Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STEM STD DISTAL TAPERLOC 16MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270676897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM STD FEMORAL HA SZ 2SN

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674074
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

STEM STD FEMORAL HA SZ 2SN

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674074
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM STS DISTAL 15 MM X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270683724
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

STEM STS DISTAL 15 MM X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270683724
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 SZ 15 TSS PRESS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270689617
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 SZ 15 TSS PRESS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270689617
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 SZ 2 CEMENTRALIZER 8.5 MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691750
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

STEM SZ 2 CEMENTRALIZER 8.5 MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691750
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

STEM TALAR 10MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270670887
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STEM TALAR 10MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270670887
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

STEM TAPER ARCOS SZ A STD 60MM

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270694443
Hospital Revenue Code	278
Min. Negotiated Rate	$1,028.36
Max. Negotiated Rate	$18,105.00
Rate for Payer: Aetna Commercial	$13,759.80
Rate for Payer: Aetna Medicare Advantage	$10,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,233.55
Rate for Payer: Cigna Commercial	$18,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50
Rate for Payer: UnitedHealthcare Community & State	$1,144.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1,028.36

STEM TAPER ARCOS SZ A STD 60MM

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270694443
Hospital Revenue Code	278
Min. Negotiated Rate	$5,431.50
Max. Negotiated Rate	$8,762.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50

STEM TAP SMOT EXT 14X75MM

Facility

$11,672.50

Service Code	HCPCS C1776
Hospital Charge Code	270691597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.88
Max. Negotiated Rate	$2,824.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,334.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,824.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.88

STEM TAP SMOT EXT 14X75MM

Facility

$11,672.50

Service Code	HCPCS C1776
Hospital Charge Code	270691597
Hospital Revenue Code	278
Min. Negotiated Rate	$331.50
Max. Negotiated Rate	$5,836.25
Rate for Payer: Aetna Commercial	$4,435.55
Rate for Payer: Aetna Medicare Advantage	$3,501.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,976.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,976.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,334.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,976.49
Rate for Payer: Cigna Commercial	$5,836.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,824.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.88
Rate for Payer: UnitedHealthcare Community & State	$368.85
Rate for Payer: Wellpoint Medicaid Managed Care	$331.50

STEM TIBIAL PSN 3 DEG SZ E

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686485
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 TIBIAL PSN 3 DEG SZ E

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686485
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 TIB PSN SZ C L TIBIAL 5D

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692329
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 TIB PSN SZ C L TIBIAL 5D

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692329
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

STEMUBLAST GEL 10CC

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686754
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

STEMUBLAST GEL 10CC

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686754
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STE MULLIN RX 3.5X23M100784923

Facility

$3,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270643219C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STE MULLIN RX 3.5X23M100784923

Facility

$3,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270643219C
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

STEM UTF #8 144MM

Facility

$11,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677117
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STEM UTF #8 144MM

Facility

$11,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677117
Hospital Revenue Code	278
Min. Negotiated Rate	$312.40
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$4,180.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

Know your out-of-pocket cost for care.

All Charges