Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

OSS AVL TI YOKE SET 12 14 16MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684638
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

OSS BASEPLATE TIBIA 71MM

Facility

$30,343.05

Service Code	HCPCS C1776
Hospital Charge Code	270697108
Hospital Revenue Code	278
Min. Negotiated Rate	$4,551.46
Max. Negotiated Rate	$7,343.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,068.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,343.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,551.46

OSS BASEPLATE TIBIA 71MM

Facility

$30,343.05

Service Code	HCPCS C1776
Hospital Charge Code	270697108
Hospital Revenue Code	278
Min. Negotiated Rate	$861.74
Max. Negotiated Rate	$15,171.52
Rate for Payer: Aetna Commercial	$11,530.36
Rate for Payer: Aetna Medicare Advantage	$9,102.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,737.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,737.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,068.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,737.48
Rate for Payer: Cigna Commercial	$15,171.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,343.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,551.46
Rate for Payer: UnitedHealthcare Community & State	$958.84
Rate for Payer: Wellpoint Medicaid Managed Care	$861.74

OSS BASEPLT TIBIA NONMOD 67MM

Facility

$29,804.40

Service Code	HCPCS C1776
Hospital Charge Code	270697106
Hospital Revenue Code	278
Min. Negotiated Rate	$4,470.66
Max. Negotiated Rate	$7,212.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,960.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$4,470.66

OSS BASEPLT TIBIA NONMOD 67MM

Facility

$29,804.40

Service Code	HCPCS C1776
Hospital Charge Code	270697106
Hospital Revenue Code	278
Min. Negotiated Rate	$846.44
Max. Negotiated Rate	$14,902.20
Rate for Payer: Aetna Commercial	$11,325.67
Rate for Payer: Aetna Medicare Advantage	$8,941.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,960.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,600.12
Rate for Payer: Cigna Commercial	$14,902.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$4,470.66
Rate for Payer: UnitedHealthcare Community & State	$941.82
Rate for Payer: Wellpoint Medicaid Managed Care	$846.44

OSS BEARING TIBIA ART LS 20MM

Facility

$8,152.25

Service Code	HCPCS C1776
Hospital Charge Code	270697107
Hospital Revenue Code	278
Min. Negotiated Rate	$231.52
Max. Negotiated Rate	$4,076.12
Rate for Payer: Aetna Commercial	$3,097.86
Rate for Payer: Aetna Medicare Advantage	$2,445.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,078.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,078.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,630.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,078.82
Rate for Payer: Cigna Commercial	$4,076.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,972.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.84
Rate for Payer: UnitedHealthcare Community & State	$257.61
Rate for Payer: Wellpoint Medicaid Managed Care	$231.52

OSS BEARING TIBIA ART LS 20MM

Facility

$8,152.25

Service Code	HCPCS C1776
Hospital Charge Code	270697107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,222.84
Max. Negotiated Rate	$1,972.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,630.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,972.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.84

OSS CEMENTED IM STEM 14 X 150

Facility

$9,540.00

Service Code	HCPCS C1776
Hospital Charge Code	270687278
Hospital Revenue Code	278
Min. Negotiated Rate	$1,431.00
Max. Negotiated Rate	$2,308.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,908.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,308.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,431.00

OSS CEMENTED IM STEM 14 X 150

Facility

$9,540.00

Service Code	HCPCS C1776
Hospital Charge Code	270687278
Hospital Revenue Code	278
Min. Negotiated Rate	$270.94
Max. Negotiated Rate	$4,770.00
Rate for Payer: Aetna Commercial	$3,625.20
Rate for Payer: Aetna Medicare Advantage	$2,862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,432.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,432.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,908.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,432.70
Rate for Payer: Cigna Commercial	$4,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,308.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,431.00
Rate for Payer: UnitedHealthcare Community & State	$301.46
Rate for Payer: Wellpoint Medicaid Managed Care	$270.94

OSSFX

Facility

$7,125.00

Hospital Charge Code	270704259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$1,724.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

OSSFX

Facility

$7,125.00

Hospital Charge Code	270704259
Hospital Revenue Code	278
Min. Negotiated Rate	$202.35
Max. Negotiated Rate	$3,562.50
Rate for Payer: Aetna Commercial	$2,707.50
Rate for Payer: Aetna Medicare Advantage	$2,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,816.88
Rate for Payer: Cigna Commercial	$3,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75
Rate for Payer: UnitedHealthcare Community & State	$225.15
Rate for Payer: Wellpoint Medicaid Managed Care	$202.35

OSSFX MOLDABLE 12CC

Facility

$16,375.00

Hospital Charge Code	270702344
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$3,962.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

OSSFX MOLDABLE 12CC

Facility

$16,375.00

Hospital Charge Code	270702344
Hospital Revenue Code	278
Min. Negotiated Rate	$465.05
Max. Negotiated Rate	$8,187.50
Rate for Payer: Aetna Commercial	$6,222.50
Rate for Payer: Aetna Medicare Advantage	$4,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.62
Rate for Payer: Cigna Commercial	$8,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25
Rate for Payer: UnitedHealthcare Community & State	$517.45
Rate for Payer: Wellpoint Medicaid Managed Care	$465.05

OSSIFUSE FLOWABLE FIBER BONE G

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270704710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

OSSIFUSE FLOWABLE FIBER BONE G

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270704710
Hospital Revenue Code	278
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

OSSIFY CORTICAL DBM FIBER 10CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIFY CORTICAL DBM FIBER 10CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691875
Hospital Revenue Code	278
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$268.60
Rate for Payer: Wellpoint Medicaid Managed Care	$241.40

OSSIFY CORTICAL FIBER 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696783
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIFY CORTICAL FIBER 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696783
Hospital Revenue Code	278
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$268.60
Rate for Payer: Wellpoint Medicaid Managed Care	$241.40

OSSIMATRIX SMALL PRFM

Facility

$6,475.00

Hospital Charge Code	270702458
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

OSSIMATRIX SMALL PRFM

Facility

$6,475.00

Hospital Charge Code	270702458
Hospital Revenue Code	278
Min. Negotiated Rate	$183.89
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$204.61
Rate for Payer: Wellpoint Medicaid Managed Care	$183.89

OSS IM STEM WITH SCREW 10MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684685
Hospital Revenue Code	278
Min. Negotiated Rate	$1,381.50
Max. Negotiated Rate	$2,228.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50

OSS IM STEM WITH SCREW 10MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684685
Hospital Revenue Code	278
Min. Negotiated Rate	$261.56
Max. Negotiated Rate	$4,605.00
Rate for Payer: Aetna Commercial	$3,499.80
Rate for Payer: Aetna Medicare Advantage	$2,763.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,348.55
Rate for Payer: Cigna Commercial	$4,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50
Rate for Payer: UnitedHealthcare Community & State	$291.04
Rate for Payer: Wellpoint Medicaid Managed Care	$261.56

OSS IM STEM WITH SCREW 11MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684689
Hospital Revenue Code	278
Min. Negotiated Rate	$261.56
Max. Negotiated Rate	$4,605.00
Rate for Payer: Aetna Commercial	$3,499.80
Rate for Payer: Aetna Medicare Advantage	$2,763.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,348.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,348.55
Rate for Payer: Cigna Commercial	$4,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50
Rate for Payer: UnitedHealthcare Community & State	$291.04
Rate for Payer: Wellpoint Medicaid Managed Care	$261.56

OSS IM STEM WITH SCREW 11MM X

Facility

$9,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270684689
Hospital Revenue Code	278
Min. Negotiated Rate	$1,381.50
Max. Negotiated Rate	$2,228.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,842.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,228.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,381.50

Know your out-of-pocket cost for care.

All Charges