Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PATELLAR COMPONENT OVAL SZ

Facility

$2,750.00

Hospital Charge Code	270667534
Hospital Revenue Code	278
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

PATELLAR COMP OVAL SZ 1 10MM

Facility

$3,750.00

Hospital Charge Code	270669292
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PATELLAR COMP OVAL SZ 1 10MM

Facility

$3,750.00

Hospital Charge Code	270669292
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

PATELLAR COMP. OVAL SZ 2 7.5

Facility

$2,976.25

Hospital Charge Code	270671357
Hospital Revenue Code	278
Min. Negotiated Rate	$84.53
Max. Negotiated Rate	$1,488.12
Rate for Payer: Aetna Commercial	$1,130.97
Rate for Payer: Aetna Medicare Advantage	$892.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.94
Rate for Payer: Cigna Commercial	$1,488.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.44
Rate for Payer: UnitedHealthcare Community & State	$94.05
Rate for Payer: Wellpoint Medicaid Managed Care	$84.53

PATELLAR COMP. OVAL SZ 2 7.5

Facility

$2,976.25

Hospital Charge Code	270671357
Hospital Revenue Code	278
Min. Negotiated Rate	$446.44
Max. Negotiated Rate	$720.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.44

PATELLA, REAMER BLADE W/ PI

Facility

$875.00

Hospital Charge Code	270665753
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

PATELLA, REAMER BLADE W/ PI

Facility

$875.00

Hospital Charge Code	270665753
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

PATELLA REAMER BLADE W/ PILOT

Facility

$6,000.00

Hospital Charge Code	270661349
Hospital Revenue Code	272
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) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$1,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

PATELLA REAMER BLADE W/ PILOT

Facility

$6,000.00

Hospital Charge Code	270661349
Hospital Revenue Code	272
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

PATELLA REAMER BLADE W PILOT H

Facility

$20,750.00

Hospital Charge Code	270657054
Hospital Revenue Code	278
Min. Negotiated Rate	$589.30
Max. Negotiated Rate	$10,375.00
Rate for Payer: Aetna Commercial	$7,885.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$10,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50
Rate for Payer: UnitedHealthcare Community & State	$655.70
Rate for Payer: Wellpoint Medicaid Managed Care	$589.30

PATELLA REAMER BLADE W PILOT H

Facility

$20,750.00

Hospital Charge Code	270657054
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

PATELLA REAMING SYSTEM 35MM

Facility

$700.00

Hospital Charge Code	270703499
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

PATELLA REAMING SYSTEM 35MM

Facility

$700.00

Hospital Charge Code	270703499
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

PATELLA REAMING SYSTEM 38MM

Facility

$700.00

Hospital Charge Code	270703498
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

PATELLA REAMING SYSTEM 38MM

Facility

$700.00

Hospital Charge Code	270703498
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

PATELLA REGENEREX SZ31

Facility

$1,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270646611
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

PATELLA REGENEREX SZ31

Facility

$1,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270646611
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

PATELLA RESURFACE RD DOME 29MM

Facility

$3,770.00

Hospital Charge Code	270668848
Hospital Revenue Code	278
Min. Negotiated Rate	$565.50
Max. Negotiated Rate	$912.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50

PATELLA RESURFACE RD DOME 29MM

Facility

$3,770.00

Hospital Charge Code	270668848
Hospital Revenue Code	278
Min. Negotiated Rate	$107.07
Max. Negotiated Rate	$1,885.00
Rate for Payer: Aetna Commercial	$1,432.60
Rate for Payer: Aetna Medicare Advantage	$1,131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$961.35
Rate for Payer: Cigna Commercial	$1,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50
Rate for Payer: UnitedHealthcare Community & State	$119.13
Rate for Payer: Wellpoint Medicaid Managed Care	$107.07

PATELLA RESURFACE RD DOME 32MM

Facility

$3,770.00

Hospital Charge Code	270668849
Hospital Revenue Code	278
Min. Negotiated Rate	$107.07
Max. Negotiated Rate	$1,885.00
Rate for Payer: Aetna Commercial	$1,432.60
Rate for Payer: Aetna Medicare Advantage	$1,131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$961.35
Rate for Payer: Cigna Commercial	$1,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50
Rate for Payer: UnitedHealthcare Community & State	$119.13
Rate for Payer: Wellpoint Medicaid Managed Care	$107.07

PATELLA RESURFACE RD DOME 32MM

Facility

$3,770.00

Hospital Charge Code	270668849
Hospital Revenue Code	278
Min. Negotiated Rate	$565.50
Max. Negotiated Rate	$912.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50

PATELLA RESURFACE RD DOME 35MM

Facility

$3,770.00

Hospital Charge Code	270668850
Hospital Revenue Code	278
Min. Negotiated Rate	$107.07
Max. Negotiated Rate	$1,885.00
Rate for Payer: Aetna Commercial	$1,432.60
Rate for Payer: Aetna Medicare Advantage	$1,131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$961.35
Rate for Payer: Cigna Commercial	$1,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50
Rate for Payer: UnitedHealthcare Community & State	$119.13
Rate for Payer: Wellpoint Medicaid Managed Care	$107.07

PATELLA RESURFACE RD DOME 35MM

Facility

$3,770.00

Hospital Charge Code	270668850
Hospital Revenue Code	278
Min. Negotiated Rate	$565.50
Max. Negotiated Rate	$912.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50

PATELLA RESURFACE RD DOME 38MM

Facility

$3,770.00

Hospital Charge Code	270668851
Hospital Revenue Code	278
Min. Negotiated Rate	$565.50
Max. Negotiated Rate	$912.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50

PATELLA RESURFACE RD DOME 38MM

Facility

$3,770.00

Hospital Charge Code	270668851
Hospital Revenue Code	278
Min. Negotiated Rate	$107.07
Max. Negotiated Rate	$1,885.00
Rate for Payer: Aetna Commercial	$1,432.60
Rate for Payer: Aetna Medicare Advantage	$1,131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$961.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$961.35
Rate for Payer: Cigna Commercial	$1,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.34
Rate for Payer: Qualcare PPO/HMO/WC	$565.50
Rate for Payer: UnitedHealthcare Community & State	$119.13
Rate for Payer: Wellpoint Medicaid Managed Care	$107.07

Know your out-of-pocket cost for care.

All Charges