Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM HUMERAL CEMENTED RIGHT 8.

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270678475
Hospital Revenue Code	278
Min. Negotiated Rate	$260.43
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Community & State	$289.77
Rate for Payer: Wellpoint Medicaid Managed Care	$260.43

STEM HUMERAL FRACTURE 10x122mm

Facility

$19,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674698
Hospital Revenue Code	278
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

STEM HUMERAL FRACTURE 10x122mm

Facility

$19,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674698
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

STEM HUMERAL HEAD FLEXPTC 82MM

Facility

$20,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698766
Hospital Revenue Code	278
Min. Negotiated Rate	$582.20
Max. Negotiated Rate	$10,250.00
Rate for Payer: Aetna Commercial	$7,790.00
Rate for Payer: Aetna Medicare Advantage	$6,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,227.50
Rate for Payer: Cigna Commercial	$10,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,075.00
Rate for Payer: UnitedHealthcare Community & State	$647.80
Rate for Payer: Wellpoint Medicaid Managed Care	$582.20

STEM HUMERAL HEAD FLEXPTC 82MM

Facility

$20,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698766
Hospital Revenue Code	278
Min. Negotiated Rate	$3,075.00
Max. Negotiated Rate	$4,961.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,075.00

STEM HUMERAL REUNION 6X113MM

Facility

$58,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270700592
Hospital Revenue Code	278
Min. Negotiated Rate	$1,667.93
Max. Negotiated Rate	$29,365.00
Rate for Payer: Aetna Commercial	$22,317.40
Rate for Payer: Aetna Medicare Advantage	$17,619.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,976.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,976.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,746.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,976.15
Rate for Payer: Cigna Commercial	$29,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$8,809.50
Rate for Payer: UnitedHealthcare Community & State	$1,855.87
Rate for Payer: Wellpoint Medicaid Managed Care	$1,667.93

STEM HUMERAL REUNION 6X113MM

Facility

$58,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270700592
Hospital Revenue Code	278
Min. Negotiated Rate	$8,809.50
Max. Negotiated Rate	$14,212.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,746.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$8,809.50

STEM HUMERAL REVRS MB UNI 5MM

Facility

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270699152
Hospital Revenue Code	278
Min. Negotiated Rate	$931.50
Max. Negotiated Rate	$1,502.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50

STEM HUMERAL REVRS MB UNI 5MM

Facility

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270699152
Hospital Revenue Code	278
Min. Negotiated Rate	$176.36
Max. Negotiated Rate	$3,105.00
Rate for Payer: Aetna Commercial	$2,359.80
Rate for Payer: Aetna Medicare Advantage	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,583.55
Rate for Payer: Cigna Commercial	$3,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50
Rate for Payer: UnitedHealthcare Community & State	$196.24
Rate for Payer: Wellpoint Medicaid Managed Care	$176.36

STEM HUMERAL RVS TM 10X130MM

Facility

$26,600.00

Service Code	HCPCS C1776
Hospital Charge Code	270696616
Hospital Revenue Code	278
Min. Negotiated Rate	$3,990.00
Max. Negotiated Rate	$6,437.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,437.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.00

STEM HUMERAL RVS TM 10X130MM

Facility

$26,600.00

Service Code	HCPCS C1776
Hospital Charge Code	270696616
Hospital Revenue Code	278
Min. Negotiated Rate	$755.44
Max. Negotiated Rate	$13,300.00
Rate for Payer: Aetna Commercial	$10,108.00
Rate for Payer: Aetna Medicare Advantage	$7,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.00
Rate for Payer: Cigna Commercial	$13,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,437.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.00
Rate for Payer: UnitedHealthcare Community & State	$840.56
Rate for Payer: Wellpoint Medicaid Managed Care	$755.44

STEM HUMERAL STD 14MMX130

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270686439
Hospital Revenue Code	278
Min. Negotiated Rate	$1,657.50
Max. Negotiated Rate	$2,674.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,674.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,657.50

STEM HUMERAL STD 14MMX130

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270686439
Hospital Revenue Code	278
Min. Negotiated Rate	$313.82
Max. Negotiated Rate	$5,525.00
Rate for Payer: Aetna Commercial	$4,199.00
Rate for Payer: Aetna Medicare Advantage	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,817.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,817.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,817.75
Rate for Payer: Cigna Commercial	$5,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,674.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,657.50
Rate for Payer: UnitedHealthcare Community & State	$349.18
Rate for Payer: Wellpoint Medicaid Managed Care	$313.82

STEM HUMERAL SZ 11

Facility

$23,856.25

Service Code	HCPCS C1776
Hospital Charge Code	270671586
Hospital Revenue Code	278
Min. Negotiated Rate	$3,578.44
Max. Negotiated Rate	$5,773.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,771.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,773.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,578.44

STEM HUMERAL SZ 11

Facility

$23,856.25

Service Code	HCPCS C1776
Hospital Charge Code	270671586
Hospital Revenue Code	278
Min. Negotiated Rate	$677.52
Max. Negotiated Rate	$11,928.12
Rate for Payer: Aetna Commercial	$9,065.38
Rate for Payer: Aetna Medicare Advantage	$7,156.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,083.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,083.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,771.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,083.34
Rate for Payer: Cigna Commercial	$11,928.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,773.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,578.44
Rate for Payer: UnitedHealthcare Community & State	$753.86
Rate for Payer: Wellpoint Medicaid Managed Care	$677.52

STEM HUMERAL SZ 8

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671584
Hospital Revenue Code	278
Min. Negotiated Rate	$5,097.75
Max. Negotiated Rate	$8,224.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75

STEM HUMERAL SZ 8

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671584
Hospital Revenue Code	278
Min. Negotiated Rate	$965.17
Max. Negotiated Rate	$16,992.50
Rate for Payer: Aetna Commercial	$12,914.30
Rate for Payer: Aetna Medicare Advantage	$10,195.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,666.17
Rate for Payer: Cigna Commercial	$16,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75
Rate for Payer: UnitedHealthcare Community & State	$1,073.93
Rate for Payer: Wellpoint Medicaid Managed Care	$965.17

STEM HUMERAL SZ8

Facility

$23,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700195
Hospital Revenue Code	278
Min. Negotiated Rate	$653.20
Max. Negotiated Rate	$11,500.00
Rate for Payer: Aetna Commercial	$8,740.00
Rate for Payer: Aetna Medicare Advantage	$6,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,865.00
Rate for Payer: Cigna Commercial	$11,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00
Rate for Payer: UnitedHealthcare Community & State	$726.80
Rate for Payer: Wellpoint Medicaid Managed Care	$653.20

STEM HUMERAL SZ8

Facility

$23,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700195
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$5,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

STEM HUMERAL SZ 9

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671585
Hospital Revenue Code	278
Min. Negotiated Rate	$965.17
Max. Negotiated Rate	$16,992.50
Rate for Payer: Aetna Commercial	$12,914.30
Rate for Payer: Aetna Medicare Advantage	$10,195.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,666.17
Rate for Payer: Cigna Commercial	$16,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75
Rate for Payer: UnitedHealthcare Community & State	$1,073.93
Rate for Payer: Wellpoint Medicaid Managed Care	$965.17

STEM HUMERAL SZ 9

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671585
Hospital Revenue Code	278
Min. Negotiated Rate	$5,097.75
Max. Negotiated Rate	$8,224.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75

STEM HUMERAL UNCEMENTED 10.5

Facility

$14,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683029
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STEM HUMERAL UNCEMENTED 10.5

Facility

$14,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683029
Hospital Revenue Code	278
Min. Negotiated Rate	$397.60
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$5,320.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00
Rate for Payer: UnitedHealthcare Community & State	$442.40
Rate for Payer: Wellpoint Medicaid Managed Care	$397.60

STEM HUMER PRIMARY MINI 6X83MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697514
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM HUMER PRIMARY MINI 6X83MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697514
Hospital Revenue Code	278
Min. Negotiated Rate	$411.80
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$458.20
Rate for Payer: Wellpoint Medicaid Managed Care	$411.80

Know your out-of-pocket cost for care.

All Charges