Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KNEE MIN 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7356250
Hospital Charge Code	94061239
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

KNEE MIN 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7356250
Hospital Charge Code	94061239
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

KNEE MIN 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73562LT
Hospital Charge Code	94061369
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

KNEE MIN 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73562LT
Hospital Charge Code	94061369
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

KNEE MIN 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73562RT
Hospital Charge Code	94061371
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

KNEE MIN 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73562RT
Hospital Charge Code	94061371
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

KNEE POSITIONER DISP 2ND ASST

Facility

$1,000.00

Hospital Charge Code	270638706
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

KNEE POSITIONER DISP 2ND ASST

Facility

$1,000.00

Hospital Charge Code	270638706
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC

Facility

$75,350.46

Service Code	MSDRG 488
Min. Negotiated Rate	$22,943.25
Max. Negotiated Rate	$75,350.46
Rate for Payer: Aetna Commercial	$55,523.97
Rate for Payer: Aetna Medicare Advantage	$75,350.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58,457.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58,457.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,150.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58,457.55
Rate for Payer: Cigna Commercial	$33,965.61
Rate for Payer: Cigna Medicare Advantage	$24,150.79
Rate for Payer: Clover Medicare Advantage	$22,943.25
Rate for Payer: EmblemHealth Commercial	$72,452.37
Rate for Payer: Humana Medicare Advantage	$24,875.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,150.79
Rate for Payer: Oxford Commercial	$26,845.83
Rate for Payer: UnitedHealthcare Commercial	$35,934.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,150.79
Rate for Payer: Wellcare Medicare Advantage	$24,150.79

KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$54,748.32

Service Code	MSDRG 489
Min. Negotiated Rate	$16,670.16
Max. Negotiated Rate	$54,748.32
Rate for Payer: Aetna Commercial	$40,850.86
Rate for Payer: Aetna Medicare Advantage	$54,748.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,354.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,354.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,547.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,354.20
Rate for Payer: Cigna Commercial	$24,896.82
Rate for Payer: Cigna Medicare Advantage	$17,547.54
Rate for Payer: Clover Medicare Advantage	$16,670.16
Rate for Payer: EmblemHealth Commercial	$52,642.62
Rate for Payer: Humana Medicare Advantage	$18,073.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,547.54
Rate for Payer: Oxford Commercial	$19,678.02
Rate for Payer: UnitedHealthcare Commercial	$26,339.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,547.54
Rate for Payer: Wellcare Medicare Advantage	$17,547.54

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC

Facility

$85,529.93

Service Code	MSDRG 486
Min. Negotiated Rate	$26,042.77
Max. Negotiated Rate	$85,529.93
Rate for Payer: Aetna Commercial	$62,773.91
Rate for Payer: Aetna Medicare Advantage	$85,529.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,687.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,687.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,413.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55,687.05
Rate for Payer: Cigna Commercial	$46,616.89
Rate for Payer: Cigna Medicare Advantage	$27,413.44
Rate for Payer: Clover Medicare Advantage	$26,042.77
Rate for Payer: EmblemHealth Commercial	$82,240.32
Rate for Payer: Humana Medicare Advantage	$28,235.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,413.44
Rate for Payer: Oxford Commercial	$36,845.18
Rate for Payer: UnitedHealthcare Commercial	$49,318.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,413.44
Rate for Payer: Wellcare Medicare Advantage	$27,413.44

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC

Facility

$121,420.26

Service Code	MSDRG 485
Min. Negotiated Rate	$36,970.91
Max. Negotiated Rate	$121,420.26
Rate for Payer: Aetna Commercial	$88,335.40
Rate for Payer: Aetna Medicare Advantage	$121,420.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91,149.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91,149.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,916.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91,149.45
Rate for Payer: Cigna Commercial	$71,941.74
Rate for Payer: Cigna Medicare Advantage	$38,916.75
Rate for Payer: Clover Medicare Advantage	$36,970.91
Rate for Payer: EmblemHealth Commercial	$116,750.25
Rate for Payer: Humana Medicare Advantage	$40,084.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,916.75
Rate for Payer: Oxford Commercial	$56,861.50
Rate for Payer: UnitedHealthcare Commercial	$76,111.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,916.75
Rate for Payer: Wellcare Medicare Advantage	$38,916.75

KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC

Facility

$68,946.51

Service Code	MSDRG 487
Min. Negotiated Rate	$20,993.33
Max. Negotiated Rate	$68,946.51
Rate for Payer: Aetna Commercial	$50,962.99
Rate for Payer: Aetna Medicare Advantage	$68,946.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,665.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,665.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,098.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,665.70
Rate for Payer: Cigna Commercial	$34,915.30
Rate for Payer: Cigna Medicare Advantage	$22,098.24
Rate for Payer: Clover Medicare Advantage	$20,993.33
Rate for Payer: EmblemHealth Commercial	$66,294.72
Rate for Payer: Humana Medicare Advantage	$22,761.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,098.24
Rate for Payer: Oxford Commercial	$27,596.44
Rate for Payer: UnitedHealthcare Commercial	$36,938.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,098.24
Rate for Payer: Wellcare Medicare Advantage	$22,098.24

KNEE REVISON SPECIALTY BUNDLE

Facility

$62,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685546
Hospital Revenue Code	278
Min. Negotiated Rate	$1,775.00
Max. Negotiated Rate	$31,250.00
Rate for Payer: Aetna Commercial	$23,750.00
Rate for Payer: Aetna Medicare Advantage	$18,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,937.50
Rate for Payer: Cigna Commercial	$31,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,375.00
Rate for Payer: UnitedHealthcare Community & State	$1,975.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,775.00

KNEE REVISON SPECIALTY BUNDLE

Facility

$62,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270685546
Hospital Revenue Code	278
Min. Negotiated Rate	$9,375.00
Max. Negotiated Rate	$15,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,375.00

KNEES BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7356050
Hospital Charge Code	2011352
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

KNEES BILATERAL

Facility

$6,601.19

Service Code	HCPCS 7356050
Hospital Charge Code	2011352
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

KNEE SPACER HIGH RELEASE MED

Facility

$19,950.00

Hospital Charge Code	270669747
Hospital Revenue Code	278
Min. Negotiated Rate	$566.58
Max. Negotiated Rate	$9,975.00
Rate for Payer: Aetna Commercial	$7,581.00
Rate for Payer: Aetna Medicare Advantage	$5,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,087.25
Rate for Payer: Cigna Commercial	$9,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,827.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,992.50
Rate for Payer: UnitedHealthcare Community & State	$630.42
Rate for Payer: Wellpoint Medicaid Managed Care	$566.58

KNEE SPACER HIGH RELEASE MED

Facility

$19,950.00

Hospital Charge Code	270669747
Hospital Revenue Code	278
Min. Negotiated Rate	$2,992.50
Max. Negotiated Rate	$4,827.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,827.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,992.50

KNEE SUPPORT MED

Facility

$49.25

Hospital Charge Code	270649586
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$24.62
Rate for Payer: Aetna Commercial	$18.71
Rate for Payer: Aetna Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.56
Rate for Payer: Cigna Commercial	$24.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.80
Rate for Payer: Oxford Commercial	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.39
Rate for Payer: UnitedHealthcare Commercial	$9.85
Rate for Payer: UnitedHealthcare Community & State	$1.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

KNEE SUPPORT MED

Facility

$49.25

Hospital Charge Code	270649586
Hospital Revenue Code	272
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$7.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.39

KNEE SUPPORT XL

Facility

$50.90

Hospital Charge Code	270649588
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$25.45
Rate for Payer: Aetna Commercial	$19.34
Rate for Payer: Aetna Medicare Advantage	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.98
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.23
Rate for Payer: Oxford Commercial	$10.18
Rate for Payer: Qualcare PPO/HMO/WC	$7.63
Rate for Payer: UnitedHealthcare Commercial	$10.18
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.45

KNEE SUPPORT XL

Facility

$50.90

Hospital Charge Code	270649588
Hospital Revenue Code	272
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$7.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

KNEE SYSTEM SOMBRERO PATELLA

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675246
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

KNEE SYSTEM SOMBRERO PATELLA

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675246
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

Know your out-of-pocket cost for care.

All Charges