Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SECFTMX127DEGSTEMSZ9NK35MMCTPR

Facility

$11,937.80

Service Code	HCPCS C1776
Hospital Charge Code	270691183
Hospital Revenue Code	278
Min. Negotiated Rate	$339.03
Max. Negotiated Rate	$5,968.90
Rate for Payer: Aetna Commercial	$4,536.36
Rate for Payer: Aetna Medicare Advantage	$3,581.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,044.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,387.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,044.14
Rate for Payer: Cigna Commercial	$5,968.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,790.67
Rate for Payer: UnitedHealthcare Community & State	$377.23
Rate for Payer: Wellpoint Medicaid Managed Care	$339.03

SEC LUM ANT CAGE MED H16 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	2703855
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SEC LUM ANT CAGE MED H16 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	2703855
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE MEDIUM

Facility

$25,000.00

Hospital Charge Code	270702843
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SEC LUM ANT CAGE MEDIUM

Facility

$25,000.00

Hospital Charge Code	270702843
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE SM H14 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703792
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SEC LUM ANT CAGE SM H14 10DEG

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703792
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE SM H16 15D

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703793
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SEC LUM ANT CAGE SM H16 15D

Facility

$25,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703793
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SECOND CHANCE PROGRAM ADULT

Facility

$665.50

Service Code	HCPCS 99213
Hospital Charge Code	485099218
Hospital Revenue Code	919
Min. Negotiated Rate	$99.83
Max. Negotiated Rate	$99.83
Rate for Payer: Qualcare PPO/HMO/WC	$99.83

SECOND CHANCE PROGRAM ADULT

Facility

$665.50

Service Code	HCPCS 99213
Hospital Charge Code	485099218
Hospital Revenue Code	919
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$332.75
Rate for Payer: Aetna Commercial	$252.89
Rate for Payer: Aetna Medicare Advantage	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.70
Rate for Payer: Cigna Commercial	$332.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: Qualcare PPO/HMO/WC	$99.83
Rate for Payer: UnitedHealthcare Community & State	$21.03
Rate for Payer: Wellpoint Medicaid Managed Care	$18.90

SECOND LEVEL CER DISKECTOMY AD

Facility

$6,238.00

Service Code	HCPCS 22858
Hospital Charge Code	1600000582
Hospital Revenue Code	360
Min. Negotiated Rate	$935.70
Max. Negotiated Rate	$935.70
Rate for Payer: Qualcare PPO/HMO/WC	$935.70

SECOND LEVEL CER DISKECTOMY AD

Facility

$6,238.00

Service Code	HCPCS 22858
Hospital Charge Code	1600000582
Hospital Revenue Code	360
Min. Negotiated Rate	$177.16
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,370.44
Rate for Payer: Aetna Medicare Advantage	$1,871.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,590.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,590.69
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	$1,590.69
Rate for Payer: Cigna Commercial	$3,119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.88
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$935.70
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$197.12
Rate for Payer: Wellpoint Medicaid Managed Care	$177.16

SECRETIN 16 MCG VIAL

Facility

$3,517.50

Service Code	HCPCS J2850
Hospital Charge Code	60628905
Hospital Revenue Code	636
Min. Negotiated Rate	$38.22
Max. Negotiated Rate	$851.24
Rate for Payer: Aetna Commercial	$109.43
Rate for Payer: Aetna Medicare Advantage	$130.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.93
Rate for Payer: Cigna Medicare Advantage	$40.23
Rate for Payer: Clover Medicare Advantage	$38.22
Rate for Payer: EmblemHealth Commercial	$120.69
Rate for Payer: Humana Medicare Advantage	$41.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62
Rate for Payer: UnitedHealthcare Community & State	$111.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.23
Rate for Payer: Wellcare Medicare Advantage	$40.23
Rate for Payer: Wellpoint Medicaid Managed Care	$99.90

SECRETIN 16 MCG VIAL

Facility

$3,517.50

Service Code	HCPCS J2850
Hospital Charge Code	60628905
Hospital Revenue Code	636
Min. Negotiated Rate	$527.62
Max. Negotiated Rate	$851.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$851.24
Rate for Payer: Qualcare PPO/HMO/WC	$527.62

SECURED LUM ANT CAGE SMALL H12

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705124
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SECURED LUM ANT CAGE SMALL H12

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705124
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SECURED LUMBAR ANTERIOR CAGE M

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704527
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

SECURED LUMBAR ANTERIOR CAGE M

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704527
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

SECURE STRAP 5MM

Facility

$862.50

Hospital Charge Code	270339466
Hospital Revenue Code	272
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$431.25
Rate for Payer: Aetna Commercial	$327.75
Rate for Payer: Aetna Medicare Advantage	$258.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.94
Rate for Payer: Cigna Commercial	$431.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.25
Rate for Payer: Oxford Commercial	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$129.38
Rate for Payer: UnitedHealthcare Commercial	$172.50
Rate for Payer: UnitedHealthcare Community & State	$27.25
Rate for Payer: Wellpoint Medicaid Managed Care	$24.50

SECURE STRAP 5MM

Facility

$862.50

Hospital Charge Code	270339466
Hospital Revenue Code	272
Min. Negotiated Rate	$129.38
Max. Negotiated Rate	$129.38
Rate for Payer: Qualcare PPO/HMO/WC	$129.38

SECUR-FIT MAX 132 HIP SYSTEM

Facility

$11,449.40

Service Code	HCPCS C1776
Hospital Charge Code	270692858
Hospital Revenue Code	278
Min. Negotiated Rate	$1,717.41
Max. Negotiated Rate	$2,770.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,289.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.41

SECUR-FIT MAX 132 HIP SYSTEM

Facility

$11,449.40

Service Code	HCPCS C1776
Hospital Charge Code	270692858
Hospital Revenue Code	278
Min. Negotiated Rate	$325.16
Max. Negotiated Rate	$5,724.70
Rate for Payer: Aetna Commercial	$4,350.77
Rate for Payer: Aetna Medicare Advantage	$3,434.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,919.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,919.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,289.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,919.60
Rate for Payer: Cigna Commercial	$5,724.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.41
Rate for Payer: UnitedHealthcare Community & State	$361.80
Rate for Payer: Wellpoint Medicaid Managed Care	$325.16

SEDIMENTATION RATE (ESR)

Facility

$667.59

Service Code	HCPCS 85651
Hospital Charge Code	3006087
Hospital Revenue Code	305
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.49
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

SEDIMENTATION RATE (ESR)

Facility

$667.59

Service Code	HCPCS 85651
Hospital Charge Code	3006087
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

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