Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM INTEGRAL POROUS 9mm170309

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270641192
Hospital Revenue Code	278
Min. Negotiated Rate	$544.71
Max. Negotiated Rate	$9,590.00
Rate for Payer: Aetna Commercial	$7,288.40
Rate for Payer: Aetna Medicare Advantage	$5,754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,890.90
Rate for Payer: Cigna Commercial	$9,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,641.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,877.00
Rate for Payer: UnitedHealthcare Community & State	$606.09
Rate for Payer: Wellpoint Medicaid Managed Care	$544.71

STEM INTGRAL POROUS 10 X170310

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270639542
Hospital Revenue Code	278
Min. Negotiated Rate	$544.71
Max. Negotiated Rate	$9,590.00
Rate for Payer: Aetna Commercial	$7,288.40
Rate for Payer: Aetna Medicare Advantage	$5,754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,890.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,890.90
Rate for Payer: Cigna Commercial	$9,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,641.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,877.00
Rate for Payer: UnitedHealthcare Community & State	$606.09
Rate for Payer: Wellpoint Medicaid Managed Care	$544.71

STEM INTGRAL POROUS 10 X170310

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270639542
Hospital Revenue Code	278
Min. Negotiated Rate	$2,877.00
Max. Negotiated Rate	$4,641.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,641.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,877.00

STEM INTGRL 9MMx12 X12-171309

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270658427
Hospital Revenue Code	278
Min. Negotiated Rate	$347.90
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$4,655.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50
Rate for Payer: UnitedHealthcare Community & State	$387.10
Rate for Payer: Wellpoint Medicaid Managed Care	$347.90

STEM INTGRL 9MMx12 X12-171309

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270658427
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM KNEE SMOOTH BMT

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270692339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

STEM KNEE SMOOTH BMT

Facility

$7,620.00

Service Code	HCPCS C1776
Hospital Charge Code	270692339
Hospital Revenue Code	278
Min. Negotiated Rate	$216.41
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$240.79
Rate for Payer: Wellpoint Medicaid Managed Care	$216.41

STEM KNEE SMTH W/SCREW 12x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647561
Hospital Revenue Code	278
Min. Negotiated Rate	$216.41
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$240.79
Rate for Payer: Wellpoint Medicaid Managed Care	$216.41

STEM KNEE SMTH W/SCREW 12x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647561
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

STEM KNEE SMTH W/SCREW 16x120m

Facility

$8,315.00

Hospital Charge Code	270675557
Hospital Revenue Code	278
Min. Negotiated Rate	$1,247.25
Max. Negotiated Rate	$2,012.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,663.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,247.25

STEM KNEE SMTH W/SCREW 16x120m

Facility

$8,315.00

Hospital Charge Code	270675557
Hospital Revenue Code	278
Min. Negotiated Rate	$236.15
Max. Negotiated Rate	$4,157.50
Rate for Payer: Aetna Commercial	$3,159.70
Rate for Payer: Aetna Medicare Advantage	$2,494.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,120.32
Rate for Payer: Cigna Commercial	$4,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,247.25
Rate for Payer: UnitedHealthcare Community & State	$262.75
Rate for Payer: Wellpoint Medicaid Managed Care	$236.15

STEM KNEE SMTH W/SCREW 16x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647560
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.00
Max. Negotiated Rate	$1,844.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00

STEM KNEE SMTH W/SCREW 16x80mm

Facility

$7,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270647560
Hospital Revenue Code	278
Min. Negotiated Rate	$216.41
Max. Negotiated Rate	$3,810.00
Rate for Payer: Aetna Commercial	$2,895.60
Rate for Payer: Aetna Medicare Advantage	$2,286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,943.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,524.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,943.10
Rate for Payer: Cigna Commercial	$3,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,844.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.00
Rate for Payer: UnitedHealthcare Community & State	$240.79
Rate for Payer: Wellpoint Medicaid Managed Care	$216.41

STEM KNEE SMTH W/SCREW 18x80mm

Facility

$8,565.00

Service Code	HCPCS C1776
Hospital Charge Code	270669893
Hospital Revenue Code	278
Min. Negotiated Rate	$1,284.75
Max. Negotiated Rate	$2,072.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,713.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,072.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,284.75

STEM KNEE SMTH W/SCREW 18x80mm

Facility

$8,565.00

Service Code	HCPCS C1776
Hospital Charge Code	270669893
Hospital Revenue Code	278
Min. Negotiated Rate	$243.25
Max. Negotiated Rate	$4,282.50
Rate for Payer: Aetna Commercial	$3,254.70
Rate for Payer: Aetna Medicare Advantage	$2,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,184.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,184.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,713.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,184.07
Rate for Payer: Cigna Commercial	$4,282.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,072.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,284.75
Rate for Payer: UnitedHealthcare Community & State	$270.65
Rate for Payer: Wellpoint Medicaid Managed Care	$243.25

STEM KNEE SMTH W/SCREW 20x120m

Facility

$8,480.00

Hospital Charge Code	270669894
Hospital Revenue Code	278
Min. Negotiated Rate	$1,272.00
Max. Negotiated Rate	$2,052.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.00

STEM KNEE SMTH W/SCREW 20x120m

Facility

$8,480.00

Hospital Charge Code	270669894
Hospital Revenue Code	278
Min. Negotiated Rate	$240.83
Max. Negotiated Rate	$4,240.00
Rate for Payer: Aetna Commercial	$3,222.40
Rate for Payer: Aetna Medicare Advantage	$2,544.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,162.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,162.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,696.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,162.40
Rate for Payer: Cigna Commercial	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.00
Rate for Payer: UnitedHealthcare Community & State	$267.97
Rate for Payer: Wellpoint Medicaid Managed Care	$240.83

STEM METATARSAL LARGE

Facility

$8,750.00

Hospital Charge Code	270672046
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

STEM METATARSAL LARGE

Facility

$8,750.00

Hospital Charge Code	270672046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

STEM MINI COMP PRIMARY 14MM

Facility

$14,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270700041
Hospital Revenue Code	278
Min. Negotiated Rate	$424.15
Max. Negotiated Rate	$7,467.50
Rate for Payer: Aetna Commercial	$5,675.30
Rate for Payer: Aetna Medicare Advantage	$4,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,808.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,808.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,808.43
Rate for Payer: Cigna Commercial	$7,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,614.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,240.25
Rate for Payer: UnitedHealthcare Community & State	$471.95
Rate for Payer: Wellpoint Medicaid Managed Care	$424.15

STEM MINI COMP PRIMARY 14MM

Facility

$14,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270700041
Hospital Revenue Code	278
Min. Negotiated Rate	$2,240.25
Max. Negotiated Rate	$3,614.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,987.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,614.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,240.25

STEM MINI HUMERAL

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	270692525
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

STEM MINI HUMERAL

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	270692525
Hospital Revenue Code	278
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: Wellpoint Medicaid Managed Care	$18.74

STEM MOD ARCOS 17X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694444
Hospital Revenue Code	278
Min. Negotiated Rate	$529.94
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$7,090.80
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00
Rate for Payer: UnitedHealthcare Community & State	$589.66
Rate for Payer: Wellpoint Medicaid Managed Care	$529.94

STEM MOD ARCOS 17X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694444
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

Know your out-of-pocket cost for care.

All Charges