Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KNEE ARTHROSCOPY KIT

Facility

$461.00

Hospital Charge Code	270338737
Hospital Revenue Code	272
Min. Negotiated Rate	$13.09
Max. Negotiated Rate	$230.50
Rate for Payer: Aetna Commercial	$175.18
Rate for Payer: Aetna Medicare Advantage	$138.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.56
Rate for Payer: Cigna Commercial	$230.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.86
Rate for Payer: Oxford Commercial	$92.20
Rate for Payer: Qualcare PPO/HMO/WC	$69.15
Rate for Payer: UnitedHealthcare Commercial	$92.20
Rate for Payer: UnitedHealthcare Community & State	$14.57
Rate for Payer: Wellpoint Medicaid Managed Care	$13.09

KNEE ARTHROSCOPY W LAT RLS

Facility

$31,016.90

Service Code	HCPCS 29873
Hospital Charge Code	16000380
Hospital Revenue Code	360
Min. Negotiated Rate	$4,652.53
Max. Negotiated Rate	$4,652.53
Rate for Payer: Qualcare PPO/HMO/WC	$4,652.53

KNEE ARTHROSCOPY W LAT RLS

Facility

$31,016.90

Service Code	HCPCS 29873
Hospital Charge Code	16000380
Hospital Revenue Code	360
Min. Negotiated Rate	$880.88
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	$8,064.39
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,652.53
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$980.13
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	$880.88

KNEE CREATION-SCP FOOT & ANKLE

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686278
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATION-SCP FOOT & ANKLE

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686278
Hospital Revenue Code	278
Min. Negotiated Rate	$441.62
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$5,909.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50
Rate for Payer: UnitedHealthcare Community & State	$491.38
Rate for Payer: Wellpoint Medicaid Managed Care	$441.62

KNEE CREATION SCP FT & AN 15 3

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686281
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATION SCP FT & AN 15 3

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686281
Hospital Revenue Code	278
Min. Negotiated Rate	$441.62
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$5,909.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50
Rate for Payer: UnitedHealthcare Community & State	$491.38
Rate for Payer: Wellpoint Medicaid Managed Care	$441.62

KNEE CREATIONS SCP FOOT ANKLE

Facility

$18,337.50

Service Code	HCPCS C1776
Hospital Charge Code	270680418
Hospital Revenue Code	278
Min. Negotiated Rate	$2,750.62
Max. Negotiated Rate	$4,437.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,750.62

KNEE CREATIONS SCP FOOT ANKLE

Facility

$18,337.50

Service Code	HCPCS C1776
Hospital Charge Code	270680418
Hospital Revenue Code	278
Min. Negotiated Rate	$520.78
Max. Negotiated Rate	$9,168.75
Rate for Payer: Aetna Commercial	$6,968.25
Rate for Payer: Aetna Medicare Advantage	$5,501.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,676.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,676.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,676.06
Rate for Payer: Cigna Commercial	$9,168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,750.62
Rate for Payer: UnitedHealthcare Community & State	$579.47
Rate for Payer: Wellpoint Medicaid Managed Care	$520.78

KNEE EXCHANGE TRIAL SET COPAL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690885
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KNEE EXCHANGE TRIAL SET COPAL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690885
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

KNEE FIBERTAK DRILL 2.8MM

Facility

$475.00

Hospital Charge Code	270703164
Hospital Revenue Code	272
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

KNEE FIBERTAK DRILL 2.8MM

Facility

$475.00

Hospital Charge Code	270703164
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

KNEE IMMOBILIZER UNIVERSAL 23

Facility

$67.70

Service Code	HCPCS L1830
Hospital Charge Code	270649884
Hospital Revenue Code	274
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$33.85
Rate for Payer: Aetna Commercial	$25.73
Rate for Payer: Aetna Medicare Advantage	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.26
Rate for Payer: Cigna Commercial	$33.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.15
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

KNEE IMMOBILIZER UNIVERSAL 23

Facility

$67.70

Service Code	HCPCS L1830
Hospital Charge Code	270649884
Hospital Revenue Code	274
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.15

KNEE IMOBILIZER UNIVERSAL 23

Facility

$291.00

Hospital Charge Code	270331551
Hospital Revenue Code	274
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$110.58
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.65
Rate for Payer: UnitedHealthcare Community & State	$9.20
Rate for Payer: Wellpoint Medicaid Managed Care	$8.26

KNEE IMOBILIZER UNIVERSAL 23

Facility

$291.00

Hospital Charge Code	270331551
Hospital Revenue Code	274
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$70.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

KNEE INJECTION

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84506005
Hospital Revenue Code	361
Min. Negotiated Rate	$30.98
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
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	$1,322.84
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.66
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$34.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$30.98

KNEE INJECTION

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84506005
Hospital Revenue Code	361
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

KNEE KIT SCP

Facility

$23,300.00

Hospital Charge Code	270691618
Hospital Revenue Code	272
Min. Negotiated Rate	$661.72
Max. Negotiated Rate	$11,650.00
Rate for Payer: Aetna Commercial	$8,854.00
Rate for Payer: Aetna Medicare Advantage	$6,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,941.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,941.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,941.50
Rate for Payer: Cigna Commercial	$11,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,058.00
Rate for Payer: Oxford Commercial	$4,660.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,495.00
Rate for Payer: UnitedHealthcare Commercial	$4,660.00
Rate for Payer: UnitedHealthcare Community & State	$736.28
Rate for Payer: Wellpoint Medicaid Managed Care	$661.72

KNEE KIT SCP

Facility

$23,300.00

Hospital Charge Code	270691618
Hospital Revenue Code	272
Min. Negotiated Rate	$3,495.00
Max. Negotiated Rate	$3,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,495.00

KNEE KLASSIC FEMUR SZ 4

Facility

$7,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685970
Hospital Revenue Code	278
Min. Negotiated Rate	$198.80
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$221.20
Rate for Payer: Wellpoint Medicaid Managed Care	$198.80

KNEE KLASSIC FEMUR SZ 4

Facility

$7,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685970
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

KNEE M COPAL EXCHANGE

Facility

$20,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690884
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

KNEE M COPAL EXCHANGE

Facility

$20,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690884
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

Know your out-of-pocket cost for care.

All Charges