Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

THYROID STIMULATING IMMUNOGLOB

Facility

$1,428.00

Service Code	HCPCS 84445
Hospital Charge Code	38473120
Hospital Revenue Code	301
Min. Negotiated Rate	$40.56
Max. Negotiated Rate	$714.00
Rate for Payer: Aetna Commercial	$138.34
Rate for Payer: Aetna Medicare Advantage	$164.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$50.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.49
Rate for Payer: Cigna Commercial	$714.00
Rate for Payer: Cigna Medicare Advantage	$50.86
Rate for Payer: Clover Medicare Advantage	$48.32
Rate for Payer: EmblemHealth Commercial	$152.58
Rate for Payer: Humana Medicare Advantage	$52.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$50.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$371.28
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$40.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$50.86
Rate for Payer: Wellcare Medicare Advantage	$50.86
Rate for Payer: Wellpoint Medicaid Managed Care	$40.56

THYROXINE BINDING GLOBULIN (TB

Facility

$214.00

Service Code	HCPCS 84442
Hospital Charge Code	38472647
Hospital Revenue Code	301
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

THYROXINE BINDING GLOBULIN (TB

Facility

$214.00

Service Code	HCPCS 84442
Hospital Charge Code	38472647
Hospital Revenue Code	301
Min. Negotiated Rate	$6.08
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$40.20
Rate for Payer: Aetna Medicare Advantage	$47.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.61
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: Cigna Medicare Advantage	$14.78
Rate for Payer: Clover Medicare Advantage	$14.04
Rate for Payer: EmblemHealth Commercial	$44.34
Rate for Payer: Humana Medicare Advantage	$15.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.78
Rate for Payer: Wellcare Medicare Advantage	$14.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.08

TI ALIF SA SPACER 10X34X24 15D

Facility

$33,125.00

Hospital Charge Code	270703553
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

TI ALIF SA SPACER 10X34X24 15D

Facility

$33,125.00

Hospital Charge Code	270703553
Hospital Revenue Code	278
Min. Negotiated Rate	$940.75
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$12,587.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75
Rate for Payer: UnitedHealthcare Community & State	$1,046.75
Rate for Payer: Wellpoint Medicaid Managed Care	$940.75

TI BAC II ACETABULAR CUP

Facility

$5,519.00

Hospital Charge Code	270335030
Hospital Revenue Code	278
Min. Negotiated Rate	$827.85
Max. Negotiated Rate	$1,335.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,335.60
Rate for Payer: Qualcare PPO/HMO/WC	$827.85

TI BAC II ACETABULAR CUP

Facility

$5,519.00

Hospital Charge Code	270335030
Hospital Revenue Code	278
Min. Negotiated Rate	$156.74
Max. Negotiated Rate	$2,759.50
Rate for Payer: Aetna Commercial	$2,097.22
Rate for Payer: Aetna Medicare Advantage	$1,655.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,407.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,407.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,407.35
Rate for Payer: Cigna Commercial	$2,759.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,335.60
Rate for Payer: Qualcare PPO/HMO/WC	$827.85
Rate for Payer: UnitedHealthcare Community & State	$174.40
Rate for Payer: Wellpoint Medicaid Managed Care	$156.74

TIBAL KNEE BASE FX BEARING SZ

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685508
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

TIBAL KNEE BASE FX BEARING SZ

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685508
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

TIBAL MODULAR

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270679530
Hospital Revenue Code	278
Min. Negotiated Rate	$157.62
Max. Negotiated Rate	$2,775.00
Rate for Payer: Aetna Commercial	$2,109.00
Rate for Payer: Aetna Medicare Advantage	$1,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,415.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,415.25
Rate for Payer: Cigna Commercial	$2,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50
Rate for Payer: UnitedHealthcare Community & State	$175.38
Rate for Payer: Wellpoint Medicaid Managed Care	$157.62

TIBAL MODULAR

Facility

$5,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270679530
Hospital Revenue Code	278
Min. Negotiated Rate	$832.50
Max. Negotiated Rate	$1,343.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.10
Rate for Payer: Qualcare PPO/HMO/WC	$832.50

TIB BEARING INSERT CS 11MM SZ4

Facility

$5,209.00

Service Code	HCPCS C1776
Hospital Charge Code	270692376
Hospital Revenue Code	278
Min. Negotiated Rate	$781.35
Max. Negotiated Rate	$1,260.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,041.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,260.58
Rate for Payer: Qualcare PPO/HMO/WC	$781.35

TIB BEARING INSERT CS 11MM SZ4

Facility

$5,209.00

Service Code	HCPCS C1776
Hospital Charge Code	270692376
Hospital Revenue Code	278
Min. Negotiated Rate	$147.94
Max. Negotiated Rate	$2,604.50
Rate for Payer: Aetna Commercial	$1,979.42
Rate for Payer: Aetna Medicare Advantage	$1,562.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,328.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,328.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,041.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,328.30
Rate for Payer: Cigna Commercial	$2,604.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,260.58
Rate for Payer: Qualcare PPO/HMO/WC	$781.35
Rate for Payer: UnitedHealthcare Community & State	$164.60
Rate for Payer: Wellpoint Medicaid Managed Care	$147.94

TIB BEARING INSET CS SZ 4 13MM

Facility

$5,336.50

Service Code	HCPCS C1776
Hospital Charge Code	270690855
Hospital Revenue Code	278
Min. Negotiated Rate	$800.48
Max. Negotiated Rate	$1,291.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,067.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,291.43
Rate for Payer: Qualcare PPO/HMO/WC	$800.48

TIB BEARING INSET CS SZ 4 13MM

Facility

$5,336.50

Service Code	HCPCS C1776
Hospital Charge Code	270690855
Hospital Revenue Code	278
Min. Negotiated Rate	$151.56
Max. Negotiated Rate	$2,668.25
Rate for Payer: Aetna Commercial	$2,027.87
Rate for Payer: Aetna Medicare Advantage	$1,600.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,360.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,360.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,067.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,360.81
Rate for Payer: Cigna Commercial	$2,668.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,291.43
Rate for Payer: Qualcare PPO/HMO/WC	$800.48
Rate for Payer: UnitedHealthcare Community & State	$168.63
Rate for Payer: Wellpoint Medicaid Managed Care	$151.56

TIB BEARING VNGRD PS 63/67X10

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270679834
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

TIB BEARING VNGRD PS 63/67X10

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270679834
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

TIB BEARNG E1 VANGARD 71/75/10

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270679849
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

TIB BEARNG E1 VANGARD 71/75/10

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270679849
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

TIB BRG VNGRD SSK PSC20X71/75

Facility

$11,880.00

Service Code	HCPCS C1776
Hospital Charge Code	270679831
Hospital Revenue Code	278
Min. Negotiated Rate	$337.39
Max. Negotiated Rate	$5,940.00
Rate for Payer: Aetna Commercial	$4,514.40
Rate for Payer: Aetna Medicare Advantage	$3,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,029.40
Rate for Payer: Cigna Commercial	$5,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00
Rate for Payer: UnitedHealthcare Community & State	$375.41
Rate for Payer: Wellpoint Medicaid Managed Care	$337.39

TIB BRG VNGRD SSK PSC20X71/75

Facility

$11,880.00

Service Code	HCPCS C1776
Hospital Charge Code	270679831
Hospital Revenue Code	278
Min. Negotiated Rate	$1,782.00
Max. Negotiated Rate	$2,874.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00

TIB/FIB 2 VWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7359050
Hospital Charge Code	94061243
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

TIB/FIB 2 VWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7359050
Hospital Charge Code	94061243
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

TIB/FIB 2 VWS-LT

Facility

$6,601.19

Service Code	HCPCS 73590LT
Hospital Charge Code	94061377
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

TIB/FIB 2 VWS-LT

Facility

$6,601.19

Service Code	HCPCS 73590LT
Hospital Charge Code	94061377
Hospital Revenue Code	320
Min. Negotiated Rate	$187.47
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$2,508.45
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.31
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$208.60
Rate for Payer: Wellpoint Medicaid Managed Care	$187.47

Know your out-of-pocket cost for care.

All Charges