Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TOE FLEX HINGE W/GRMT #3

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270611670
Hospital Revenue Code	278
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$198.45
Rate for Payer: Wellpoint Medicaid Managed Care	$178.35

TOE FLEX HINGE W/GRMT #3

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270611670
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #4

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270675527
Hospital Revenue Code	278
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$198.45
Rate for Payer: Wellpoint Medicaid Managed Care	$178.35

TOE FLEX HINGE W/GRMT #4

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270675527
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #5

Facility

$6,280.00

Hospital Charge Code	270611672
Hospital Revenue Code	278
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$198.45
Rate for Payer: Wellpoint Medicaid Managed Care	$178.35

TOE FLEX HINGE W/GRMT #5

Facility

$6,280.00

Hospital Charge Code	270611672
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #3

Facility

$6,280.00

Hospital Charge Code	270645984
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #3

Facility

$6,280.00

Hospital Charge Code	270645984
Hospital Revenue Code	278
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$198.45
Rate for Payer: Wellpoint Medicaid Managed Care	$178.35

TOE FLEX HINGE W/O GRMT #6

Facility

$6,280.00

Hospital Charge Code	270675545
Hospital Revenue Code	278
Min. Negotiated Rate	$178.35
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$2,386.40
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00
Rate for Payer: UnitedHealthcare Community & State	$198.45
Rate for Payer: Wellpoint Medicaid Managed Care	$178.35

TOE FLEX HINGE W/O GRMT #6

Facility

$6,280.00

Hospital Charge Code	270675545
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLXBL HNGE SWNSN#6 4260006

Facility

$1,736.00

Service Code	HCPCS C1776
Hospital Charge Code	270611673
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLXBL HNGE SWNSN#6 4260006

Facility

$1,736.00

Service Code	HCPCS C1776
Hospital Charge Code	270611673
Hospital Revenue Code	278
Min. Negotiated Rate	$49.30
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$659.68
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40
Rate for Payer: UnitedHealthcare Community & State	$54.86
Rate for Payer: Wellpoint Medicaid Managed Care	$49.30

TOE IMPLANT

Facility

$822.00

Hospital Charge Code	270335036
Hospital Revenue Code	278
Min. Negotiated Rate	$123.30
Max. Negotiated Rate	$198.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.92
Rate for Payer: Qualcare PPO/HMO/WC	$123.30

TOE IMPLANT

Facility

$822.00

Hospital Charge Code	270335036
Hospital Revenue Code	278
Min. Negotiated Rate	$23.34
Max. Negotiated Rate	$411.00
Rate for Payer: Aetna Commercial	$312.36
Rate for Payer: Aetna Medicare Advantage	$246.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.61
Rate for Payer: Cigna Commercial	$411.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.92
Rate for Payer: Qualcare PPO/HMO/WC	$123.30
Rate for Payer: UnitedHealthcare Community & State	$25.98
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

TOE IMPLANT REG GREAT SZ1

Facility

$9,970.00

Service Code	HCPCS C1776
Hospital Charge Code	270634572
Hospital Revenue Code	278
Min. Negotiated Rate	$1,495.50
Max. Negotiated Rate	$2,412.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,994.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.50

TOE IMPLANT REG GREAT SZ1

Facility

$9,970.00

Service Code	HCPCS C1776
Hospital Charge Code	270634572
Hospital Revenue Code	278
Min. Negotiated Rate	$283.15
Max. Negotiated Rate	$4,985.00
Rate for Payer: Aetna Commercial	$3,788.60
Rate for Payer: Aetna Medicare Advantage	$2,991.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,994.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,542.35
Rate for Payer: Cigna Commercial	$4,985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.50
Rate for Payer: UnitedHealthcare Community & State	$315.05
Rate for Payer: Wellpoint Medicaid Managed Care	$283.15

TOE-LEFT FOOT, 5TH DIG

Facility

$5,100.00

Service Code	HCPCS 73660T4
Hospital Charge Code	94061415
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

TOE-LEFT FOOT, 5TH DIG

Facility

$5,100.00

Service Code	HCPCS 73660T4
Hospital Charge Code	94061415
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

TOE-LEFT FOOT, GREAT T

Facility

$5,100.00

Service Code	HCPCS 73660TA
Hospital Charge Code	94061427
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

TOE-LEFT FOOT, GREAT T

Facility

$5,100.00

Service Code	HCPCS 73660TA
Hospital Charge Code	94061427
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

TOE-RIGHT FOOT, GREAT

Facility

$5,100.00

Service Code	HCPCS 73660T5
Hospital Charge Code	94061417
Hospital Revenue Code	320
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

TOE-RIGHT FOOT, GREAT

Facility

$5,100.00

Service Code	HCPCS 73660T5
Hospital Charge Code	94061417
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

TOE STRAPPING

Facility

$468.75

Service Code	HCPCS 29550
Hospital Charge Code	9808180
Hospital Revenue Code	361
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.22
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.88
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.31
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$14.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$13.31

TOE STRAPPING

Facility

$468.75

Service Code	HCPCS 29550
Hospital Charge Code	9808180
Hospital Revenue Code	361
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

TOE TAC MEDIUM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270677359
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

Know your out-of-pocket cost for care.

All Charges