Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ATTUNE KNEE SYSTEM TIBIAL BASE

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686057
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

ATTUNE KNEE SYSTEM TIBIAL BASE

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686057
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

ATTUNE PATELLA MEDIALIZED DOME

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686020
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ATTUNE PATELLA MEDIALIZED DOME

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686020
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

ATTUNE PINNING SYSTEM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270686446
Hospital Revenue Code	278
Min. Negotiated Rate	$46.01
Max. Negotiated Rate	$810.00
Rate for Payer: Aetna Commercial	$615.60
Rate for Payer: Aetna Medicare Advantage	$486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.10
Rate for Payer: Cigna Commercial	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00
Rate for Payer: UnitedHealthcare Community & State	$51.19
Rate for Payer: Wellpoint Medicaid Managed Care	$46.01

ATTUNE PINNING SYSTEM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270686446
Hospital Revenue Code	278
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$392.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00

ATTUNE TIBAL INSERT FIXED BEAR

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686058
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

ATTUNE TIBAL INSERT FIXED BEAR

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686058
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

ATTUN PAT MED DOM 38MM CEM AOX

Facility

$1,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673974
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

ATTUN PAT MED DOM 38MM CEM AOX

Facility

$1,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673974
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ATTUN SYS TIB BASE FIX BRNG

Facility

$1,621.75

Service Code	HCPCS C1776
Hospital Charge Code	270686564
Hospital Revenue Code	278
Min. Negotiated Rate	$243.26
Max. Negotiated Rate	$392.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.46
Rate for Payer: Qualcare PPO/HMO/WC	$243.26

ATTUN SYS TIB BASE FIX BRNG

Facility

$1,621.75

Service Code	HCPCS C1776
Hospital Charge Code	270686564
Hospital Revenue Code	278
Min. Negotiated Rate	$46.06
Max. Negotiated Rate	$810.88
Rate for Payer: Aetna Commercial	$616.26
Rate for Payer: Aetna Medicare Advantage	$486.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.55
Rate for Payer: Cigna Commercial	$810.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.46
Rate for Payer: Qualcare PPO/HMO/WC	$243.26
Rate for Payer: UnitedHealthcare Community & State	$51.25
Rate for Payer: Wellpoint Medicaid Managed Care	$46.06

ATTUN TIB INS FXD B PST SZ66MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686575
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

ATTUN TIB INS FXD B PST SZ66MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686575
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

AUGMENT 3CC

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270686745
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$4,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

AUGMENT 3CC

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270686745
Hospital Revenue Code	278
Min. Negotiated Rate	$496.29
Max. Negotiated Rate	$8,737.50
Rate for Payer: Aetna Commercial	$6,640.50
Rate for Payer: Aetna Medicare Advantage	$5,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,456.12
Rate for Payer: Cigna Commercial	$8,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25
Rate for Payer: UnitedHealthcare Community & State	$552.21
Rate for Payer: Wellpoint Medicaid Managed Care	$496.29

AUGMENT BONE MATRIX IMPL 3CC

Facility

$20,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270694903
Hospital Revenue Code	278
Min. Negotiated Rate	$588.59
Max. Negotiated Rate	$10,362.50
Rate for Payer: Aetna Commercial	$7,875.50
Rate for Payer: Aetna Medicare Advantage	$6,217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,284.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,284.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,284.88
Rate for Payer: Cigna Commercial	$10,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,015.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,108.75
Rate for Payer: UnitedHealthcare Community & State	$654.91
Rate for Payer: Wellpoint Medicaid Managed Care	$588.59

AUGMENT BONE MATRIX IMPL 3CC

Facility

$20,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270694903
Hospital Revenue Code	278
Min. Negotiated Rate	$3,108.75
Max. Negotiated Rate	$5,015.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,015.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,108.75

AUGMENTIN 200MG/5ML

Facility

$4.00

Service Code	NDC 43598021352
Hospital Charge Code	6063943289
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

AUGMENTIN 200MG/5ML

Facility

$4.00

Service Code	NDC 43598021352
Hospital Charge Code	6063943289
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

AUTGRFT IMPLNT KNEE W/SCOPE

Facility

$28,042.44

Service Code	HCPCS 29866
Hospital Charge Code	16000729
Hospital Revenue Code	360
Min. Negotiated Rate	$4,206.37
Max. Negotiated Rate	$4,206.37
Rate for Payer: Qualcare PPO/HMO/WC	$4,206.37

AUTGRFT IMPLNT KNEE W/SCOPE

Facility

$28,042.44

Service Code	HCPCS 29866
Hospital Charge Code	16000729
Hospital Revenue Code	360
Min. Negotiated Rate	$796.41
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	$7,291.03
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,206.37
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$886.14
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	$796.41

AUTO BLOOD PROCESSING&STORAGE

Facility

$405.00

Service Code	HCPCS 86890
Hospital Charge Code	38470103
Hospital Revenue Code	309
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.30
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$75.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

AUTO BLOOD PROCESSING&STORAGE

Facility

$405.00

Service Code	HCPCS 86890
Hospital Charge Code	38470103
Hospital Revenue Code	309
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

AUTOCHONDROCYTE IMPLANT KNEE

Facility

$22,425.68

Service Code	HCPCS 27412
Hospital Charge Code	16000885
Hospital Revenue Code	360
Min. Negotiated Rate	$636.89
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	$5,830.68
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,363.85
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$708.65
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	$636.89

Know your out-of-pocket cost for care.

All Charges