Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE CEMENT SIMPLEX HV

Facility

$355.00

Hospital Charge Code	270673762
Hospital Revenue Code	278
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$134.90
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Community & State	$11.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.08

BONE CEMENT SIMPLEX HV GENT

Facility

$1,006.77

Hospital Charge Code	270673387
Hospital Revenue Code	278
Min. Negotiated Rate	$151.02
Max. Negotiated Rate	$243.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.64
Rate for Payer: Qualcare PPO/HMO/WC	$151.02

BONE CEMENT SIMPLEX HV GENT

Facility

$1,006.75

Service Code	HCPCS C1713
Hospital Charge Code	270669205
Hospital Revenue Code	278
Min. Negotiated Rate	$28.59
Max. Negotiated Rate	$503.38
Rate for Payer: Aetna Commercial	$382.56
Rate for Payer: Aetna Medicare Advantage	$302.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.72
Rate for Payer: Cigna Commercial	$503.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.63
Rate for Payer: Qualcare PPO/HMO/WC	$151.01
Rate for Payer: UnitedHealthcare Community & State	$31.81
Rate for Payer: Wellpoint Medicaid Managed Care	$28.59

BONE CEMENT SIMPLEX HV GENT

Facility

$1,006.77

Hospital Charge Code	270673387
Hospital Revenue Code	278
Min. Negotiated Rate	$28.59
Max. Negotiated Rate	$503.38
Rate for Payer: Aetna Commercial	$382.57
Rate for Payer: Aetna Medicare Advantage	$302.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.73
Rate for Payer: Cigna Commercial	$503.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.64
Rate for Payer: Qualcare PPO/HMO/WC	$151.02
Rate for Payer: UnitedHealthcare Community & State	$31.81
Rate for Payer: Wellpoint Medicaid Managed Care	$28.59

BONE CEMENT SIMPLEX HV GENT

Facility

$1,006.75

Service Code	HCPCS C1713
Hospital Charge Code	270669205
Hospital Revenue Code	278
Min. Negotiated Rate	$151.01
Max. Negotiated Rate	$243.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.63
Rate for Payer: Qualcare PPO/HMO/WC	$151.01

BONE CEMENT TOB FULL DOSE

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270660302
Hospital Revenue Code	278
Min. Negotiated Rate	$44.45
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$49.45
Rate for Payer: Wellpoint Medicaid Managed Care	$44.45

BONE CEMENT TOB FULL DOSE

Facility

$1,490.00

Hospital Charge Code	270673763
Hospital Revenue Code	278
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$360.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.58
Rate for Payer: Qualcare PPO/HMO/WC	$223.50

BONE CEMENT TOB FULL DOSE

Facility

$1,490.00

Hospital Charge Code	270673763
Hospital Revenue Code	278
Min. Negotiated Rate	$42.32
Max. Negotiated Rate	$745.00
Rate for Payer: Aetna Commercial	$566.20
Rate for Payer: Aetna Medicare Advantage	$447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.95
Rate for Payer: Cigna Commercial	$745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.58
Rate for Payer: Qualcare PPO/HMO/WC	$223.50
Rate for Payer: UnitedHealthcare Community & State	$47.08
Rate for Payer: Wellpoint Medicaid Managed Care	$42.32

BONE CEMENT TOB FULL DOSE

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270660302
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

BONE CERAMENT BONE FILLER 5CC

Facility

$9,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270651533
Hospital Revenue Code	278
Min. Negotiated Rate	$257.87
Max. Negotiated Rate	$4,540.00
Rate for Payer: Aetna Commercial	$3,450.40
Rate for Payer: Aetna Medicare Advantage	$2,724.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,315.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,315.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,315.40
Rate for Payer: Cigna Commercial	$4,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,197.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,362.00
Rate for Payer: UnitedHealthcare Community & State	$286.93
Rate for Payer: Wellpoint Medicaid Managed Care	$257.87

BONE CERAMENT BONE FILLER 5CC

Facility

$9,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270651533
Hospital Revenue Code	278
Min. Negotiated Rate	$1,362.00
Max. Negotiated Rate	$2,197.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,816.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,197.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,362.00

BONE CHIP CANCELLOUS,1-8MM

Facility

$1,221.50

Service Code	HCPCS C1762
Hospital Charge Code	270659902
Hospital Revenue Code	278
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$610.75
Rate for Payer: Aetna Commercial	$464.17
Rate for Payer: Aetna Medicare Advantage	$366.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.48
Rate for Payer: Cigna Commercial	$610.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.60
Rate for Payer: Qualcare PPO/HMO/WC	$183.22
Rate for Payer: UnitedHealthcare Community & State	$38.60
Rate for Payer: Wellpoint Medicaid Managed Care	$34.69

BONE CHIP CANCELLOUS,1-8MM

Facility

$1,221.50

Service Code	HCPCS C1762
Hospital Charge Code	270659902
Hospital Revenue Code	278
Min. Negotiated Rate	$183.22
Max. Negotiated Rate	$295.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.60
Rate for Payer: Qualcare PPO/HMO/WC	$183.22

BONE CHIPS CANCELLOUS 30CC

Facility

$2,130.00

Service Code	HCPCS C1713
Hospital Charge Code	270673109
Hospital Revenue Code	278
Min. Negotiated Rate	$60.49
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$809.40
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50
Rate for Payer: UnitedHealthcare Community & State	$67.31
Rate for Payer: Wellpoint Medicaid Managed Care	$60.49

BONE CHIPS CANCELLOUS 30CC

Facility

$2,130.00

Service Code	HCPCS C1713
Hospital Charge Code	270673109
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

BONE CHIPS CANCELLOUS 30CC 4MM

Facility

$2,800.00

Hospital Charge Code	270673970
Hospital Revenue Code	272
Min. Negotiated Rate	$79.52
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$728.00
Rate for Payer: Oxford Commercial	$560.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$560.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

BONE CHIPS CANCELLOUS 30CC 4MM

Facility

$2,800.00

Hospital Charge Code	270673970
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

BONE CHIPS CANCELLOUS 5CC

Facility

$670.00

Hospital Charge Code	270673108
Hospital Revenue Code	278
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$162.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

BONE CHIPS CANCELLOUS 5CC

Facility

$670.00

Hospital Charge Code	270673108
Hospital Revenue Code	278
Min. Negotiated Rate	$19.03
Max. Negotiated Rate	$335.00
Rate for Payer: Aetna Commercial	$254.60
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.50
Rate for Payer: UnitedHealthcare Community & State	$21.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.03

BONE CLAMP W MARKER-MEDIUM

Facility

$7,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270698381
Hospital Revenue Code	278
Min. Negotiated Rate	$1,113.75
Max. Negotiated Rate	$1,796.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75

BONE CLAMP W MARKER-MEDIUM

Facility

$7,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270698381
Hospital Revenue Code	278
Min. Negotiated Rate	$210.87
Max. Negotiated Rate	$3,712.50
Rate for Payer: Aetna Commercial	$2,821.50
Rate for Payer: Aetna Medicare Advantage	$2,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,893.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,893.38
Rate for Payer: Cigna Commercial	$3,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,796.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.75
Rate for Payer: UnitedHealthcare Community & State	$234.63
Rate for Payer: Wellpoint Medicaid Managed Care	$210.87

BONE CORTICAL CANC CHIPS 15CC

Facility

$1,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270673112
Hospital Revenue Code	278
Min. Negotiated Rate	$44.16
Max. Negotiated Rate	$777.50
Rate for Payer: Aetna Commercial	$590.90
Rate for Payer: Aetna Medicare Advantage	$466.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$396.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$396.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$311.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$396.52
Rate for Payer: Cigna Commercial	$777.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.31
Rate for Payer: Qualcare PPO/HMO/WC	$233.25
Rate for Payer: UnitedHealthcare Community & State	$49.14
Rate for Payer: Wellpoint Medicaid Managed Care	$44.16

BONE CORTICAL CANC CHIPS 15CC

Facility

$1,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270673112
Hospital Revenue Code	278
Min. Negotiated Rate	$233.25
Max. Negotiated Rate	$376.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$311.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.31
Rate for Payer: Qualcare PPO/HMO/WC	$233.25

BONE CORTICAL CANC CRUSH 15CC

Facility

$1,245.00

Service Code	HCPCS C1713
Hospital Charge Code	270673111
Hospital Revenue Code	278
Min. Negotiated Rate	$35.36
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$473.10
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: Qualcare PPO/HMO/WC	$186.75
Rate for Payer: UnitedHealthcare Community & State	$39.34
Rate for Payer: Wellpoint Medicaid Managed Care	$35.36

BONE CORTICAL CANC CRUSH 15CC

Facility

$1,245.00

Service Code	HCPCS C1713
Hospital Charge Code	270673111
Hospital Revenue Code	278
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$301.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

Know your out-of-pocket cost for care.

All Charges