Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL NAIL STD 9x310MM

Facility

$11,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270673976
Hospital Revenue Code	278
Min. Negotiated Rate	$340.23
Max. Negotiated Rate	$5,990.00
Rate for Payer: Aetna Commercial	$4,552.40
Rate for Payer: Aetna Medicare Advantage	$3,594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,054.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,054.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,054.90
Rate for Payer: Cigna Commercial	$5,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,899.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,797.00
Rate for Payer: UnitedHealthcare Community & State	$378.57
Rate for Payer: Wellpoint Medicaid Managed Care	$340.23

TIBIAL NAIL TI CANNU 300 MM

Facility

$6,365.40

Service Code	HCPCS C1713
Hospital Charge Code	270686005
Hospital Revenue Code	278
Min. Negotiated Rate	$180.78
Max. Negotiated Rate	$3,182.70
Rate for Payer: Aetna Commercial	$2,418.85
Rate for Payer: Aetna Medicare Advantage	$1,909.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,623.18
Rate for Payer: Cigna Commercial	$3,182.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.43
Rate for Payer: Qualcare PPO/HMO/WC	$954.81
Rate for Payer: UnitedHealthcare Community & State	$201.15
Rate for Payer: Wellpoint Medicaid Managed Care	$180.78

TIBIAL NAIL TI CANNU 300 MM

Facility

$6,365.40

Service Code	HCPCS C1713
Hospital Charge Code	270686005
Hospital Revenue Code	278
Min. Negotiated Rate	$954.81
Max. Negotiated Rate	$1,540.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.43
Rate for Payer: Qualcare PPO/HMO/WC	$954.81

TIBIAL NAIL TI STD 10x345MM

Facility

$7,913.45

Service Code	HCPCS C1713
Hospital Charge Code	270651325
Hospital Revenue Code	278
Min. Negotiated Rate	$224.74
Max. Negotiated Rate	$3,956.72
Rate for Payer: Aetna Commercial	$3,007.11
Rate for Payer: Aetna Medicare Advantage	$2,374.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.93
Rate for Payer: Cigna Commercial	$3,956.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.02
Rate for Payer: UnitedHealthcare Community & State	$250.07
Rate for Payer: Wellpoint Medicaid Managed Care	$224.74

TIBIAL NAIL TI STD 10x345MM

Facility

$7,913.45

Service Code	HCPCS C1713
Hospital Charge Code	270651325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.02
Max. Negotiated Rate	$1,915.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.02

TIBIAL PLATE NEXGEN PRECOAT

Facility

$6,156.25

Hospital Charge Code	270660844
Hospital Revenue Code	278
Min. Negotiated Rate	$923.44
Max. Negotiated Rate	$1,489.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.81
Rate for Payer: Qualcare PPO/HMO/WC	$923.44

TIBIAL PLATE NEXGEN PRECOAT

Facility

$6,156.25

Hospital Charge Code	270660844
Hospital Revenue Code	278
Min. Negotiated Rate	$174.84
Max. Negotiated Rate	$3,078.12
Rate for Payer: Aetna Commercial	$2,339.38
Rate for Payer: Aetna Medicare Advantage	$1,846.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.84
Rate for Payer: Cigna Commercial	$3,078.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.81
Rate for Payer: Qualcare PPO/HMO/WC	$923.44
Rate for Payer: UnitedHealthcare Community & State	$194.54
Rate for Payer: Wellpoint Medicaid Managed Care	$174.84

TIBIAL PLATE STEMMED SZ 1

Facility

$6,156.70

Hospital Charge Code	270657858
Hospital Revenue Code	278
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$1,489.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.92
Rate for Payer: Qualcare PPO/HMO/WC	$923.50

TIBIAL PLATE STEMMED SZ 1

Facility

$6,156.70

Hospital Charge Code	270657858
Hospital Revenue Code	278
Min. Negotiated Rate	$174.85
Max. Negotiated Rate	$3,078.35
Rate for Payer: Aetna Commercial	$2,339.55
Rate for Payer: Aetna Medicare Advantage	$1,847.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.96
Rate for Payer: Cigna Commercial	$3,078.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.92
Rate for Payer: Qualcare PPO/HMO/WC	$923.50
Rate for Payer: UnitedHealthcare Community & State	$194.55
Rate for Payer: Wellpoint Medicaid Managed Care	$174.85

TIBIAL PLATFORM COMPONENT S

Facility

$11,675.00

Hospital Charge Code	270666804
Hospital Revenue Code	278
Min. Negotiated Rate	$1,751.25
Max. Negotiated Rate	$2,825.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,825.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.25

TIBIAL PLATFORM COMPONENT S

Facility

$11,675.00

Hospital Charge Code	270666804
Hospital Revenue Code	278
Min. Negotiated Rate	$331.57
Max. Negotiated Rate	$5,837.50
Rate for Payer: Aetna Commercial	$4,436.50
Rate for Payer: Aetna Medicare Advantage	$3,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,977.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,977.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,977.12
Rate for Payer: Cigna Commercial	$5,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,825.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.25
Rate for Payer: UnitedHealthcare Community & State	$368.93
Rate for Payer: Wellpoint Medicaid Managed Care	$331.57

TIBIAL POROUS TITM CONSTRUCT

Facility

$11,060.00

Hospital Charge Code	270668334
Hospital Revenue Code	278
Min. Negotiated Rate	$314.10
Max. Negotiated Rate	$5,530.00
Rate for Payer: Aetna Commercial	$4,202.80
Rate for Payer: Aetna Medicare Advantage	$3,318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,820.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,820.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,820.30
Rate for Payer: Cigna Commercial	$5,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,676.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.00
Rate for Payer: UnitedHealthcare Community & State	$349.50
Rate for Payer: Wellpoint Medicaid Managed Care	$314.10

TIBIAL POROUS TITM CONSTRUCT

Facility

$11,060.00

Hospital Charge Code	270668334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,659.00
Max. Negotiated Rate	$2,676.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,676.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.00

TIBIAL POSTERIOR STAB SZ1 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679842
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TIBIAL POSTERIOR STAB SZ1 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679842
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

TIBIAL POSTERIOR STAB SZ1 13MM

Facility

$4,000.00

Hospital Charge Code	270671564
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

TIBIAL POSTERIOR STAB SZ1 13MM

Facility

$4,000.00

Hospital Charge Code	270671564
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

TIBIAL POSTERIOR STAB SZ1 18MM

Facility

$4,284.65

Hospital Charge Code	270670879
Hospital Revenue Code	278
Min. Negotiated Rate	$121.68
Max. Negotiated Rate	$2,142.32
Rate for Payer: Aetna Commercial	$1,628.17
Rate for Payer: Aetna Medicare Advantage	$1,285.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.59
Rate for Payer: Cigna Commercial	$2,142.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70
Rate for Payer: UnitedHealthcare Community & State	$135.39
Rate for Payer: Wellpoint Medicaid Managed Care	$121.68

TIBIAL POSTERIOR STAB SZ1 18MM

Facility

$4,284.65

Hospital Charge Code	270670879
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$1,036.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

TIBIAL POSTERIOR STAB SZ1 30MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680581
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

TIBIAL POSTERIOR STAB SZ1 30MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680581
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TIBIAL POSTERIOR STAB SZ1 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678221
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

TIBIAL POSTERIOR STAB SZ1 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678221
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

TIBIAL POSTERIOR STAB SZ2 15MM

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270671566
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

TIBIAL POSTERIOR STAB SZ2 15MM

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270671566
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

Know your out-of-pocket cost for care.

All Charges