Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM PERSONA CEMENTE SZ 7

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686536
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

STEM PERSONA TIBIAL 5 DEG SZ1

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686543
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM PERSONA TIBIAL 5 DEG SZ1

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686543
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

STEM PERSONA TIBIAL 5 DEG SZD

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689500
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM PERSONA TIBIAL 5 DEG SZD

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270689500
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

STEM PLASMA DISTAL 12x127MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270675958
Hospital Revenue Code	278
Min. Negotiated Rate	$807.13
Max. Negotiated Rate	$14,210.00
Rate for Payer: Aetna Commercial	$10,799.60
Rate for Payer: Aetna Medicare Advantage	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,247.10
Rate for Payer: Cigna Commercial	$14,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00
Rate for Payer: UnitedHealthcare Community & State	$898.07
Rate for Payer: Wellpoint Medicaid Managed Care	$807.13

STEM PLASMA DISTAL 12x127MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270675958
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.00
Max. Negotiated Rate	$6,877.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00

STEM POROCOAT STAND SZ8 107MM

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270685582
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 POROCOAT STAND SZ8 107MM

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270685582
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 POROUS 11mm INTEGRAL LAT-

Facility

$19,180.00

Hospital Charge Code	270670961
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 POROUS 11mm INTEGRAL LAT-

Facility

$19,180.00

Hospital Charge Code	270670961
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 POROUS 12mm INTEGRAL LAT-

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270636129
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 POROUS 12mm INTEGRAL LAT-

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270636129
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 POROUS 13 INTEG X11170313

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270635321
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 POROUS 13 INTEG X11170313

Facility

$19,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270635321
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 POROUS BOWED 14.5x150MM

Facility

$10,515.00

Service Code	HCPCS C1776
Hospital Charge Code	270673719
Hospital Revenue Code	278
Min. Negotiated Rate	$298.63
Max. Negotiated Rate	$5,257.50
Rate for Payer: Aetna Commercial	$3,995.70
Rate for Payer: Aetna Medicare Advantage	$3,154.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,681.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,681.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,681.32
Rate for Payer: Cigna Commercial	$5,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.25
Rate for Payer: UnitedHealthcare Community & State	$332.27
Rate for Payer: Wellpoint Medicaid Managed Care	$298.63

STEM POROUS BOWED 14.5x150MM

Facility

$10,515.00

Service Code	HCPCS C1776
Hospital Charge Code	270673719
Hospital Revenue Code	278
Min. Negotiated Rate	$1,577.25
Max. Negotiated Rate	$2,544.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,544.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,577.25

STEM PRESSFIT 10 MM

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270688858
Hospital Revenue Code	278
Min. Negotiated Rate	$270.81
Max. Negotiated Rate	$4,767.75
Rate for Payer: Aetna Commercial	$3,623.49
Rate for Payer: Aetna Medicare Advantage	$2,860.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,431.55
Rate for Payer: Cigna Commercial	$4,767.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33
Rate for Payer: UnitedHealthcare Community & State	$301.32
Rate for Payer: Wellpoint Medicaid Managed Care	$270.81

STEM PRESSFIT 10 MM

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270688858
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$2,307.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

STEM PRESS FIT SZ 13 TSS

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270689214
Hospital Revenue Code	278
Min. Negotiated Rate	$270.81
Max. Negotiated Rate	$4,767.75
Rate for Payer: Aetna Commercial	$3,623.49
Rate for Payer: Aetna Medicare Advantage	$2,860.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,431.55
Rate for Payer: Cigna Commercial	$4,767.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33
Rate for Payer: UnitedHealthcare Community & State	$301.32
Rate for Payer: Wellpoint Medicaid Managed Care	$270.81

STEM PRESS FIT SZ 13 TSS

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270689214
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$2,307.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

STEM PRESS FT SZ 12 TSS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690434
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.21
Max. Negotiated Rate	$1,915.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21

STEM PRESS FT SZ 12 TSS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690434
Hospital Revenue Code	278
Min. Negotiated Rate	$224.78
Max. Negotiated Rate	$3,957.38
Rate for Payer: Aetna Commercial	$3,007.61
Rate for Payer: Aetna Medicare Advantage	$2,374.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,018.26
Rate for Payer: Cigna Commercial	$3,957.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21
Rate for Payer: UnitedHealthcare Community & State	$250.11
Rate for Payer: Wellpoint Medicaid Managed Care	$224.78

STEM PRESS TSS SZ 11

Facility

$7,711.70

Service Code	HCPCS C1776
Hospital Charge Code	270689674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,156.76
Max. Negotiated Rate	$1,866.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,542.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,156.76

STEM PRESS TSS SZ 11

Facility

$7,711.70

Service Code	HCPCS C1776
Hospital Charge Code	270689674
Hospital Revenue Code	278
Min. Negotiated Rate	$219.01
Max. Negotiated Rate	$3,855.85
Rate for Payer: Aetna Commercial	$2,930.45
Rate for Payer: Aetna Medicare Advantage	$2,313.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,966.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,966.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,542.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,966.48
Rate for Payer: Cigna Commercial	$3,855.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,156.76
Rate for Payer: UnitedHealthcare Community & State	$243.69
Rate for Payer: Wellpoint Medicaid Managed Care	$219.01

Know your out-of-pocket cost for care.

All Charges