Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPI FIL WIRE 6.0M SPD2US060320

Facility

$6,000.00

Hospital Charge Code	270638657
Hospital Revenue Code	272
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$1,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

SPINA LAMINA 1/2 CRVL

Facility

$23,080.70

Service Code	HCPCS 63001
Hospital Charge Code	16001018
Hospital Revenue Code	360
Min. Negotiated Rate	$655.49
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,000.98
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,462.11
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$729.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$655.49

SPINA LAMINA 1/2 CRVL

Facility

$23,080.70

Service Code	HCPCS 63001
Hospital Charge Code	16001018
Hospital Revenue Code	360
Min. Negotiated Rate	$3,462.11
Max. Negotiated Rate	$3,462.11
Rate for Payer: Qualcare PPO/HMO/WC	$3,462.11

SPINAL BLADE 60

Facility

$2,563.85

Hospital Charge Code	270687792
Hospital Revenue Code	272
Min. Negotiated Rate	$72.81
Max. Negotiated Rate	$1,281.92
Rate for Payer: Aetna Commercial	$974.26
Rate for Payer: Aetna Medicare Advantage	$769.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$653.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$653.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$653.78
Rate for Payer: Cigna Commercial	$1,281.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$666.60
Rate for Payer: Oxford Commercial	$512.77
Rate for Payer: Qualcare PPO/HMO/WC	$384.58
Rate for Payer: UnitedHealthcare Commercial	$512.77
Rate for Payer: UnitedHealthcare Community & State	$81.02
Rate for Payer: Wellpoint Medicaid Managed Care	$72.81

SPINAL BLADE 60

Facility

$2,563.85

Hospital Charge Code	270687792
Hospital Revenue Code	272
Min. Negotiated Rate	$384.58
Max. Negotiated Rate	$384.58
Rate for Payer: Qualcare PPO/HMO/WC	$384.58

SPINAL CORD NEUROSTIMULATOR

Facility

$31,800.00

Hospital Charge Code	270335911
Hospital Revenue Code	278
Min. Negotiated Rate	$903.12
Max. Negotiated Rate	$15,900.00
Rate for Payer: Aetna Commercial	$12,084.00
Rate for Payer: Aetna Medicare Advantage	$9,540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,109.00
Rate for Payer: Cigna Commercial	$15,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,695.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,770.00
Rate for Payer: UnitedHealthcare Community & State	$1,004.88
Rate for Payer: Wellpoint Medicaid Managed Care	$903.12

SPINAL CORD NEUROSTIMULATOR

Facility

$31,800.00

Hospital Charge Code	270335911
Hospital Revenue Code	278
Min. Negotiated Rate	$4,770.00
Max. Negotiated Rate	$7,695.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,695.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,770.00

SPINAL CORD STIM GEN IMP VANTA

Facility

$122,085.00

Service Code	HCPCS C1767
Hospital Charge Code	270699096
Hospital Revenue Code	278
Min. Negotiated Rate	$18,312.75
Max. Negotiated Rate	$29,544.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24,417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,544.57
Rate for Payer: Qualcare PPO/HMO/WC	$18,312.75

SPINAL CORD STIM GEN IMP VANTA

Facility

$122,085.00

Service Code	HCPCS C1767
Hospital Charge Code	270699096
Hospital Revenue Code	278
Min. Negotiated Rate	$3,467.21
Max. Negotiated Rate	$61,042.50
Rate for Payer: Aetna Commercial	$46,392.30
Rate for Payer: Aetna Medicare Advantage	$36,625.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,131.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,131.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24,417.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,131.67
Rate for Payer: Cigna Commercial	$61,042.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,544.57
Rate for Payer: Qualcare PPO/HMO/WC	$18,312.75
Rate for Payer: UnitedHealthcare Community & State	$3,857.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3,467.21

SPINAL CORD STIMULATION IMPLAN

Facility

$122,085.00

Service Code	HCPCS C1889
Hospital Charge Code	270699302
Hospital Revenue Code	278
Min. Negotiated Rate	$3,467.21
Max. Negotiated Rate	$61,042.50
Rate for Payer: Aetna Commercial	$46,392.30
Rate for Payer: Aetna Medicare Advantage	$36,625.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,131.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,131.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24,417.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,131.67
Rate for Payer: Cigna Commercial	$61,042.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,544.57
Rate for Payer: Qualcare PPO/HMO/WC	$18,312.75
Rate for Payer: UnitedHealthcare Community & State	$3,857.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3,467.21

SPINAL CORD STIMULATION IMPLAN

Facility

$122,085.00

Service Code	HCPCS C1889
Hospital Charge Code	270699302
Hospital Revenue Code	278
Min. Negotiated Rate	$18,312.75
Max. Negotiated Rate	$29,544.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24,417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29,544.57
Rate for Payer: Qualcare PPO/HMO/WC	$18,312.75

SPINAL DISK SURGERY ADD-ON

Facility

$29,387.89

Service Code	HCPCS 63035
Hospital Charge Code	16000489
Hospital Revenue Code	360
Min. Negotiated Rate	$834.62
Max. Negotiated Rate	$14,693.94
Rate for Payer: Aetna Commercial	$11,167.40
Rate for Payer: Aetna Medicare Advantage	$8,816.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,493.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,493.91
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	$7,493.91
Rate for Payer: Cigna Commercial	$14,693.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,640.85
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,408.18
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$928.66
Rate for Payer: Wellpoint Medicaid Managed Care	$834.62

SPINAL DISK SURGERY ADD-ON

Facility

$29,387.89

Service Code	HCPCS 63035
Hospital Charge Code	16000489
Hospital Revenue Code	360
Min. Negotiated Rate	$4,408.18
Max. Negotiated Rate	$4,408.18
Rate for Payer: Qualcare PPO/HMO/WC	$4,408.18

SPINAL DISORDERS AND INJURIES

Facility

$11,970.94

Service Code	APR-DRG 0401
Min. Negotiated Rate	$11,736.22
Max. Negotiated Rate	$11,970.94
Rate for Payer: UnitedHealthcare Community & State	$11,736.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,970.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11,736.22

SPINAL DISORDERS AND INJURIES

Facility

$23,721.39

Service Code	APR-DRG 0403
Min. Negotiated Rate	$23,256.26
Max. Negotiated Rate	$23,721.39
Rate for Payer: UnitedHealthcare Community & State	$23,256.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,721.39
Rate for Payer: Wellpoint Medicaid Managed Care	$23,256.26

SPINAL DISORDERS AND INJURIES

Facility

$35,210.64

Service Code	APR-DRG 0404
Min. Negotiated Rate	$34,520.24
Max. Negotiated Rate	$35,210.64
Rate for Payer: UnitedHealthcare Community & State	$34,520.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,210.64
Rate for Payer: Wellpoint Medicaid Managed Care	$34,520.24

SPINAL DISORDERS AND INJURIES

Facility

$16,901.71

Service Code	APR-DRG 0402
Min. Negotiated Rate	$16,570.30
Max. Negotiated Rate	$16,901.71
Rate for Payer: UnitedHealthcare Community & State	$16,570.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,901.71
Rate for Payer: Wellpoint Medicaid Managed Care	$16,570.30

SPINAL DISORDERS AND INJURIES WITH CC/MCC

Facility

$76,690.07

Service Code	MSDRG 052
Min. Negotiated Rate	$23,351.14
Max. Negotiated Rate	$76,690.07
Rate for Payer: Aetna Medicare Advantage	$76,690.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53,747.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53,747.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,580.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53,747.70
Rate for Payer: Cigna Commercial	$39,699.37
Rate for Payer: Cigna Medicare Advantage	$24,580.15
Rate for Payer: Clover Medicare Advantage	$23,351.14
Rate for Payer: EmblemHealth Commercial	$73,740.45
Rate for Payer: Humana Medicare Advantage	$25,317.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,580.15
Rate for Payer: Oxford Commercial	$31,377.70
Rate for Payer: UnitedHealthcare Commercial	$42,000.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,580.15
Rate for Payer: Wellcare Medicare Advantage	$24,580.15

SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC

Facility

$50,401.10

Service Code	MSDRG 053
Min. Negotiated Rate	$15,346.49
Max. Negotiated Rate	$50,401.10
Rate for Payer: Aetna Medicare Advantage	$50,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,154.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,150.90
Rate for Payer: Cigna Commercial	$21,829.31
Rate for Payer: Cigna Medicare Advantage	$16,154.20
Rate for Payer: Clover Medicare Advantage	$15,346.49
Rate for Payer: EmblemHealth Commercial	$48,462.60
Rate for Payer: Humana Medicare Advantage	$16,638.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,154.20
Rate for Payer: Oxford Commercial	$17,253.50
Rate for Payer: UnitedHealthcare Commercial	$23,094.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,154.20
Rate for Payer: Wellcare Medicare Advantage	$16,154.20

SPINAL FLUID TAP DIAGNOSTIC

Facility

$2,864.05

Service Code	HCPCS 62270
Hospital Charge Code	411062270
Hospital Revenue Code	361
Min. Negotiated Rate	$81.34
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,042.06
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.65
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$429.61
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$90.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$81.34

SPINAL FLUID TAP DIAGNOSTIC

Facility

$2,864.05

Service Code	HCPCS 62270
Hospital Charge Code	411062270
Hospital Revenue Code	361
Min. Negotiated Rate	$429.61
Max. Negotiated Rate	$429.61
Rate for Payer: Qualcare PPO/HMO/WC	$429.61

SPINAL FLUID TAP DIAGNOSTIC

Facility

$2,864.05

Service Code	HCPCS 62270
Hospital Charge Code	366862270
Hospital Revenue Code	361
Min. Negotiated Rate	$429.61
Max. Negotiated Rate	$429.61
Rate for Payer: Qualcare PPO/HMO/WC	$429.61

SPINAL FLUID TAP DIAGNOSTIC

Facility

$2,864.05

Service Code	HCPCS 62270
Hospital Charge Code	366862270
Hospital Revenue Code	361
Min. Negotiated Rate	$81.34
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,281.02
Rate for Payer: Aetna Medicare Advantage	$2,717.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,042.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$838.61
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	$3,042.06
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: Cigna Medicare Advantage	$838.61
Rate for Payer: Clover Medicare Advantage	$796.68
Rate for Payer: EmblemHealth Commercial	$2,515.83
Rate for Payer: Humana Medicare Advantage	$863.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$838.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.65
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$429.61
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$90.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$838.61
Rate for Payer: Wellcare Medicare Advantage	$838.61
Rate for Payer: Wellpoint Medicaid Managed Care	$81.34

SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$39,790.31

Service Code	APR-DRG 3213
Min. Negotiated Rate	$39,010.11
Max. Negotiated Rate	$39,790.31
Rate for Payer: UnitedHealthcare Community & State	$39,010.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,790.31
Rate for Payer: Wellpoint Medicaid Managed Care	$39,010.11

SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES

Facility

$29,129.70

Service Code	APR-DRG 3212
Min. Negotiated Rate	$28,558.53
Max. Negotiated Rate	$29,129.70
Rate for Payer: UnitedHealthcare Community & State	$28,558.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,129.70
Rate for Payer: Wellpoint Medicaid Managed Care	$28,558.53

Know your out-of-pocket cost for care.

All Charges