Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM FEMORAL CRUCIATE RT SZ4

Facility

$7,845.00

Service Code	HCPCS C1776
Hospital Charge Code	270692203
Hospital Revenue Code	278
Min. Negotiated Rate	$222.80
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,981.10
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75
Rate for Payer: UnitedHealthcare Community & State	$247.90
Rate for Payer: Wellpoint Medicaid Managed Care	$222.80

STEM FEMORAL CRUCIATE RT SZ4

Facility

$7,845.00

Service Code	HCPCS C1776
Hospital Charge Code	270692203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

STEM FEMORAL EXT OSS 11X150MM

Facility

$10,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270667950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,558.50
Max. Negotiated Rate	$2,514.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,078.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,558.50

STEM FEMORAL EXT OSS 11X150MM

Facility

$10,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270667950
Hospital Revenue Code	278
Min. Negotiated Rate	$295.08
Max. Negotiated Rate	$5,195.00
Rate for Payer: Aetna Commercial	$3,948.20
Rate for Payer: Aetna Medicare Advantage	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,078.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,649.45
Rate for Payer: Cigna Commercial	$5,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,558.50
Rate for Payer: UnitedHealthcare Community & State	$328.32
Rate for Payer: Wellpoint Medicaid Managed Care	$295.08

STEM FEMORAL EXT TIB 10x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677686
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 FEMORAL EXT TIB 10x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677686
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 FEMORAL EXT TIB 14X25MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678639
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 FEMORAL EXT TIB 14X25MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678639
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 FEMORAL EXT TIB 16x120MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678640
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 FEMORAL EXT TIB 16x120MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678640
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 FEMORAL EXT TIB 16x80MM

Facility

$4,164.50

Service Code	HCPCS C1776
Hospital Charge Code	270676557
Hospital Revenue Code	278
Min. Negotiated Rate	$118.27
Max. Negotiated Rate	$2,082.25
Rate for Payer: Aetna Commercial	$1,582.51
Rate for Payer: Aetna Medicare Advantage	$1,249.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,061.95
Rate for Payer: Cigna Commercial	$2,082.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.81
Rate for Payer: Qualcare PPO/HMO/WC	$624.67
Rate for Payer: UnitedHealthcare Community & State	$131.60
Rate for Payer: Wellpoint Medicaid Managed Care	$118.27

STEM FEMORAL EXT TIB 16x80MM

Facility

$4,164.50

Service Code	HCPCS C1776
Hospital Charge Code	270676557
Hospital Revenue Code	278
Min. Negotiated Rate	$624.67
Max. Negotiated Rate	$1,007.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.81
Rate for Payer: Qualcare PPO/HMO/WC	$624.67

STEM FEMORAL EXT TIB 20x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676683
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 FEMORAL EXT TIB 20x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676683
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 FEMORAL FX HIP 11X140MM

Facility

$6,275.00

Service Code	HCPCS C1776
Hospital Charge Code	270640212
Hospital Revenue Code	278
Min. Negotiated Rate	$941.25
Max. Negotiated Rate	$1,518.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.55
Rate for Payer: Qualcare PPO/HMO/WC	$941.25

STEM FEMORAL FX HIP 11X140MM

Facility

$6,275.00

Service Code	HCPCS C1776
Hospital Charge Code	270640212
Hospital Revenue Code	278
Min. Negotiated Rate	$178.21
Max. Negotiated Rate	$3,137.50
Rate for Payer: Aetna Commercial	$2,384.50
Rate for Payer: Aetna Medicare Advantage	$1,882.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.12
Rate for Payer: Cigna Commercial	$3,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.55
Rate for Payer: Qualcare PPO/HMO/WC	$941.25
Rate for Payer: UnitedHealthcare Community & State	$198.29
Rate for Payer: Wellpoint Medicaid Managed Care	$178.21

STEM FEMORAL LAT AVENIR SZ5

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698185
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM FEMORAL LAT AVENIR SZ5

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698185
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

STEM FEMORAL NECK SHORT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270676061
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 FEMORAL NECK SHORT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270676061
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 FEMORAL PF TAP SZ10 10MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692925
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

STEM FEMORAL PF TAP SZ10 10MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692925
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM FEMORAL PS OPEN 60mm RT

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270644717
Hospital Revenue Code	278
Min. Negotiated Rate	$489.33
Max. Negotiated Rate	$8,615.00
Rate for Payer: Aetna Commercial	$6,547.40
Rate for Payer: Aetna Medicare Advantage	$5,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,393.65
Rate for Payer: Cigna Commercial	$8,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50
Rate for Payer: UnitedHealthcare Community & State	$544.47
Rate for Payer: Wellpoint Medicaid Managed Care	$489.33

STEM FEMORAL PS OPEN 60mm RT

Facility

$17,230.00

Service Code	HCPCS C1776
Hospital Charge Code	270644717
Hospital Revenue Code	278
Min. Negotiated Rate	$2,584.50
Max. Negotiated Rate	$4,169.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50

STEM FEMORAL PS OPEN 62.5MM RT

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270642311
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

Know your out-of-pocket cost for care.

All Charges