Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM FINNED 14x80MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270672168
Hospital Revenue Code	278
Min. Negotiated Rate	$170.97
Max. Negotiated Rate	$3,010.00
Rate for Payer: Aetna Commercial	$2,287.60
Rate for Payer: Aetna Medicare Advantage	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,535.10
Rate for Payer: Cigna Commercial	$3,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00
Rate for Payer: UnitedHealthcare Community & State	$190.23
Rate for Payer: Wellpoint Medicaid Managed Care	$170.97

STEM FINNED 17MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270672314
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED 17MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270672314
Hospital Revenue Code	278
Min. Negotiated Rate	$153.36
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

STEM FINNED 24MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676611
Hospital Revenue Code	278
Min. Negotiated Rate	$170.97
Max. Negotiated Rate	$3,010.00
Rate for Payer: Aetna Commercial	$2,287.60
Rate for Payer: Aetna Medicare Advantage	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,535.10
Rate for Payer: Cigna Commercial	$3,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00
Rate for Payer: UnitedHealthcare Community & State	$190.23
Rate for Payer: Wellpoint Medicaid Managed Care	$170.97

STEM FINNED 24MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676611
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

STEM FINNED CEMENTLESS 18MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676167
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED CEMENTLESS 18MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676167
Hospital Revenue Code	278
Min. Negotiated Rate	$153.36
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

STEM FINNED SHOULDER 20MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676365
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 20MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676365
Hospital Revenue Code	278
Min. Negotiated Rate	$153.36
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

STEM FINNED SHOULDER 21MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676632
Hospital Revenue Code	278
Min. Negotiated Rate	$153.36
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

STEM FINNED SHOULDER 21MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676632
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FLUTED EXTENSION 14x40MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270668739
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 FLUTED EXTENSION 14x40MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270668739
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 G7 OSSEOTI MULTI 62MM

Facility

$18,980.00

Service Code	HCPCS C1776
Hospital Charge Code	270690941
Hospital Revenue Code	278
Min. Negotiated Rate	$539.03
Max. Negotiated Rate	$9,490.00
Rate for Payer: Aetna Commercial	$7,212.40
Rate for Payer: Aetna Medicare Advantage	$5,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,839.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,839.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,796.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,839.90
Rate for Payer: Cigna Commercial	$9,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,593.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,847.00
Rate for Payer: UnitedHealthcare Community & State	$599.77
Rate for Payer: Wellpoint Medicaid Managed Care	$539.03

STEM G7 OSSEOTI MULTI 62MM

Facility

$18,980.00

Service Code	HCPCS C1776
Hospital Charge Code	270690941
Hospital Revenue Code	278
Min. Negotiated Rate	$2,847.00
Max. Negotiated Rate	$4,593.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,796.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,593.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,847.00

STEM G7 OSSEOTI MULTIHOLE 56 M

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270688679
Hospital Revenue Code	278
Min. Negotiated Rate	$539.32
Max. Negotiated Rate	$9,495.00
Rate for Payer: Aetna Commercial	$7,216.20
Rate for Payer: Aetna Medicare Advantage	$5,697.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,842.45
Rate for Payer: Cigna Commercial	$9,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50
Rate for Payer: UnitedHealthcare Community & State	$600.08
Rate for Payer: Wellpoint Medicaid Managed Care	$539.32

STEM G7 OSSEOTI MULTIHOLE 56 M

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270688679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,848.50
Max. Negotiated Rate	$4,595.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50

STEMHEAD 12X0MMX2.0MM

Facility

$12,165.00

Service Code	HCPCS C1776
Hospital Charge Code	270693318
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.75
Max. Negotiated Rate	$2,943.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75

STEMHEAD 12X0MMX2.0MM

Facility

$12,165.00

Service Code	HCPCS C1776
Hospital Charge Code	270693318
Hospital Revenue Code	278
Min. Negotiated Rate	$345.49
Max. Negotiated Rate	$6,082.50
Rate for Payer: Aetna Commercial	$4,622.70
Rate for Payer: Aetna Medicare Advantage	$3,649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.07
Rate for Payer: Cigna Commercial	$6,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75
Rate for Payer: UnitedHealthcare Community & State	$384.41
Rate for Payer: Wellpoint Medicaid Managed Care	$345.49

STEM HIGH OFFSET SZ4 36X103MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700615
Hospital Revenue Code	278
Min. Negotiated Rate	$348.47
Max. Negotiated Rate	$6,135.00
Rate for Payer: Aetna Commercial	$4,662.60
Rate for Payer: Aetna Medicare Advantage	$3,681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,128.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,128.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,128.85
Rate for Payer: Cigna Commercial	$6,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,969.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,840.50
Rate for Payer: UnitedHealthcare Community & State	$387.73
Rate for Payer: Wellpoint Medicaid Managed Care	$348.47

STEM HIGH OFFSET SZ4 36X103MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,840.50
Max. Negotiated Rate	$2,969.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,969.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,840.50

STEM HIP 127 DEG SZ9 DIST 15MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673478
Hospital Revenue Code	278
Min. Negotiated Rate	$421.74
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$5,643.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50
Rate for Payer: UnitedHealthcare Community & State	$469.26
Rate for Payer: Wellpoint Medicaid Managed Care	$421.74

STEM HIP 127 DEG SZ9 DIST 15MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673478
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

STEM HIP ACCO 127D NCK ANG SZ8

Facility

$9,831.20

Service Code	HCPCS C1776
Hospital Charge Code	270699505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,474.68
Max. Negotiated Rate	$2,379.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,966.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,379.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,474.68

STEM HIP ACCO 127D NCK ANG SZ8

Facility

$9,831.20

Service Code	HCPCS C1776
Hospital Charge Code	270699505
Hospital Revenue Code	278
Min. Negotiated Rate	$279.21
Max. Negotiated Rate	$4,915.60
Rate for Payer: Aetna Commercial	$3,735.86
Rate for Payer: Aetna Medicare Advantage	$2,949.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,506.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,506.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,966.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,506.96
Rate for Payer: Cigna Commercial	$4,915.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,379.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,474.68
Rate for Payer: UnitedHealthcare Community & State	$310.67
Rate for Payer: Wellpoint Medicaid Managed Care	$279.21

Know your out-of-pocket cost for care.

All Charges