Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPACER SIDE RAIL

Facility

$77.00

Hospital Charge Code	270679661
Hospital Revenue Code	272
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$11.55
Rate for Payer: Qualcare PPO/HMO/WC	$11.55

SPACER SPINE PK CAPST 26X11MM

Facility

$35,190.00

Service Code	HCPCS C1889
Hospital Charge Code	270696283
Hospital Revenue Code	278
Min. Negotiated Rate	$999.40
Max. Negotiated Rate	$17,595.00
Rate for Payer: Aetna Commercial	$13,372.20
Rate for Payer: Aetna Medicare Advantage	$10,557.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,973.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,973.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,038.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,973.45
Rate for Payer: Cigna Commercial	$17,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,515.98
Rate for Payer: Qualcare PPO/HMO/WC	$5,278.50
Rate for Payer: UnitedHealthcare Community & State	$1,112.00
Rate for Payer: Wellpoint Medicaid Managed Care	$999.40

SPACER SPINE PK CAPST 26X11MM

Facility

$35,190.00

Service Code	HCPCS C1889
Hospital Charge Code	270696283
Hospital Revenue Code	278
Min. Negotiated Rate	$5,278.50
Max. Negotiated Rate	$8,515.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,038.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,515.98
Rate for Payer: Qualcare PPO/HMO/WC	$5,278.50

SPACER STEALTH PEEK 12X14X7 0D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695241
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

SPACER STEALTH PEEK 12X14X7 0D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695241
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

SPACER SUPERION IDS 10MM

Facility

$56,500.00

Service Code	HCPCS C1821
Hospital Charge Code	270698041
Hospital Revenue Code	278
Min. Negotiated Rate	$8,475.00
Max. Negotiated Rate	$13,673.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,673.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,475.00

SPACER SUPERION IDS 10MM

Facility

$56,500.00

Service Code	HCPCS C1821
Hospital Charge Code	270698041
Hospital Revenue Code	278
Min. Negotiated Rate	$1,604.60
Max. Negotiated Rate	$28,250.00
Rate for Payer: Aetna Commercial	$21,470.00
Rate for Payer: Aetna Medicare Advantage	$16,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,407.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,407.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,407.50
Rate for Payer: Cigna Commercial	$28,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,673.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,475.00
Rate for Payer: UnitedHealthcare Community & State	$1,785.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,604.60

SPACER,TI PC 7X10X25MM

Facility

$23,250.00

Hospital Charge Code	270703574
Hospital Revenue Code	278
Min. Negotiated Rate	$660.30
Max. Negotiated Rate	$11,625.00
Rate for Payer: Aetna Commercial	$8,835.00
Rate for Payer: Aetna Medicare Advantage	$6,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,928.75
Rate for Payer: Cigna Commercial	$11,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50
Rate for Payer: UnitedHealthcare Community & State	$734.70
Rate for Payer: Wellpoint Medicaid Managed Care	$660.30

SPACER,TI PC 7X10X25MM

Facility

$23,250.00

Hospital Charge Code	270703574
Hospital Revenue Code	278
Min. Negotiated Rate	$3,487.50
Max. Negotiated Rate	$5,626.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50

SPACER,TI PC 7X10X25MM

Facility

$23,250.00

Hospital Charge Code	27070321
Hospital Revenue Code	278
Min. Negotiated Rate	$660.30
Max. Negotiated Rate	$11,625.00
Rate for Payer: Aetna Commercial	$8,835.00
Rate for Payer: Aetna Medicare Advantage	$6,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,928.75
Rate for Payer: Cigna Commercial	$11,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50
Rate for Payer: UnitedHealthcare Community & State	$734.70
Rate for Payer: Wellpoint Medicaid Managed Care	$660.30

SPACER,TI PC 7X10X25MM

Facility

$23,250.00

Hospital Charge Code	27070321
Hospital Revenue Code	278
Min. Negotiated Rate	$3,487.50
Max. Negotiated Rate	$5,626.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50

SPACER TLIF TLX 12X11X26MM20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699355
Hospital Revenue Code	278
Min. Negotiated Rate	$5,850.00
Max. Negotiated Rate	$9,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00

SPACER TLIF TLX 12X11X26MM20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699355
Hospital Revenue Code	278
Min. Negotiated Rate	$1,107.60
Max. Negotiated Rate	$19,500.00
Rate for Payer: Aetna Commercial	$14,820.00
Rate for Payer: Aetna Medicare Advantage	$11,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,945.00
Rate for Payer: Cigna Commercial	$19,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00
Rate for Payer: UnitedHealthcare Community & State	$1,232.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,107.60

SPACER UNICORT PAR 6

Facility

$3,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270688756
Hospital Revenue Code	278
Min. Negotiated Rate	$97.13
Max. Negotiated Rate	$1,710.00
Rate for Payer: Aetna Commercial	$1,299.60
Rate for Payer: Aetna Medicare Advantage	$1,026.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.10
Rate for Payer: Cigna Commercial	$1,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$827.64
Rate for Payer: Qualcare PPO/HMO/WC	$513.00
Rate for Payer: UnitedHealthcare Community & State	$108.07
Rate for Payer: Wellpoint Medicaid Managed Care	$97.13

SPACER UNICORT PAR 6

Facility

$3,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270688756
Hospital Revenue Code	278
Min. Negotiated Rate	$513.00
Max. Negotiated Rate	$827.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$827.64
Rate for Payer: Qualcare PPO/HMO/WC	$513.00

SPACER VBR 14X14.5X13MM

Facility

$41,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697507
Hospital Revenue Code	278
Min. Negotiated Rate	$6,150.00
Max. Negotiated Rate	$9,922.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,922.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,150.00

SPACER VBR 14X14.5X13MM

Facility

$41,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697507
Hospital Revenue Code	278
Min. Negotiated Rate	$1,164.40
Max. Negotiated Rate	$20,500.00
Rate for Payer: Aetna Commercial	$15,580.00
Rate for Payer: Aetna Medicare Advantage	$12,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,455.00
Rate for Payer: Cigna Commercial	$20,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,922.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,150.00
Rate for Payer: UnitedHealthcare Community & State	$1,295.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1,164.40

SPACER VBR 14X14.5X2MM

Facility

$3,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697506
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

SPACER VBR 14X14.5X2MM

Facility

$3,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697506
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

SPACER W/BN GFT 14X12X6 6D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695237
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

SPACER W/BN GFT 14X12X6 6D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695237
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

SPACER W/BN GFT 16X14X6 6D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695236
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

SPACER W/BN GFT 16X14X6 6D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695236
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

SPACER ZFUSE PLIF 22X9MM

Facility

$20,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695041
Hospital Revenue Code	278
Min. Negotiated Rate	$582.20
Max. Negotiated Rate	$10,250.00
Rate for Payer: Aetna Commercial	$7,790.00
Rate for Payer: Aetna Medicare Advantage	$6,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,227.50
Rate for Payer: Cigna Commercial	$10,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,075.00
Rate for Payer: UnitedHealthcare Community & State	$647.80
Rate for Payer: Wellpoint Medicaid Managed Care	$582.20

SPACER ZFUSE PLIF 22X9MM

Facility

$20,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695041
Hospital Revenue Code	278
Min. Negotiated Rate	$3,075.00
Max. Negotiated Rate	$4,961.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,075.00

Know your out-of-pocket cost for care.

All Charges