Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM 8.0MM x 4.0MM TI ALLOY

Facility

$10,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270682453
Hospital Revenue Code	278
Min. Negotiated Rate	$1,623.75
Max. Negotiated Rate	$2,619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,619.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,623.75

STEM 8MM DIA X 4.0MM TR

Facility

$10,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270682462
Hospital Revenue Code	278
Min. Negotiated Rate	$307.43
Max. Negotiated Rate	$5,412.50
Rate for Payer: Aetna Commercial	$4,113.50
Rate for Payer: Aetna Medicare Advantage	$3,247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,760.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,760.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,760.38
Rate for Payer: Cigna Commercial	$5,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,619.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,623.75
Rate for Payer: UnitedHealthcare Community & State	$342.07
Rate for Payer: Wellpoint Medicaid Managed Care	$307.43

STEM 8MM DIA X 4.0MM TR

Facility

$10,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270682462
Hospital Revenue Code	278
Min. Negotiated Rate	$1,623.75
Max. Negotiated Rate	$2,619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,619.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,623.75

STEM 8MM REUNION RFX

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270700460
Hospital Revenue Code	278
Min. Negotiated Rate	$1,065.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$14,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00
Rate for Payer: UnitedHealthcare Community & State	$1,185.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,065.00

STEM 8MM REUNION RFX

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270700460
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

STEM 9MM DIA X 0MM TR

Facility

$9,820.00

Hospital Charge Code	270666834
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.00
Max. Negotiated Rate	$2,376.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,376.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.00

STEM 9MM DIA X 0MM TR

Facility

$9,820.00

Hospital Charge Code	270666834
Hospital Revenue Code	278
Min. Negotiated Rate	$278.89
Max. Negotiated Rate	$4,910.00
Rate for Payer: Aetna Commercial	$3,731.60
Rate for Payer: Aetna Medicare Advantage	$2,946.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,504.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,504.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,504.10
Rate for Payer: Cigna Commercial	$4,910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,376.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.00
Rate for Payer: UnitedHealthcare Community & State	$310.31
Rate for Payer: Wellpoint Medicaid Managed Care	$278.89

STEM ACCOLADE 127DEGxSZ7x37MM

Facility

$11,760.95

Service Code	HCPCS C1776
Hospital Charge Code	270681084
Hospital Revenue Code	278
Min. Negotiated Rate	$1,764.14
Max. Negotiated Rate	$2,846.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,352.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,846.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,764.14

STEM ACCOLADE 127DEGxSZ7x37MM

Facility

$11,760.95

Service Code	HCPCS C1776
Hospital Charge Code	270681084
Hospital Revenue Code	278
Min. Negotiated Rate	$334.01
Max. Negotiated Rate	$5,880.48
Rate for Payer: Aetna Commercial	$4,469.16
Rate for Payer: Aetna Medicare Advantage	$3,528.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,999.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,999.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,352.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,999.04
Rate for Payer: Cigna Commercial	$5,880.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,846.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,764.14
Rate for Payer: UnitedHealthcare Community & State	$371.65
Rate for Payer: Wellpoint Medicaid Managed Care	$334.01

STEM ACCOLADE II SZ7 132D

Facility

$12,723.60

Service Code	HCPCS C1776
Hospital Charge Code	270700759
Hospital Revenue Code	278
Min. Negotiated Rate	$1,908.54
Max. Negotiated Rate	$3,079.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,544.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,079.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,908.54

STEM ACCOLADE II SZ7 132D

Facility

$12,723.60

Service Code	HCPCS C1776
Hospital Charge Code	270700759
Hospital Revenue Code	278
Min. Negotiated Rate	$361.35
Max. Negotiated Rate	$6,361.80
Rate for Payer: Aetna Commercial	$4,834.97
Rate for Payer: Aetna Medicare Advantage	$3,817.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,244.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,244.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,544.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,244.52
Rate for Payer: Cigna Commercial	$6,361.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,079.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,908.54
Rate for Payer: UnitedHealthcare Community & State	$402.07
Rate for Payer: Wellpoint Medicaid Managed Care	$361.35

STEM ACTIS COLLAR

Facility

$14,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270694116
Hospital Revenue Code	278
Min. Negotiated Rate	$2,137.50
Max. Negotiated Rate	$3,448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,448.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,137.50

STEM ACTIS COLLAR

Facility

$14,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270694116
Hospital Revenue Code	278
Min. Negotiated Rate	$404.70
Max. Negotiated Rate	$7,125.00
Rate for Payer: Aetna Commercial	$5,415.00
Rate for Payer: Aetna Medicare Advantage	$4,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,633.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,633.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,633.75
Rate for Payer: Cigna Commercial	$7,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,448.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,137.50
Rate for Payer: UnitedHealthcare Community & State	$450.30
Rate for Payer: Wellpoint Medicaid Managed Care	$404.70

STEM ADAPTER 5 DEG OPTETRAK

Facility

$1,284.00

Service Code	HCPCS C1776
Hospital Charge Code	270679525
Hospital Revenue Code	278
Min. Negotiated Rate	$36.47
Max. Negotiated Rate	$642.00
Rate for Payer: Aetna Commercial	$487.92
Rate for Payer: Aetna Medicare Advantage	$385.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$327.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$327.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$327.42
Rate for Payer: Cigna Commercial	$642.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.73
Rate for Payer: Qualcare PPO/HMO/WC	$192.60
Rate for Payer: UnitedHealthcare Community & State	$40.57
Rate for Payer: Wellpoint Medicaid Managed Care	$36.47

STEM ADAPTER 5 DEG OPTETRAK

Facility

$1,284.00

Service Code	HCPCS C1776
Hospital Charge Code	270679525
Hospital Revenue Code	278
Min. Negotiated Rate	$192.60
Max. Negotiated Rate	$310.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.73
Rate for Payer: Qualcare PPO/HMO/WC	$192.60

STEM AMI P LATERAL SZ4

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692573
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

STEM AMI P LATERAL SZ4

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692573
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM AMISTEM C LAT SZ 6

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692927
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

STEM AMISTEM C LAT SZ 6

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692927
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM AMISTEM-H HA SIZE 4

Facility

$12,240.00

Service Code	HCPCS C1776
Hospital Charge Code	270678721
Hospital Revenue Code	278
Min. Negotiated Rate	$1,836.00
Max. Negotiated Rate	$2,962.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,448.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,962.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,836.00

STEM AMISTEM-H HA SIZE 4

Facility

$12,240.00

Service Code	HCPCS C1776
Hospital Charge Code	270678721
Hospital Revenue Code	278
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$6,120.00
Rate for Payer: Aetna Commercial	$4,651.20
Rate for Payer: Aetna Medicare Advantage	$3,672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,121.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,121.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,448.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,121.20
Rate for Payer: Cigna Commercial	$6,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,962.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,836.00
Rate for Payer: UnitedHealthcare Community & State	$386.78
Rate for Payer: Wellpoint Medicaid Managed Care	$347.62

STEM AMISTEM P STD SZ 7

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694394
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM AMISTEM P STD SZ 7

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694394
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

STEM ARCOS SPL TPR 14X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694538
Hospital Revenue Code	278
Min. Negotiated Rate	$529.94
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$589.66
Rate for Payer: Wellpoint Medicaid Managed Care	$529.94

STEM ARCOS SPL TPR 14X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694538
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

Know your out-of-pocket cost for care.

All Charges