Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SYSTEM FIXATION MENISCAL ULTRA

Facility

$1,595.00

Hospital Charge Code	270656316
Hospital Revenue Code	272
Min. Negotiated Rate	$45.30
Max. Negotiated Rate	$797.50
Rate for Payer: Aetna Commercial	$606.10
Rate for Payer: Aetna Medicare Advantage	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.73
Rate for Payer: Cigna Commercial	$797.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.70
Rate for Payer: Oxford Commercial	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.25
Rate for Payer: UnitedHealthcare Commercial	$319.00
Rate for Payer: UnitedHealthcare Community & State	$50.40
Rate for Payer: Wellpoint Medicaid Managed Care	$45.30

SYSTEM GELPORT HAND ACCESS

Facility

$2,875.00

Hospital Charge Code	270639482
Hospital Revenue Code	272
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$575.00
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

SYSTEM GELPORT HAND ACCESS

Facility

$2,875.00

Hospital Charge Code	270639482
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SYSTEM IMPLANT LNT 4.75 BC

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692479
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

SYSTEM IMPLANT LNT 4.75 BC

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692479
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

SYSTEM INDIGO 12 LIGHTING ASPI

Facility

$34,050.00

Hospital Charge Code	270689719
Hospital Revenue Code	272
Min. Negotiated Rate	$967.02
Max. Negotiated Rate	$17,025.00
Rate for Payer: Aetna Commercial	$12,939.00
Rate for Payer: Aetna Medicare Advantage	$10,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,682.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,682.75
Rate for Payer: Cigna Commercial	$17,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,853.00
Rate for Payer: Oxford Commercial	$6,810.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50
Rate for Payer: UnitedHealthcare Commercial	$6,810.00
Rate for Payer: UnitedHealthcare Community & State	$1,075.98
Rate for Payer: Wellpoint Medicaid Managed Care	$967.02

SYSTEM INDIGO 12 LIGHTING ASPI

Facility

$34,050.00

Hospital Charge Code	270689719
Hospital Revenue Code	272
Min. Negotiated Rate	$5,107.50
Max. Negotiated Rate	$5,107.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,107.50

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820S
Hospital Revenue Code	272
Min. Negotiated Rate	$160.31
Max. Negotiated Rate	$160.31
Rate for Payer: Qualcare PPO/HMO/WC	$160.31

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820
Hospital Revenue Code	272
Min. Negotiated Rate	$160.31
Max. Negotiated Rate	$160.31
Rate for Payer: Qualcare PPO/HMO/WC	$160.31

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820S
Hospital Revenue Code	272
Min. Negotiated Rate	$30.35
Max. Negotiated Rate	$534.38
Rate for Payer: Aetna Commercial	$406.12
Rate for Payer: Aetna Medicare Advantage	$320.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.53
Rate for Payer: Cigna Commercial	$534.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.88
Rate for Payer: Oxford Commercial	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$160.31
Rate for Payer: UnitedHealthcare Commercial	$213.75
Rate for Payer: UnitedHealthcare Community & State	$33.77
Rate for Payer: Wellpoint Medicaid Managed Care	$30.35

SYSTEM INZONE DETACHMENT

Facility

$1,068.75

Hospital Charge Code	270689820
Hospital Revenue Code	272
Min. Negotiated Rate	$30.35
Max. Negotiated Rate	$534.38
Rate for Payer: Aetna Commercial	$406.12
Rate for Payer: Aetna Medicare Advantage	$320.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.53
Rate for Payer: Cigna Commercial	$534.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.88
Rate for Payer: Oxford Commercial	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$160.31
Rate for Payer: UnitedHealthcare Commercial	$213.75
Rate for Payer: UnitedHealthcare Community & State	$33.77
Rate for Payer: Wellpoint Medicaid Managed Care	$30.35

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM 1.6mm

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322S
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322C
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM 1.6MM PV3116F

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270646322N
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM G3 PV31300

Facility

$16,125.00

Service Code	HCPCS C1757
Hospital Charge Code	270643857A
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM G3 PV31300

Facility

$16,125.00

Service Code	HCPCS C1757
Hospital Charge Code	270643857C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM G3 PV31300

Facility

$16,125.00

Service Code	HCPCS C1757
Hospital Charge Code	270643857A
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

SYSTEM JETSTREAM G3 PV31300

Facility

$16,125.00

Service Code	HCPCS C1757
Hospital Charge Code	270643857C
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM G3SF

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270645044
Hospital Revenue Code	278
Min. Negotiated Rate	$457.95
Max. Negotiated Rate	$8,062.50
Rate for Payer: Aetna Commercial	$6,127.50
Rate for Payer: Aetna Medicare Advantage	$4,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,111.88
Rate for Payer: Cigna Commercial	$8,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75
Rate for Payer: UnitedHealthcare Community & State	$509.55
Rate for Payer: Wellpoint Medicaid Managed Care	$457.95

SYSTEM JETSTREAM G3SF

Facility

$16,125.00

Service Code	HCPCS C1724
Hospital Charge Code	270645044
Hospital Revenue Code	278
Min. Negotiated Rate	$2,418.75
Max. Negotiated Rate	$3,902.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,902.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,418.75

Know your out-of-pocket cost for care.

All Charges