Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM HUMERAL 10x148MM

Facility

$18,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270672692
Hospital Revenue Code	278
Min. Negotiated Rate	$521.85
Max. Negotiated Rate	$9,187.50
Rate for Payer: Aetna Commercial	$6,982.50
Rate for Payer: Aetna Medicare Advantage	$5,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,685.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,685.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,685.62
Rate for Payer: Cigna Commercial	$9,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,446.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,756.25
Rate for Payer: UnitedHealthcare Community & State	$580.65
Rate for Payer: Wellpoint Medicaid Managed Care	$521.85

STEM HUMERAL 10x148MM

Facility

$18,375.00

Service Code	HCPCS C1776
Hospital Charge Code	270672692
Hospital Revenue Code	278
Min. Negotiated Rate	$2,756.25
Max. Negotiated Rate	$4,446.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,446.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,756.25

STEM HUMERAL 11MM

Facility

$11,175.00

Hospital Charge Code	270672289
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 11MM

Facility

$11,175.00

Hospital Charge Code	270672289
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL 12MM

Facility

$11,175.00

Hospital Charge Code	270672290
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL 12MM

Facility

$11,175.00

Hospital Charge Code	270672290
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 13MM

Facility

$11,175.00

Hospital Charge Code	270672291
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL 13MM

Facility

$11,175.00

Hospital Charge Code	270672291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 2BSTD70MM132.5D

Facility

$45,220.00

Service Code	HCPCS C1776
Hospital Charge Code	270697094
Hospital Revenue Code	278
Min. Negotiated Rate	$1,284.25
Max. Negotiated Rate	$22,610.00
Rate for Payer: Aetna Commercial	$17,183.60
Rate for Payer: Aetna Medicare Advantage	$13,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,531.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,531.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,044.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,531.10
Rate for Payer: Cigna Commercial	$22,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$6,783.00
Rate for Payer: UnitedHealthcare Community & State	$1,428.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1,284.25

STEM HUMERAL 2BSTD70MM132.5D

Facility

$45,220.00

Service Code	HCPCS C1776
Hospital Charge Code	270697094
Hospital Revenue Code	278
Min. Negotiated Rate	$6,783.00
Max. Negotiated Rate	$10,943.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,044.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,943.24
Rate for Payer: Qualcare PPO/HMO/WC	$6,783.00

STEM HUMERAL 5MM FIXED 135 DEG

Facility

$17,000.00

Hospital Charge Code	270672282
Hospital Revenue Code	278
Min. Negotiated Rate	$2,550.00
Max. Negotiated Rate	$4,114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,114.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,550.00

STEM HUMERAL 5MM FIXED 135 DEG

Facility

$17,000.00

Hospital Charge Code	270672282
Hospital Revenue Code	278
Min. Negotiated Rate	$482.80
Max. Negotiated Rate	$8,500.00
Rate for Payer: Aetna Commercial	$6,460.00
Rate for Payer: Aetna Medicare Advantage	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,335.00
Rate for Payer: Cigna Commercial	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,114.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,550.00
Rate for Payer: UnitedHealthcare Community & State	$537.20
Rate for Payer: Wellpoint Medicaid Managed Care	$482.80

STEM HUMERAL 5MM FIXED 155 DEG

Facility

$17,000.00

Hospital Charge Code	270672283
Hospital Revenue Code	278
Min. Negotiated Rate	$482.80
Max. Negotiated Rate	$8,500.00
Rate for Payer: Aetna Commercial	$6,460.00
Rate for Payer: Aetna Medicare Advantage	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,335.00
Rate for Payer: Cigna Commercial	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,114.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,550.00
Rate for Payer: UnitedHealthcare Community & State	$537.20
Rate for Payer: Wellpoint Medicaid Managed Care	$482.80

STEM HUMERAL 5MM FIXED 155 DEG

Facility

$17,000.00

Hospital Charge Code	270672283
Hospital Revenue Code	278
Min. Negotiated Rate	$2,550.00
Max. Negotiated Rate	$4,114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,114.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,550.00

STEM HUMERAL 6MM

Facility

$11,175.00

Hospital Charge Code	270672284
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 6MM

Facility

$11,175.00

Hospital Charge Code	270672284
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL 7MM

Facility

$11,175.00

Hospital Charge Code	270672285
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL 7MM

Facility

$11,175.00

Hospital Charge Code	270672285
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 7x120mm CEMENTED

Facility

$26,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270679733
Hospital Revenue Code	278
Min. Negotiated Rate	$4,005.00
Max. Negotiated Rate	$6,461.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,461.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,005.00

STEM HUMERAL 7x120mm CEMENTED

Facility

$26,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270679733
Hospital Revenue Code	278
Min. Negotiated Rate	$758.28
Max. Negotiated Rate	$13,350.00
Rate for Payer: Aetna Commercial	$10,146.00
Rate for Payer: Aetna Medicare Advantage	$8,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,808.50
Rate for Payer: Cigna Commercial	$13,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,461.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,005.00
Rate for Payer: UnitedHealthcare Community & State	$843.72
Rate for Payer: Wellpoint Medicaid Managed Care	$758.28

STEM HUMERAL 8MM

Facility

$11,175.00

Hospital Charge Code	270672286
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 8MM

Facility

$11,175.00

Hospital Charge Code	270672286
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL 9MM

Facility

$11,175.00

Hospital Charge Code	270672287
Hospital Revenue Code	278
Min. Negotiated Rate	$1,676.25
Max. Negotiated Rate	$2,704.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25

STEM HUMERAL 9MM

Facility

$11,175.00

Hospital Charge Code	270672287
Hospital Revenue Code	278
Min. Negotiated Rate	$317.37
Max. Negotiated Rate	$5,587.50
Rate for Payer: Aetna Commercial	$4,246.50
Rate for Payer: Aetna Medicare Advantage	$3,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,849.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,849.62
Rate for Payer: Cigna Commercial	$5,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,704.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,676.25
Rate for Payer: UnitedHealthcare Community & State	$353.13
Rate for Payer: Wellpoint Medicaid Managed Care	$317.37

STEM HUMERAL CEMENTED RIGHT 8.

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270678475
Hospital Revenue Code	278
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$2,219.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

Know your out-of-pocket cost for care.

All Charges