Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM EXTENSION FEM TIB 12x80MM

Facility

$4,164.75

Hospital Charge Code	270675508
Hospital Revenue Code	278
Min. Negotiated Rate	$118.28
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,582.61
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71
Rate for Payer: UnitedHealthcare Community & State	$131.61
Rate for Payer: Wellpoint Medicaid Managed Care	$118.28

STEM EXTENSION FEM TIB 18X80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270670651
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM EXTENSION FEM TIB 18X80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270670651
Hospital Revenue Code	278
Min. Negotiated Rate	$118.28
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,582.61
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71
Rate for Payer: UnitedHealthcare Community & State	$131.61
Rate for Payer: Wellpoint Medicaid Managed Care	$118.28

STEM EXTENSION SCREW REPLAC

Facility

$750.00

Hospital Charge Code	270657078
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

STEM EXTENSION SCREW REPLAC

Facility

$750.00

Hospital Charge Code	270657078
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

STEM EXT FEMORAL TIB 14X80MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668747
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

STEM EXT FEMORAL TIB 14X80MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270668747
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

STEM EXT FEM &TIB CEM 10x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680667
Hospital Revenue Code	278
Min. Negotiated Rate	$312.68
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$4,183.80
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50
Rate for Payer: UnitedHealthcare Community & State	$347.92
Rate for Payer: Wellpoint Medicaid Managed Care	$312.68

STEM EXT FEM &TIB CEM 10x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXT FEM &TIB CEM 12x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680666
Hospital Revenue Code	278
Min. Negotiated Rate	$312.68
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$4,183.80
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50
Rate for Payer: UnitedHealthcare Community & State	$347.92
Rate for Payer: Wellpoint Medicaid Managed Care	$312.68

STEM EXT FEM &TIB CEM 12x80MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270680666
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXT TAPERED SMTH PSN 14X7

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270690151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$4,386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

STEM EXT TAPERED SMTH PSN 14X7

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270690151
Hospital Revenue Code	278
Min. Negotiated Rate	$514.75
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$6,887.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75
Rate for Payer: UnitedHealthcare Community & State	$572.75
Rate for Payer: Wellpoint Medicaid Managed Care	$514.75

STEM FEM 12/14 TAPER SZ6 127MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270699296
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

STEM FEM 12/14 TAPER SZ6 127MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270699296
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

STEM FEM 12/14 TAP SZ 5 120MM

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	270697315
Hospital Revenue Code	278
Min. Negotiated Rate	$1,456.50
Max. Negotiated Rate	$2,349.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,942.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,349.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,456.50

STEM FEM 12/14 TAP SZ 5 120MM

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	270697315
Hospital Revenue Code	278
Min. Negotiated Rate	$275.76
Max. Negotiated Rate	$4,855.00
Rate for Payer: Aetna Commercial	$3,689.80
Rate for Payer: Aetna Medicare Advantage	$2,913.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,476.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,476.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,942.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,476.05
Rate for Payer: Cigna Commercial	$4,855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,349.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,456.50
Rate for Payer: UnitedHealthcare Community & State	$306.84
Rate for Payer: Wellpoint Medicaid Managed Care	$275.76

STEM FEM ARCOS 13X210MM 0 CALC

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270698954
Hospital Revenue Code	278
Min. Negotiated Rate	$5,958.00
Max. Negotiated Rate	$9,612.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00

STEM FEM ARCOS 13X210MM 0 CALC

Facility

$39,720.00

Service Code	HCPCS C1776
Hospital Charge Code	270698954
Hospital Revenue Code	278
Min. Negotiated Rate	$1,128.05
Max. Negotiated Rate	$19,860.00
Rate for Payer: Aetna Commercial	$15,093.60
Rate for Payer: Aetna Medicare Advantage	$11,916.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,128.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,128.60
Rate for Payer: Cigna Commercial	$19,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,612.24
Rate for Payer: Qualcare PPO/HMO/WC	$5,958.00
Rate for Payer: UnitedHealthcare Community & State	$1,255.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1,128.05

STEM FEM AVEN COMP STD COL SZ2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695309
Hospital Revenue Code	278
Min. Negotiated Rate	$419.97
Max. Negotiated Rate	$7,393.77
Rate for Payer: Aetna Commercial	$5,619.27
Rate for Payer: Aetna Medicare Advantage	$4,436.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.83
Rate for Payer: Cigna Commercial	$7,393.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13
Rate for Payer: UnitedHealthcare Community & State	$467.29
Rate for Payer: Wellpoint Medicaid Managed Care	$419.97

STEM FEM AVEN COMP STD COL SZ2

Facility

$14,787.55

Service Code	HCPCS C1776
Hospital Charge Code	270695309
Hospital Revenue Code	278
Min. Negotiated Rate	$2,218.13
Max. Negotiated Rate	$3,578.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,578.59
Rate for Payer: Qualcare PPO/HMO/WC	$2,218.13

STEM FEM BROACH STD 15X175MM

Facility

$10,815.00

Service Code	HCPCS C1776
Hospital Charge Code	270699266
Hospital Revenue Code	278
Min. Negotiated Rate	$307.15
Max. Negotiated Rate	$5,407.50
Rate for Payer: Aetna Commercial	$4,109.70
Rate for Payer: Aetna Medicare Advantage	$3,244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,757.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,757.82
Rate for Payer: Cigna Commercial	$5,407.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25
Rate for Payer: UnitedHealthcare Community & State	$341.75
Rate for Payer: Wellpoint Medicaid Managed Care	$307.15

STEM FEM BROACH STD 15X175MM

Facility

$10,815.00

Service Code	HCPCS C1776
Hospital Charge Code	270699266
Hospital Revenue Code	278
Min. Negotiated Rate	$1,622.25
Max. Negotiated Rate	$2,617.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,617.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,622.25

STEM FEM ECHO FX STD SZ9130MM

Facility

$8,820.00

Service Code	HCPCS C1776
Hospital Charge Code	270694261
Hospital Revenue Code	278
Min. Negotiated Rate	$250.49
Max. Negotiated Rate	$4,410.00
Rate for Payer: Aetna Commercial	$3,351.60
Rate for Payer: Aetna Medicare Advantage	$2,646.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,249.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,249.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,249.10
Rate for Payer: Cigna Commercial	$4,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,134.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.00
Rate for Payer: UnitedHealthcare Community & State	$278.71
Rate for Payer: Wellpoint Medicaid Managed Care	$250.49

STEM FEM ECHO FX STD SZ9130MM

Facility

$8,820.00

Service Code	HCPCS C1776
Hospital Charge Code	270694261
Hospital Revenue Code	278
Min. Negotiated Rate	$1,323.00
Max. Negotiated Rate	$2,134.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,134.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.00

Know your out-of-pocket cost for care.

All Charges