Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM HIP AMCA 16 x 200MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683438
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP AMCA 16 x 200MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683438
Hospital Revenue Code	278
Min. Negotiated Rate	$795.20
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$884.80
Rate for Payer: Wellpoint Medicaid Managed Care	$795.20

STEM HIP AMCA 18 x 40MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682863
Hospital Revenue Code	278
Min. Negotiated Rate	$795.20
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$884.80
Rate for Payer: Wellpoint Medicaid Managed Care	$795.20

STEM HIP AMCA 18 x 40MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682863
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP ANGL SZ2 30x99MM

Facility

$11,921.55

Service Code	HCPCS C1776
Hospital Charge Code	270680956
Hospital Revenue Code	278
Min. Negotiated Rate	$1,788.23
Max. Negotiated Rate	$2,885.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,384.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,885.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,788.23

STEM HIP ANGL SZ2 30x99MM

Facility

$11,921.55

Service Code	HCPCS C1776
Hospital Charge Code	270680956
Hospital Revenue Code	278
Min. Negotiated Rate	$338.57
Max. Negotiated Rate	$5,960.77
Rate for Payer: Aetna Commercial	$4,530.19
Rate for Payer: Aetna Medicare Advantage	$3,576.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,384.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,040.00
Rate for Payer: Cigna Commercial	$5,960.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,885.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,788.23
Rate for Payer: UnitedHealthcare Community & State	$376.72
Rate for Payer: Wellpoint Medicaid Managed Care	$338.57

STEM HIP ANGL SZ3 30x102MM

Facility

$25,265.50

Service Code	HCPCS C1776
Hospital Charge Code	270676775
Hospital Revenue Code	278
Min. Negotiated Rate	$3,789.82
Max. Negotiated Rate	$6,114.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,053.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,114.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,789.82

STEM HIP ANGL SZ3 30x102MM

Facility

$25,265.50

Service Code	HCPCS C1776
Hospital Charge Code	270676775
Hospital Revenue Code	278
Min. Negotiated Rate	$717.54
Max. Negotiated Rate	$12,632.75
Rate for Payer: Aetna Commercial	$9,600.89
Rate for Payer: Aetna Medicare Advantage	$7,579.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,442.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,442.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,053.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,442.70
Rate for Payer: Cigna Commercial	$12,632.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,114.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,789.82
Rate for Payer: UnitedHealthcare Community & State	$798.39
Rate for Payer: Wellpoint Medicaid Managed Care	$717.54

STEM HIP ANGL SZ5 35x108MM

Facility

$26,022.75

Service Code	HCPCS C1776
Hospital Charge Code	270678863
Hospital Revenue Code	278
Min. Negotiated Rate	$3,903.41
Max. Negotiated Rate	$6,297.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,204.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,297.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,903.41

STEM HIP ANGL SZ5 35x108MM

Facility

$26,022.75

Service Code	HCPCS C1776
Hospital Charge Code	270678863
Hospital Revenue Code	278
Min. Negotiated Rate	$739.05
Max. Negotiated Rate	$13,011.38
Rate for Payer: Aetna Commercial	$9,888.65
Rate for Payer: Aetna Medicare Advantage	$7,806.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,635.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,635.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,204.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,635.80
Rate for Payer: Cigna Commercial	$13,011.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,297.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,903.41
Rate for Payer: UnitedHealthcare Community & State	$822.32
Rate for Payer: Wellpoint Medicaid Managed Care	$739.05

STEM HIP ANGL SZ6 35x111MM

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677352
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$9,373.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

STEM HIP ANGL SZ6 35x111MM

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677352
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.04
Max. Negotiated Rate	$19,366.97
Rate for Payer: Aetna Commercial	$14,718.90
Rate for Payer: Aetna Medicare Advantage	$11,620.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,877.16
Rate for Payer: Cigna Commercial	$19,366.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09
Rate for Payer: UnitedHealthcare Community & State	$1,223.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1,100.04

STEM HIP ANGL SZ9 37x120MM

Facility

$12,033.00

Service Code	HCPCS C1776
Hospital Charge Code	270677484
Hospital Revenue Code	278
Min. Negotiated Rate	$341.74
Max. Negotiated Rate	$6,016.50
Rate for Payer: Aetna Commercial	$4,572.54
Rate for Payer: Aetna Medicare Advantage	$3,609.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,068.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,068.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,068.41
Rate for Payer: Cigna Commercial	$6,016.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,911.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.95
Rate for Payer: UnitedHealthcare Community & State	$380.24
Rate for Payer: Wellpoint Medicaid Managed Care	$341.74

STEM HIP ANGL SZ9 37x120MM

Facility

$12,033.00

Service Code	HCPCS C1776
Hospital Charge Code	270677484
Hospital Revenue Code	278
Min. Negotiated Rate	$1,804.95
Max. Negotiated Rate	$2,911.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,911.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.95

STEM HIP HIGH OFFSET SZ2 99MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700712
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP HIGH OFFSET SZ2 99MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700712
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

STEM HIP INSIGINIA OFFSET SZ6

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700625
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 INSIGINIA OFFSET SZ6

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700625
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 HIP INSIGNIA SZ7 38X109MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700768
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

STEM HIP INSIGNIA SZ7 38X109MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700768
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP NECK ANGLE 30MM SZ2

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677398
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.04
Max. Negotiated Rate	$19,366.97
Rate for Payer: Aetna Commercial	$14,718.90
Rate for Payer: Aetna Medicare Advantage	$11,620.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,877.16
Rate for Payer: Cigna Commercial	$19,366.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09
Rate for Payer: UnitedHealthcare Community & State	$1,223.99
Rate for Payer: Wellpoint Medicaid Managed Care	$1,100.04

STEM HIP NECK ANGLE 30MM SZ2

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677398
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$9,373.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

STEM HIP OFFSET HIGH SZ7 109MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700466
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 HIP OFFSET HIGH SZ7 109MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700466
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 SECURE FIT #7 30x130M

Facility

$12,957.00

Service Code	HCPCS C1776
Hospital Charge Code	270676938
Hospital Revenue Code	278
Min. Negotiated Rate	$1,943.55
Max. Negotiated Rate	$3,135.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,591.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,943.55

Know your out-of-pocket cost for care.

All Charges