Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LAG SCREW SOLID SLIDING 75MM

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270685415
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

LAG SCREW SOLID SLIDING 75MM

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270685415
Hospital Revenue Code	278
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$73.47
Rate for Payer: Wellpoint Medicaid Managed Care	$66.03

LAG SCREW TI 10.5MMX95MM

Facility

$3,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270656522
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$891.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

LAG SCREW TI 10.5MMX95MM

Facility

$3,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270656522
Hospital Revenue Code	278
Min. Negotiated Rate	$104.65
Max. Negotiated Rate	$1,842.50
Rate for Payer: Aetna Commercial	$1,400.30
Rate for Payer: Aetna Medicare Advantage	$1,105.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.67
Rate for Payer: Cigna Commercial	$1,842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: Qualcare PPO/HMO/WC	$552.75
Rate for Payer: UnitedHealthcare Community & State	$116.45
Rate for Payer: Wellpoint Medicaid Managed Care	$104.65

LAG SCREW TI 10.5x80MM

Facility

$3,077.10

Hospital Charge Code	270663318
Hospital Revenue Code	278
Min. Negotiated Rate	$461.56
Max. Negotiated Rate	$744.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: Qualcare PPO/HMO/WC	$461.56

LAG SCREW TI 10.5x80MM

Facility

$3,077.10

Hospital Charge Code	270663318
Hospital Revenue Code	278
Min. Negotiated Rate	$87.39
Max. Negotiated Rate	$1,538.55
Rate for Payer: Aetna Commercial	$1,169.30
Rate for Payer: Aetna Medicare Advantage	$923.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.66
Rate for Payer: Cigna Commercial	$1,538.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: Qualcare PPO/HMO/WC	$461.56
Rate for Payer: UnitedHealthcare Community & State	$97.24
Rate for Payer: Wellpoint Medicaid Managed Care	$87.39

LAMELLAR BLADE

Facility

$190.00

Hospital Charge Code	270332568
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$72.20
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.40
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$38.00
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

LAMELLAR BLADE

Facility

$190.00

Hospital Charge Code	270332568
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

LAM FACETC/FRMT ARTHRD LUM 1

Facility

$1,133.60

Service Code	HCPCS 63052
Hospital Charge Code	16001022
Hospital Revenue Code	360
Min. Negotiated Rate	$32.19
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$430.77
Rate for Payer: Aetna Medicare Advantage	$340.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.07
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	$289.07
Rate for Payer: Cigna Commercial	$566.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.74
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$170.04
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$35.82
Rate for Payer: Wellpoint Medicaid Managed Care	$32.19

LAM FACETC/FRMT ARTHRD LUM 1

Facility

$1,133.60

Service Code	HCPCS 63052
Hospital Charge Code	16001022
Hospital Revenue Code	360
Min. Negotiated Rate	$170.04
Max. Negotiated Rate	$170.04
Rate for Payer: Qualcare PPO/HMO/WC	$170.04

LAM FACTC/FRMT ARTHRD LUM EA

Facility

$848.24

Service Code	HCPCS 63053
Hospital Charge Code	16001023
Hospital Revenue Code	360
Min. Negotiated Rate	$127.24
Max. Negotiated Rate	$127.24
Rate for Payer: Qualcare PPO/HMO/WC	$127.24

LAM FACTC/FRMT ARTHRD LUM EA

Facility

$848.24

Service Code	HCPCS 63053
Hospital Charge Code	16001023
Hospital Revenue Code	360
Min. Negotiated Rate	$24.09
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$322.33
Rate for Payer: Aetna Medicare Advantage	$254.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.30
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	$216.30
Rate for Payer: Cigna Commercial	$424.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.54
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.24
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$26.80
Rate for Payer: Wellpoint Medicaid Managed Care	$24.09

LAMICTRAL 150MG

Facility

$40.07

Service Code	NDC 51079086520
Hospital Charge Code	60635087
Hospital Revenue Code	250
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$6.01

LAMICTRAL 150MG

Facility

$40.07

Service Code	NDC 51079086520
Hospital Charge Code	60635087
Hospital Revenue Code	250
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.04
Rate for Payer: Aetna Commercial	$15.23
Rate for Payer: Aetna Medicare Advantage	$12.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.22
Rate for Payer: Cigna Commercial	$20.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.42
Rate for Payer: Oxford Commercial	$8.01
Rate for Payer: Qualcare PPO/HMO/WC	$6.01
Rate for Payer: UnitedHealthcare Commercial	$8.01
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

LAMICTRAL 200MG

Facility

$43.62

Service Code	NDC 51079086620
Hospital Charge Code	60635088
Hospital Revenue Code	250
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$6.54
Rate for Payer: Qualcare PPO/HMO/WC	$6.54

LAMICTRAL 200MG

Facility

$43.62

Service Code	NDC 51079086620
Hospital Charge Code	60635088
Hospital Revenue Code	250
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$21.81
Rate for Payer: Aetna Commercial	$16.58
Rate for Payer: Aetna Medicare Advantage	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.12
Rate for Payer: Cigna Commercial	$21.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.34
Rate for Payer: Oxford Commercial	$8.72
Rate for Payer: Qualcare PPO/HMO/WC	$6.54
Rate for Payer: UnitedHealthcare Commercial	$8.72
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

LAMINCT IMPL NS ELCTRDS,EPIDRL

Facility

$88,183.60

Service Code	HCPCS 63655
Hospital Charge Code	1600000858
Hospital Revenue Code	360
Min. Negotiated Rate	$13,227.54
Max. Negotiated Rate	$13,227.54
Rate for Payer: Qualcare PPO/HMO/WC	$13,227.54

LAMINCT IMPL NS ELCTRDS,EPIDRL

Facility

$88,183.60

Service Code	HCPCS 63655
Hospital Charge Code	1600000858
Hospital Revenue Code	360
Min. Negotiated Rate	$2,504.41
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	$22,927.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,227.54
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,786.60
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	$2,504.41

LAMINOTOMY ADDL CERVICAL

Facility

$7,312.94

Service Code	HCPCS 63043
Hospital Charge Code	1600000556
Hospital Revenue Code	360
Min. Negotiated Rate	$207.69
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,778.92
Rate for Payer: Aetna Medicare Advantage	$2,193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,864.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,864.80
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	$1,864.80
Rate for Payer: Cigna Commercial	$3,656.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,901.36
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,096.94
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$231.09
Rate for Payer: Wellpoint Medicaid Managed Care	$207.69

LAMINOTOMY ADDL CERVICAL

Facility

$7,312.94

Service Code	HCPCS 63043
Hospital Charge Code	1600000556
Hospital Revenue Code	360
Min. Negotiated Rate	$1,096.94
Max. Negotiated Rate	$1,096.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,096.94

LAMINOTOMY ADDL LUMBAR

Facility

$63,107.55

Service Code	HCPCS 63044
Hospital Charge Code	1600000303
Hospital Revenue Code	360
Min. Negotiated Rate	$1,792.25
Max. Negotiated Rate	$31,553.78
Rate for Payer: Aetna Commercial	$23,980.87
Rate for Payer: Aetna Medicare Advantage	$18,932.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,092.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,092.43
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	$16,092.43
Rate for Payer: Cigna Commercial	$31,553.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,407.96
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$1,994.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,792.25

LAMINOTOMY ADDL LUMBAR

Facility

$63,107.55

Service Code	HCPCS 63044
Hospital Charge Code	1600000303
Hospital Revenue Code	360
Min. Negotiated Rate	$9,466.13
Max. Negotiated Rate	$9,466.13
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13

LAMINOTOMY SINGLE CERVICAL

Facility

$47,548.90

Service Code	HCPCS 63040
Hospital Charge Code	1600000507
Hospital Revenue Code	360
Min. Negotiated Rate	$1,350.39
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,362.71
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,502.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,350.39

LAMINOTOMY SINGLE CERVICAL

Facility

$47,548.90

Service Code	HCPCS 63040
Hospital Charge Code	1600000507
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

LAMINOTOMY SINGLE LUMBAR-LT

Facility

$63,107.55

Service Code	HCPCS 63042
Hospital Charge Code	16001020
Hospital Revenue Code	360
Min. Negotiated Rate	$1,792.25
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,407.96
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,466.13
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,994.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,792.25

Know your out-of-pocket cost for care.

All Charges