Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPACER IDENTITI 6X14X12MM 7D

Facility

$17,190.00

Service Code	HCPCS C1889
Hospital Charge Code	270697765
Hospital Revenue Code	278
Min. Negotiated Rate	$488.20
Max. Negotiated Rate	$8,595.00
Rate for Payer: Aetna Commercial	$6,532.20
Rate for Payer: Aetna Medicare Advantage	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,383.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,383.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,383.45
Rate for Payer: Cigna Commercial	$8,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,159.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,578.50
Rate for Payer: UnitedHealthcare Community & State	$543.20
Rate for Payer: Wellpoint Medicaid Managed Care	$488.20

SPACER IDENTITI ALIF 7X38X28

Facility

$33,165.00

Hospital Charge Code	270703008
Hospital Revenue Code	278
Min. Negotiated Rate	$4,974.75
Max. Negotiated Rate	$8,025.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,633.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,025.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,974.75

SPACER IDENTITI ALIF 7X38X28

Facility

$33,165.00

Hospital Charge Code	270703008
Hospital Revenue Code	278
Min. Negotiated Rate	$941.89
Max. Negotiated Rate	$16,582.50
Rate for Payer: Aetna Commercial	$12,602.70
Rate for Payer: Aetna Medicare Advantage	$9,949.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,457.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,457.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,633.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,457.08
Rate for Payer: Cigna Commercial	$16,582.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,025.93
Rate for Payer: Qualcare PPO/HMO/WC	$4,974.75
Rate for Payer: UnitedHealthcare Community & State	$1,048.01
Rate for Payer: Wellpoint Medicaid Managed Care	$941.89

SPACER IDENTITI SA 7X14X12MM7D

Facility

$17,190.00

Service Code	HCPCS C1889
Hospital Charge Code	270698831
Hospital Revenue Code	278
Min. Negotiated Rate	$488.20
Max. Negotiated Rate	$8,595.00
Rate for Payer: Aetna Commercial	$6,532.20
Rate for Payer: Aetna Medicare Advantage	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,383.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,383.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,383.45
Rate for Payer: Cigna Commercial	$8,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,159.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,578.50
Rate for Payer: UnitedHealthcare Community & State	$543.20
Rate for Payer: Wellpoint Medicaid Managed Care	$488.20

SPACER IDENTITI SA 7X14X12MM7D

Facility

$17,190.00

Service Code	HCPCS C1889
Hospital Charge Code	270698831
Hospital Revenue Code	278
Min. Negotiated Rate	$2,578.50
Max. Negotiated Rate	$4,159.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,438.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,159.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,578.50

SPACER KNEE COPAL XCHANGE G LT

Facility

$20,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696274
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 KNEE COPAL XCHANGE G LT

Facility

$20,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696274
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 LUMB SUPERION IDS 12MM

Facility

$13,375.00

Service Code	HCPCS C1889
Hospital Charge Code	270699506
Hospital Revenue Code	278
Min. Negotiated Rate	$379.85
Max. Negotiated Rate	$6,687.50
Rate for Payer: Aetna Commercial	$5,082.50
Rate for Payer: Aetna Medicare Advantage	$4,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,410.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,410.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,410.62
Rate for Payer: Cigna Commercial	$6,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,236.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,006.25
Rate for Payer: UnitedHealthcare Community & State	$422.65
Rate for Payer: Wellpoint Medicaid Managed Care	$379.85

SPACER LUMB SUPERION IDS 12MM

Facility

$13,375.00

Service Code	HCPCS C1889
Hospital Charge Code	270699506
Hospital Revenue Code	278
Min. Negotiated Rate	$2,006.25
Max. Negotiated Rate	$3,236.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,236.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,006.25

SPACER MIS COALIT 12X14X7D7MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270693441
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 MIS COALIT 12X14X7D7MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270693441
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 MIS COALITION 14X16 7D

Facility

$27,720.00

Service Code	HCPCS C1889
Hospital Charge Code	270692223
Hospital Revenue Code	278
Min. Negotiated Rate	$4,158.00
Max. Negotiated Rate	$6,708.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,544.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,708.24
Rate for Payer: Qualcare PPO/HMO/WC	$4,158.00

SPACER MIS COALITION 14X16 7D

Facility

$27,720.00

Service Code	HCPCS C1889
Hospital Charge Code	270692223
Hospital Revenue Code	278
Min. Negotiated Rate	$787.25
Max. Negotiated Rate	$13,860.00
Rate for Payer: Aetna Commercial	$10,533.60
Rate for Payer: Aetna Medicare Advantage	$8,316.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,068.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,068.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,544.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,068.60
Rate for Payer: Cigna Commercial	$13,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,708.24
Rate for Payer: Qualcare PPO/HMO/WC	$4,158.00
Rate for Payer: UnitedHealthcare Community & State	$875.95
Rate for Payer: Wellpoint Medicaid Managed Care	$787.25

SPACER MIS TI 12X14X9MM 7D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270697647
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 MIS TI 12X14X9MM 7D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270697647
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 MIS TI 7D 6MM 14X16MM

Facility

$31,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695460
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 MIS TI 7D 6MM 14X16MM

Facility

$31,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695460
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 MOD TLIF-O 8D 8X10X25MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270693670
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

SPACER MOD TLIF-O 8D 8X10X25MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270693670
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

SPACER NANO 6D SM 6MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697819
Hospital Revenue Code	278
Min. Negotiated Rate	$1,097.77
Max. Negotiated Rate	$19,326.88
Rate for Payer: Aetna Commercial	$14,688.42
Rate for Payer: Aetna Medicare Advantage	$11,596.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,856.71
Rate for Payer: Cigna Commercial	$19,326.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06
Rate for Payer: UnitedHealthcare Community & State	$1,221.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1,097.77

SPACER NANO 6D SM 6MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697819
Hospital Revenue Code	278
Min. Negotiated Rate	$5,798.06
Max. Negotiated Rate	$9,354.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06

SPACER NANO TC 6D SM 7MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697822
Hospital Revenue Code	278
Min. Negotiated Rate	$5,798.06
Max. Negotiated Rate	$9,354.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06

SPACER NANO TC 6D SM 7MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697822
Hospital Revenue Code	278
Min. Negotiated Rate	$1,097.77
Max. Negotiated Rate	$19,326.88
Rate for Payer: Aetna Commercial	$14,688.42
Rate for Payer: Aetna Medicare Advantage	$11,596.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,856.71
Rate for Payer: Cigna Commercial	$19,326.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06
Rate for Payer: UnitedHealthcare Community & State	$1,221.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1,097.77

SPACER NANO TI 7D 21X32X12MM

Facility

$105,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270696607
Hospital Revenue Code	278
Min. Negotiated Rate	$15,821.25
Max. Negotiated Rate	$25,524.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,524.95
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25

SPACER NANO TI 7D 21X32X12MM

Facility

$105,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270696607
Hospital Revenue Code	278
Min. Negotiated Rate	$2,995.49
Max. Negotiated Rate	$52,737.50
Rate for Payer: Aetna Commercial	$40,080.50
Rate for Payer: Aetna Medicare Advantage	$31,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,896.12
Rate for Payer: Cigna Commercial	$52,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,524.95
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25
Rate for Payer: UnitedHealthcare Community & State	$3,333.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2,995.49

Know your out-of-pocket cost for care.

All Charges