Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE DRILL 3.0

Facility

$676.40

Hospital Charge Code	270670675
Hospital Revenue Code	272
Min. Negotiated Rate	$101.46
Max. Negotiated Rate	$101.46
Rate for Payer: Qualcare PPO/HMO/WC	$101.46

BONE FENESTRATION PERFORATOR

Facility

$877.50

Hospital Charge Code	270699686
Hospital Revenue Code	278
Min. Negotiated Rate	$24.92
Max. Negotiated Rate	$438.75
Rate for Payer: Aetna Commercial	$333.45
Rate for Payer: Aetna Medicare Advantage	$263.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.76
Rate for Payer: Cigna Commercial	$438.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.35
Rate for Payer: Qualcare PPO/HMO/WC	$131.62
Rate for Payer: UnitedHealthcare Community & State	$27.73
Rate for Payer: Wellpoint Medicaid Managed Care	$24.92

BONE FENESTRATION PERFORATOR

Facility

$877.50

Hospital Charge Code	270699686
Hospital Revenue Code	278
Min. Negotiated Rate	$131.62
Max. Negotiated Rate	$212.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.35
Rate for Payer: Qualcare PPO/HMO/WC	$131.62

BONE FILLER 10 CC

Facility

$19,337.50

Service Code	HCPCS C1713
Hospital Charge Code	270701671
Hospital Revenue Code	278
Min. Negotiated Rate	$549.18
Max. Negotiated Rate	$9,668.75
Rate for Payer: Aetna Commercial	$7,348.25
Rate for Payer: Aetna Medicare Advantage	$5,801.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,931.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,931.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,867.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,931.06
Rate for Payer: Cigna Commercial	$9,668.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,900.62
Rate for Payer: UnitedHealthcare Community & State	$611.07
Rate for Payer: Wellpoint Medicaid Managed Care	$549.18

BONE FILLER 10 CC

Facility

$19,337.50

Service Code	HCPCS C1713
Hospital Charge Code	270701671
Hospital Revenue Code	278
Min. Negotiated Rate	$2,900.62
Max. Negotiated Rate	$4,679.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,900.62

BONE FILLER 5ML CERAMENT

Facility

$6,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270690281
Hospital Revenue Code	278
Min. Negotiated Rate	$978.75
Max. Negotiated Rate	$1,579.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,579.05
Rate for Payer: Qualcare PPO/HMO/WC	$978.75

BONE FILLER 5ML CERAMENT

Facility

$6,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270690281
Hospital Revenue Code	278
Min. Negotiated Rate	$185.31
Max. Negotiated Rate	$3,262.50
Rate for Payer: Aetna Commercial	$2,479.50
Rate for Payer: Aetna Medicare Advantage	$1,957.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,663.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,663.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,663.88
Rate for Payer: Cigna Commercial	$3,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,579.05
Rate for Payer: Qualcare PPO/HMO/WC	$978.75
Rate for Payer: UnitedHealthcare Community & State	$206.19
Rate for Payer: Wellpoint Medicaid Managed Care	$185.31

BONE GRAFT 10CC INJECTABLE

Facility

$14,615.00

Hospital Charge Code	270667747
Hospital Revenue Code	278
Min. Negotiated Rate	$415.07
Max. Negotiated Rate	$7,307.50
Rate for Payer: Aetna Commercial	$5,553.70
Rate for Payer: Aetna Medicare Advantage	$4,384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,726.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,726.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,923.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,726.82
Rate for Payer: Cigna Commercial	$7,307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,536.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.25
Rate for Payer: UnitedHealthcare Community & State	$461.83
Rate for Payer: Wellpoint Medicaid Managed Care	$415.07

BONE GRAFT 10CC INJECTABLE

Facility

$14,615.00

Hospital Charge Code	270667747
Hospital Revenue Code	278
Min. Negotiated Rate	$2,192.25
Max. Negotiated Rate	$3,536.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,923.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,536.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.25

BONE GRAFT 4CC INJECTABLE

Facility

$7,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270656818
Hospital Revenue Code	278
Min. Negotiated Rate	$1,084.50
Max. Negotiated Rate	$1,749.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,749.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,084.50

BONE GRAFT 4CC INJECTABLE

Facility

$7,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270656818
Hospital Revenue Code	278
Min. Negotiated Rate	$205.33
Max. Negotiated Rate	$3,615.00
Rate for Payer: Aetna Commercial	$2,747.40
Rate for Payer: Aetna Medicare Advantage	$2,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,843.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,843.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,843.65
Rate for Payer: Cigna Commercial	$3,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,749.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,084.50
Rate for Payer: UnitedHealthcare Community & State	$228.47
Rate for Payer: Wellpoint Medicaid Managed Care	$205.33

BONE GRAFT 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692660
Hospital Revenue Code	278
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$268.60
Rate for Payer: Wellpoint Medicaid Managed Care	$241.40

BONE GRAFT 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692660
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

BONE GRAFT DELIV TUBE 10 CC

Facility

$693.00

Hospital Charge Code	270339051
Hospital Revenue Code	272
Min. Negotiated Rate	$19.68
Max. Negotiated Rate	$346.50
Rate for Payer: Aetna Commercial	$263.34
Rate for Payer: Aetna Medicare Advantage	$207.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.72
Rate for Payer: Cigna Commercial	$346.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.18
Rate for Payer: Oxford Commercial	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$103.95
Rate for Payer: UnitedHealthcare Commercial	$138.60
Rate for Payer: UnitedHealthcare Community & State	$21.90
Rate for Payer: Wellpoint Medicaid Managed Care	$19.68

BONE GRAFT DELIV TUBE 10 CC

Facility

$693.00

Hospital Charge Code	270339051
Hospital Revenue Code	272
Min. Negotiated Rate	$103.95
Max. Negotiated Rate	$103.95
Rate for Payer: Qualcare PPO/HMO/WC	$103.95

BONE GRAFT GRAINS 10CC

Facility

$4,275.00

Hospital Charge Code	270671737
Hospital Revenue Code	278
Min. Negotiated Rate	$121.41
Max. Negotiated Rate	$2,137.50
Rate for Payer: Aetna Commercial	$1,624.50
Rate for Payer: Aetna Medicare Advantage	$1,282.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,090.12
Rate for Payer: Cigna Commercial	$2,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25
Rate for Payer: UnitedHealthcare Community & State	$135.09
Rate for Payer: Wellpoint Medicaid Managed Care	$121.41

BONE GRAFT GRAINS 10CC

Facility

$4,275.00

Hospital Charge Code	270671737
Hospital Revenue Code	278
Min. Negotiated Rate	$641.25
Max. Negotiated Rate	$1,034.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25

BONE GRAFT GRAINS 30CC

Facility

$13,000.00

Hospital Charge Code	270671738
Hospital Revenue Code	278
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$6,500.00
Rate for Payer: Aetna Commercial	$4,940.00
Rate for Payer: Aetna Medicare Advantage	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,315.00
Rate for Payer: Cigna Commercial	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00
Rate for Payer: UnitedHealthcare Community & State	$410.80
Rate for Payer: Wellpoint Medicaid Managed Care	$369.20

BONE GRAFT GRAINS 30CC

Facility

$13,000.00

Hospital Charge Code	270671738
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$3,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

BONE GRAFT GRAINS 5CC

Facility

$2,250.00

Hospital Charge Code	270671736
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BONE GRAFT GRAINS 5CC

Facility

$2,250.00

Hospital Charge Code	270671736
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

BONE GRAFT INQU GRANULES 10CC

Facility

$6,465.00

Hospital Charge Code	270671739
Hospital Revenue Code	278
Min. Negotiated Rate	$969.75
Max. Negotiated Rate	$1,564.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,564.53
Rate for Payer: Qualcare PPO/HMO/WC	$969.75

BONE GRAFT INQU GRANULES 10CC

Facility

$6,465.00

Hospital Charge Code	270671739
Hospital Revenue Code	278
Min. Negotiated Rate	$183.61
Max. Negotiated Rate	$3,232.50
Rate for Payer: Aetna Commercial	$2,456.70
Rate for Payer: Aetna Medicare Advantage	$1,939.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,648.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,648.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,648.58
Rate for Payer: Cigna Commercial	$3,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,564.53
Rate for Payer: Qualcare PPO/HMO/WC	$969.75
Rate for Payer: UnitedHealthcare Community & State	$204.29
Rate for Payer: Wellpoint Medicaid Managed Care	$183.61

BONE GRAFT INQU GRANULES 30CC

Facility

$14,940.00

Hospital Charge Code	270671740
Hospital Revenue Code	278
Min. Negotiated Rate	$424.30
Max. Negotiated Rate	$7,470.00
Rate for Payer: Aetna Commercial	$5,677.20
Rate for Payer: Aetna Medicare Advantage	$4,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,809.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,809.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,809.70
Rate for Payer: Cigna Commercial	$7,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.00
Rate for Payer: UnitedHealthcare Community & State	$472.10
Rate for Payer: Wellpoint Medicaid Managed Care	$424.30

BONE GRAFT INQU GRANULES 30CC

Facility

$14,940.00

Hospital Charge Code	270671740
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.00
Max. Negotiated Rate	$3,615.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.00

Know your out-of-pocket cost for care.

All Charges