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$651.92
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.38
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$444.45
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$93.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellpoint Medicaid Managed Care	$84.15

INTERP CERV MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72240
Hospital Charge Code	84506070
Hospital Revenue Code	320
Min. Negotiated Rate	$444.45
Max. Negotiated Rate	$444.45
Rate for Payer: Qualcare PPO/HMO/WC	$444.45

INTERP LUMBAR MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72265
Hospital Charge Code	84506080
Hospital Revenue Code	320
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$3,378.36
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.36
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$651.92
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.38
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$444.45
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$93.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellpoint Medicaid Managed Care	$84.15

INTERP LUMBAR MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72265
Hospital Charge Code	84506080
Hospital Revenue Code	320
Min. Negotiated Rate	$444.45
Max. Negotiated Rate	$444.45
Rate for Payer: Qualcare PPO/HMO/WC	$444.45

INTERPRETATION OF OUTSIDE SLID

Facility

$680.00

Service Code	HCPCS 88321
Hospital Charge Code	38474079
Hospital Revenue Code	310
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$102.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

INTERPRETATION OF OUTSIDE SLID

Facility

$680.00

Service Code	HCPCS 88321
Hospital Charge Code	38474079
Hospital Revenue Code	310
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$176.80
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.95
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.80
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$76.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$19.31

INTERPSTIN ARTHROPL IC/ICM JNT

Facility

$16,063.45

Service Code	HCPCS 25447
Hospital Charge Code	16000395
Hospital Revenue Code	360
Min. Negotiated Rate	$2,409.52
Max. Negotiated Rate	$2,409.52
Rate for Payer: Qualcare PPO/HMO/WC	$2,409.52

INTERPSTIN ARTHROPL IC/ICM JNT

Facility

$16,063.45

Service Code	HCPCS 25447
Hospital Charge Code	16000395
Hospital Revenue Code	360
Min. Negotiated Rate	$456.20
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,176.50
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,409.52
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$507.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$456.20

INTERP THORACIC MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72255
Hospital Charge Code	84506075
Hospital Revenue Code	320
Min. Negotiated Rate	$444.45
Max. Negotiated Rate	$444.45
Rate for Payer: Qualcare PPO/HMO/WC	$444.45

INTERP THORACIC MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72255
Hospital Charge Code	84506075
Hospital Revenue Code	320
Min. Negotiated Rate	$84.15
Max. Negotiated Rate	$3,378.36
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.36
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$651.92
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.38
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$444.45
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$93.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00
Rate for Payer: Wellpoint Medicaid Managed Care	$84.15

INTERPULSE HANDPIECE W/HI FLOW

Facility

$197.98

Hospital Charge Code	270668406
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$98.99
Rate for Payer: Aetna Commercial	$75.23
Rate for Payer: Aetna Medicare Advantage	$59.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.48
Rate for Payer: Cigna Commercial	$98.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.47
Rate for Payer: Oxford Commercial	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$29.70
Rate for Payer: UnitedHealthcare Commercial	$39.60
Rate for Payer: UnitedHealthcare Community & State	$6.26
Rate for Payer: Wellpoint Medicaid Managed Care	$5.62

INTERPULSE HANDPIECE W/HI FLOW

Facility

$197.98

Hospital Charge Code	270668406
Hospital Revenue Code	272
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$29.70

INTER SCREW12X28 FULL THREAD

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270681480
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

INTER SCREW12X28 FULL THREAD

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270681480
Hospital Revenue Code	278
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

INTERSPACE FOR KNEE LARGE 74mm

Facility

$21,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270680018
Hospital Revenue Code	278
Min. Negotiated Rate	$3,206.25
Max. Negotiated Rate	$5,172.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,172.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,206.25

INTERSPACE FOR KNEE LARGE 74mm

Facility

$21,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270680018
Hospital Revenue Code	278
Min. Negotiated Rate	$607.05
Max. Negotiated Rate	$10,687.50
Rate for Payer: Aetna Commercial	$8,122.50
Rate for Payer: Aetna Medicare Advantage	$6,412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,450.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,450.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,450.62
Rate for Payer: Cigna Commercial	$10,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,172.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,206.25
Rate for Payer: UnitedHealthcare Community & State	$675.45
Rate for Payer: Wellpoint Medicaid Managed Care	$607.05

INTERSTIM I CON PROGRAMMER

Facility

$9,750.00

Service Code	HCPCS C1787
Hospital Charge Code	270685083
Hospital Revenue Code	278
Min. Negotiated Rate	$276.90
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$3,705.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50
Rate for Payer: UnitedHealthcare Community & State	$308.10
Rate for Payer: Wellpoint Medicaid Managed Care	$276.90

Know your out-of-pocket cost for care.

All Charges