Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE PYRENEES LVL 2 50MM

Facility

$6,940.00

Hospital Charge Code	270670302
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 50MM

Facility

$6,940.00

Hospital Charge Code	270670302
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 52MM

Facility

$6,940.00

Hospital Charge Code	270670303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 52MM

Facility

$6,940.00

Hospital Charge Code	270670303
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 2 54MM

Facility

$6,940.00

Hospital Charge Code	270670304
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENEES LVL 2 54MM

Facility

$6,940.00

Hospital Charge Code	270670304
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE PYRENEES LVL 3 48MM

Facility

$7,845.00

Hospital Charge Code	270670305
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 48MM

Facility

$7,845.00

Hospital Charge Code	270670305
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 51MM

Facility

$7,845.00

Hospital Charge Code	270670306
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 51MM

Facility

$7,845.00

Hospital Charge Code	270670306
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 54MM

Facility

$7,845.00

Hospital Charge Code	270648864
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 54MM

Facility

$7,845.00

Hospital Charge Code	270648864
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 57MM

Facility

$7,845.00

Hospital Charge Code	270670307
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 57MM

Facility

$7,845.00

Hospital Charge Code	270670307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 60MM

Facility

$7,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270670308
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 60MM

Facility

$7,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270670308
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 63MM

Facility

$7,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270670309
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 63MM

Facility

$7,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270670309
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 66MM

Facility

$7,845.00

Hospital Charge Code	270670310
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 66MM

Facility

$7,845.00

Hospital Charge Code	270670310
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 69MM

Facility

$7,845.00

Hospital Charge Code	270670311
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 69MM

Facility

$7,845.00

Hospital Charge Code	270670311
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 72MM

Facility

$7,845.00

Hospital Charge Code	270670312
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

PLATE PYRENEES LVL 3 72MM

Facility

$7,845.00

Hospital Charge Code	270670312
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

PLATE PYRENEES LVL 3 75MM

Facility

$7,845.00

Hospital Charge Code	270670313
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

Know your out-of-pocket cost for care.

All Charges