Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPACERCOALITIONMIS12X14X7MM0D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694453
Hospital Revenue Code	278
Min. Negotiated Rate	$905.39
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$1,007.41
Rate for Payer: Wellpoint Medicaid Managed Care	$905.39

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694414
Hospital Revenue Code	278
Min. Negotiated Rate	$905.39
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$1,007.41
Rate for Payer: Wellpoint Medicaid Managed Care	$905.39

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	278694414
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270694414
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALITION MIS TI 12X14

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	278694414
Hospital Revenue Code	278
Min. Negotiated Rate	$905.39
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$1,007.41
Rate for Payer: Wellpoint Medicaid Managed Care	$905.39

SPACER COALIT TI 14X16 7D 8MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695928
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER COALIT TI 14X16 7D 8MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695928
Hospital Revenue Code	278
Min. Negotiated Rate	$905.39
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$12,114.40
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00
Rate for Payer: UnitedHealthcare Community & State	$1,007.41
Rate for Payer: Wellpoint Medicaid Managed Care	$905.39

SPACER DISTAL MED

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270660303
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SPACER DISTAL MED

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270660303
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$24.96
Rate for Payer: Wellpoint Medicaid Managed Care	$22.44

SPACER EVO SYNFIX 10.5MM 10D

Facility

$45,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698975
Hospital Revenue Code	278
Min. Negotiated Rate	$6,750.00
Max. Negotiated Rate	$10,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,890.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

SPACER EVO SYNFIX 10.5MM 10D

Facility

$45,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698975
Hospital Revenue Code	278
Min. Negotiated Rate	$1,278.00
Max. Negotiated Rate	$22,500.00
Rate for Payer: Aetna Commercial	$17,100.00
Rate for Payer: Aetna Medicare Advantage	$13,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,475.00
Rate for Payer: Cigna Commercial	$22,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,890.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00
Rate for Payer: UnitedHealthcare Community & State	$1,422.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,278.00

SPACER FLAT CERV 14X12X5MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698828
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACER FLAT CERV 14X12X5MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698828
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

SPACER FLAT CERVICAL 14X12X6MM

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697657
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

SPACER FLAT CERVICAL 14X12X6MM

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697657
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACER FORTICORE 14X12X7MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697215
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

SPACER FORTICORE 14X12X7MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697215
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACERFORTICORECERV8X12X14MM6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698377
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

SPACERFORTICORECERV8X12X14MM6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698377
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

SPACER HAMMERTOE 2.8MM X 10MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695045
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SPACER HAMMERTOE 2.8MM X 10MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695045
Hospital Revenue Code	278
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

SPACER HUMERAL 36MM +12

Facility

$2,450.00

Hospital Charge Code	270672434
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +12

Facility

$2,450.00

Hospital Charge Code	270672434
Hospital Revenue Code	278
Min. Negotiated Rate	$69.58
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Community & State	$77.42
Rate for Payer: Wellpoint Medicaid Managed Care	$69.58

SPACER HUMERAL 36MM +15

Facility

$2,450.00

Hospital Charge Code	270672435
Hospital Revenue Code	278
Min. Negotiated Rate	$69.58
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Community & State	$77.42
Rate for Payer: Wellpoint Medicaid Managed Care	$69.58

SPACER HUMERAL 36MM +15

Facility

$2,450.00

Hospital Charge Code	270672435
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

Know your out-of-pocket cost for care.

All Charges