Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BEAM CAN HDLS FULL THD

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701477
Hospital Revenue Code	278
Min. Negotiated Rate	$818.81
Max. Negotiated Rate	$1,321.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: Qualcare PPO/HMO/WC	$818.81

BEAM CAN HDLS FULL THD

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701477
Hospital Revenue Code	278
Min. Negotiated Rate	$155.03
Max. Negotiated Rate	$2,729.38
Rate for Payer: Aetna Commercial	$2,074.32
Rate for Payer: Aetna Medicare Advantage	$1,637.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.98
Rate for Payer: Cigna Commercial	$2,729.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: Qualcare PPO/HMO/WC	$818.81
Rate for Payer: UnitedHealthcare Community & State	$172.50
Rate for Payer: Wellpoint Medicaid Managed Care	$155.03

BEAM CAN HDLS FULL THD 5X90MM

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270701674
Hospital Revenue Code	278
Min. Negotiated Rate	$767.25
Max. Negotiated Rate	$1,237.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25

BEAM CAN HDLS FULL THD 5X90MM

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270701674
Hospital Revenue Code	278
Min. Negotiated Rate	$145.27
Max. Negotiated Rate	$2,557.50
Rate for Payer: Aetna Commercial	$1,943.70
Rate for Payer: Aetna Medicare Advantage	$1,534.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,304.33
Rate for Payer: Cigna Commercial	$2,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25
Rate for Payer: UnitedHealthcare Community & State	$161.63
Rate for Payer: Wellpoint Medicaid Managed Care	$145.27

BEAM CAN HDLS MED THD

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270701478
Hospital Revenue Code	278
Min. Negotiated Rate	$767.25
Max. Negotiated Rate	$1,237.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25

BEAM CAN HDLS MED THD

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270701478
Hospital Revenue Code	278
Min. Negotiated Rate	$145.27
Max. Negotiated Rate	$2,557.50
Rate for Payer: Aetna Commercial	$1,943.70
Rate for Payer: Aetna Medicare Advantage	$1,534.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,304.33
Rate for Payer: Cigna Commercial	$2,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25
Rate for Payer: UnitedHealthcare Community & State	$161.63
Rate for Payer: Wellpoint Medicaid Managed Care	$145.27

BEAM SALVATION TOE JT 7X120MM

Facility

$9,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270698683
Hospital Revenue Code	278
Min. Negotiated Rate	$1,384.50
Max. Negotiated Rate	$2,233.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,846.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,384.50

BEAM SALVATION TOE JT 7X120MM

Facility

$9,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270698683
Hospital Revenue Code	278
Min. Negotiated Rate	$262.13
Max. Negotiated Rate	$4,615.00
Rate for Payer: Aetna Commercial	$3,507.40
Rate for Payer: Aetna Medicare Advantage	$2,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,353.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,353.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,846.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,353.65
Rate for Payer: Cigna Commercial	$4,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,384.50
Rate for Payer: UnitedHealthcare Community & State	$291.67
Rate for Payer: Wellpoint Medicaid Managed Care	$262.13

BEAM SLD HADL FULL THD 7.2X135

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701924
Hospital Revenue Code	278
Min. Negotiated Rate	$155.03
Max. Negotiated Rate	$2,729.38
Rate for Payer: Aetna Commercial	$2,074.32
Rate for Payer: Aetna Medicare Advantage	$1,637.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.98
Rate for Payer: Cigna Commercial	$2,729.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: Qualcare PPO/HMO/WC	$818.81
Rate for Payer: UnitedHealthcare Community & State	$172.50
Rate for Payer: Wellpoint Medicaid Managed Care	$155.03

BEAM SLD HADL FULL THD 7.2X135

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701924
Hospital Revenue Code	278
Min. Negotiated Rate	$818.81
Max. Negotiated Rate	$1,321.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: Qualcare PPO/HMO/WC	$818.81

BEAM SLD HDLS FULL THD 7.2X125

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701673
Hospital Revenue Code	278
Min. Negotiated Rate	$155.03
Max. Negotiated Rate	$2,729.38
Rate for Payer: Aetna Commercial	$2,074.32
Rate for Payer: Aetna Medicare Advantage	$1,637.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.98
Rate for Payer: Cigna Commercial	$2,729.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: Qualcare PPO/HMO/WC	$818.81
Rate for Payer: UnitedHealthcare Community & State	$172.50
Rate for Payer: Wellpoint Medicaid Managed Care	$155.03

BEAM SLD HDLS FULL THD 7.2X125

Facility

$5,458.75

Service Code	HCPCS C1713
Hospital Charge Code	270701673
Hospital Revenue Code	278
Min. Negotiated Rate	$818.81
Max. Negotiated Rate	$1,321.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,321.02
Rate for Payer: Qualcare PPO/HMO/WC	$818.81

BEAM SLD HDLS MD THD 7.2X120MM

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270701411
Hospital Revenue Code	278
Min. Negotiated Rate	$767.25
Max. Negotiated Rate	$1,237.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25

BEAM SLD HDLS MD THD 7.2X120MM

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270701411
Hospital Revenue Code	278
Min. Negotiated Rate	$145.27
Max. Negotiated Rate	$2,557.50
Rate for Payer: Aetna Commercial	$1,943.70
Rate for Payer: Aetna Medicare Advantage	$1,534.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,304.33
Rate for Payer: Cigna Commercial	$2,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25
Rate for Payer: UnitedHealthcare Community & State	$161.63
Rate for Payer: Wellpoint Medicaid Managed Care	$145.27

BEARING 10MM RIGHT

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690963
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

BEARING 10MM RIGHT

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270690963
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

BEARING ACT ARTIC HIP 28x42mm

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680835
Hospital Revenue Code	278
Min. Negotiated Rate	$383.40
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$5,130.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

BEARING ACT ARTIC HIP 28x42mm

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680835
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

BEARING ARCOM XL 28 MM X 46 MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270683723
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

BEARING ARCOM XL 28 MM X 46 MM

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270683723
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

BEARING ART SURF 16 MM

Facility

$18,668.75

Hospital Charge Code	270703333
Hospital Revenue Code	278
Min. Negotiated Rate	$530.19
Max. Negotiated Rate	$9,334.38
Rate for Payer: Aetna Commercial	$7,094.12
Rate for Payer: Aetna Medicare Advantage	$5,600.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,760.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,760.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,760.53
Rate for Payer: Cigna Commercial	$9,334.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,517.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,800.31
Rate for Payer: UnitedHealthcare Community & State	$589.93
Rate for Payer: Wellpoint Medicaid Managed Care	$530.19

BEARING ART SURF 16 MM

Facility

$18,668.75

Hospital Charge Code	270703333
Hospital Revenue Code	278
Min. Negotiated Rate	$2,800.31
Max. Negotiated Rate	$4,517.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,733.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,517.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,800.31

BEARING DM LONGEVITY 28 X 44 M

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270690470
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

BEARING DM LONGEVITY 28 X 44 M

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270690470
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

BEARING DM VIVCIT -E 28X 44 MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270689913
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

Know your out-of-pocket cost for care.

All Charges