Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPACER ZFUZE PLIF 22X10MM

Facility

$20,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695435
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

SPACER ZFUZE PLIF 22X10MM

Facility

$20,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695435
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

SPACR OSTBR IKA KNEE ARTH 40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270678247
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SPACR OSTBR IKA KNEE ARTH 40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270678247
Hospital Revenue Code	278
Min. Negotiated Rate	$639.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$711.00
Rate for Payer: Wellpoint Medicaid Managed Care	$639.00

SPANAID BOOT CRADLE

Facility

$98.58

Hospital Charge Code	270302706
Hospital Revenue Code	270
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$49.29
Rate for Payer: Aetna Commercial	$37.46
Rate for Payer: Aetna Medicare Advantage	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.14
Rate for Payer: Cigna Commercial	$49.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.63
Rate for Payer: Oxford Commercial	$19.72
Rate for Payer: Qualcare PPO/HMO/WC	$14.79
Rate for Payer: UnitedHealthcare Commercial	$19.72
Rate for Payer: UnitedHealthcare Community & State	$3.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.80

SPANAID BOOT CRADLE

Facility

$98.58

Hospital Charge Code	270302706
Hospital Revenue Code	270
Min. Negotiated Rate	$14.79
Max. Negotiated Rate	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$14.79

SPANAID FOOT DROP STOP

Facility

$633.39

Hospital Charge Code	270303018
Hospital Revenue Code	270
Min. Negotiated Rate	$95.01
Max. Negotiated Rate	$95.01
Rate for Payer: Qualcare PPO/HMO/WC	$95.01

SPANAID FOOT DROP STOP

Facility

$633.39

Hospital Charge Code	270303018
Hospital Revenue Code	270
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$316.69
Rate for Payer: Aetna Commercial	$240.69
Rate for Payer: Aetna Medicare Advantage	$190.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.51
Rate for Payer: Cigna Commercial	$316.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.68
Rate for Payer: Oxford Commercial	$126.68
Rate for Payer: Qualcare PPO/HMO/WC	$95.01
Rate for Payer: UnitedHealthcare Commercial	$126.68
Rate for Payer: UnitedHealthcare Community & State	$20.02
Rate for Payer: Wellpoint Medicaid Managed Care	$17.99

SPANDAGE SZ 8 MT8X24

Facility

$5.53

Hospital Charge Code	270640000W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

SPANDAGE SZ 8 MT8X24

Facility

$5.53

Hospital Charge Code	270640000W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.77
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.41
Rate for Payer: Cigna Commercial	$2.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.44
Rate for Payer: Oxford Commercial	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$0.83
Rate for Payer: UnitedHealthcare Commercial	$1.11
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SPANDAGE TOE 24 MT1X24

Facility

$10.00

Hospital Charge Code	270639040
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

SPANDAGE TOE 24 MT1X24

Facility

$10.00

Hospital Charge Code	270639040
Hospital Revenue Code	272
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

SP BONE AGRFT MORSEL ADD-ON

Facility

$6,322.68

Service Code	HCPCS 20937
Hospital Charge Code	16000603
Hospital Revenue Code	360
Min. Negotiated Rate	$199.80
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$2,402.62
Rate for Payer: Aetna Medicare Advantage	$1,896.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,612.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,612.28
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	$1,612.28
Rate for Payer: Cigna Commercial	$3,161.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,643.90
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$948.40
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$199.80

SP BONE AGRFT MORSEL ADD-ON

Facility

$6,322.68

Service Code	HCPCS 20937
Hospital Charge Code	16000603
Hospital Revenue Code	360
Min. Negotiated Rate	$948.40
Max. Negotiated Rate	$948.40
Rate for Payer: Qualcare PPO/HMO/WC	$948.40

SP BONE ALGRFT MORSEL ADD-ON

Facility

$11,887.22

Service Code	HCPCS 20930
Hospital Charge Code	16000253
Hospital Revenue Code	360
Min. Negotiated Rate	$1,783.08
Max. Negotiated Rate	$1,783.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08

SP BONE ALGRFT MORSEL ADD-ON

Facility

$11,887.22

Service Code	HCPCS 20930
Hospital Charge Code	16000253
Hospital Revenue Code	360
Min. Negotiated Rate	$337.60
Max. Negotiated Rate	$5,943.61
Rate for Payer: Aetna Commercial	$4,517.14
Rate for Payer: Aetna Medicare Advantage	$3,566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,031.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,031.24
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	$3,031.24
Rate for Payer: Cigna Commercial	$5,943.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,090.68
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$375.64
Rate for Payer: Wellpoint Medicaid Managed Care	$337.60

SP BONE ALGRFT STRUCT ADD - ON

Facility

$25,282.63

Service Code	HCPCS 20931
Hospital Charge Code	16000669
Hospital Revenue Code	360
Min. Negotiated Rate	$718.03
Max. Negotiated Rate	$12,641.32
Rate for Payer: Aetna Commercial	$9,607.40
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$12,641.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,573.48
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$798.93
Rate for Payer: Wellpoint Medicaid Managed Care	$718.03

SP BONE ALGRFT STRUCT ADD - ON

Facility

$25,282.63

Service Code	HCPCS 20931
Hospital Charge Code	16000669
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

SP COGN SKILL DEVELOP EA 15 MN

Facility

$116.85

Service Code	HCPCS 96125GN
Hospital Charge Code	9100145
Hospital Revenue Code	440
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$44.40
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.38
Rate for Payer: Oxford Commercial	$933.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$3.69
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

SP COGN SKILL DEVELOP EA 15 MN

Facility

$116.85

Service Code	HCPCS 96125GN
Hospital Charge Code	9100145
Hospital Revenue Code	440
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

SPCR PLATEAU-C 8MM 37-1613-708

Facility

$5,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270698919
Hospital Revenue Code	278
Min. Negotiated Rate	$159.04
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$2,128.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00
Rate for Payer: UnitedHealthcare Community & State	$176.96
Rate for Payer: Wellpoint Medicaid Managed Care	$159.04

SPCR PLATEAU-C 8MM 37-1613-708

Facility

$5,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270698919
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

SPCR PRODISC INS TPS DP TM 6mm

Facility

$1,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270693165
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SPCR PRODISC INS TPS DP TM 6mm

Facility

$1,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270693165
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SPEAKING VALVE PURPLE

Facility

$532.05

Hospital Charge Code	270616940
Hospital Revenue Code	270
Min. Negotiated Rate	$79.81
Max. Negotiated Rate	$79.81
Rate for Payer: Qualcare PPO/HMO/WC	$79.81

Know your out-of-pocket cost for care.

All Charges