Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ONLAY TIBIAL INSERT SZ 6 12MM

Facility

$3,935.00

Hospital Charge Code	270668798
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 6 12MM

Facility

$3,935.00

Hospital Charge Code	270668798
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 6 12MM

Facility

$3,935.00

Hospital Charge Code	270668802
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 6 12MM

Facility

$3,935.00

Hospital Charge Code	270668802
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 6 8MM

Facility

$3,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270668799
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 6 8MM

Facility

$3,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270668799
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 6 9MM

Facility

$3,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270668800
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 6 9MM

Facility

$3,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270668800
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 7 10MM

Facility

$3,935.00

Hospital Charge Code	270668805
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 7 10MM

Facility

$3,935.00

Hospital Charge Code	270668805
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 7 12MM

Facility

$3,935.00

Hospital Charge Code	270668806
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 7 12MM

Facility

$3,935.00

Hospital Charge Code	270668806
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 7 8MM

Facility

$3,935.00

Hospital Charge Code	270668803
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 7 8MM

Facility

$3,935.00

Hospital Charge Code	270668803
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 7 9MM

Facility

$3,935.00

Hospital Charge Code	270668804
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 7 9MM

Facility

$3,935.00

Hospital Charge Code	270668804
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 8 10MM

Facility

$3,935.00

Hospital Charge Code	270668809
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 8 10MM

Facility

$3,935.00

Hospital Charge Code	270668809
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 8 12MM

Facility

$3,935.00

Hospital Charge Code	270668810
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 8 12MM

Facility

$3,935.00

Hospital Charge Code	270668810
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 8 8MM

Facility

$3,935.00

Hospital Charge Code	270668807
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 8 8MM

Facility

$3,935.00

Hospital Charge Code	270668807
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIBIAL INSERT SZ 8 9MM

Facility

$3,935.00

Hospital Charge Code	270668808
Hospital Revenue Code	278
Min. Negotiated Rate	$590.25
Max. Negotiated Rate	$952.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25

ONLAY TIBIAL INSERT SZ 8 9MM

Facility

$3,935.00

Hospital Charge Code	270668808
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,967.50
Rate for Payer: Aetna Commercial	$1,495.30
Rate for Payer: Aetna Medicare Advantage	$1,180.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.42
Rate for Payer: Cigna Commercial	$1,967.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$952.27
Rate for Payer: Qualcare PPO/HMO/WC	$590.25
Rate for Payer: UnitedHealthcare Community & State	$124.35
Rate for Payer: Wellpoint Medicaid Managed Care	$111.75

ONLAY TIB INSRT SZ1 10MM THICK

Facility

$5,435.00

Hospital Charge Code	270668816
Hospital Revenue Code	278
Min. Negotiated Rate	$154.35
Max. Negotiated Rate	$2,717.50
Rate for Payer: Aetna Commercial	$2,065.30
Rate for Payer: Aetna Medicare Advantage	$1,630.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,385.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,087.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,385.92
Rate for Payer: Cigna Commercial	$2,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,315.27
Rate for Payer: Qualcare PPO/HMO/WC	$815.25
Rate for Payer: UnitedHealthcare Community & State	$171.75
Rate for Payer: Wellpoint Medicaid Managed Care	$154.35

Know your out-of-pocket cost for care.

All Charges