Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE SOURCE 6CC 6184-0-100

Facility

$1,382.00

Hospital Charge Code	270335735
Hospital Revenue Code	278
Min. Negotiated Rate	$207.30
Max. Negotiated Rate	$334.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.44
Rate for Payer: Qualcare PPO/HMO/WC	$207.30

BONE SOURCE 6CC 6184-0-100

Facility

$1,382.00

Hospital Charge Code	270335735
Hospital Revenue Code	278
Min. Negotiated Rate	$39.25
Max. Negotiated Rate	$691.00
Rate for Payer: Aetna Commercial	$525.16
Rate for Payer: Aetna Medicare Advantage	$414.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.41
Rate for Payer: Cigna Commercial	$691.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.44
Rate for Payer: Qualcare PPO/HMO/WC	$207.30
Rate for Payer: UnitedHealthcare Community & State	$43.67
Rate for Payer: Wellpoint Medicaid Managed Care	$39.25

BONE STIM SPF 60 MICROAMP

Facility

$37,651.65

Hospital Charge Code	270677411
Hospital Revenue Code	278
Min. Negotiated Rate	$1,069.31
Max. Negotiated Rate	$18,825.83
Rate for Payer: Aetna Commercial	$14,307.63
Rate for Payer: Aetna Medicare Advantage	$11,295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,601.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,601.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,530.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,601.17
Rate for Payer: Cigna Commercial	$18,825.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,111.70
Rate for Payer: Qualcare PPO/HMO/WC	$5,647.75
Rate for Payer: UnitedHealthcare Community & State	$1,189.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1,069.31

BONE STIM SPF 60 MICROAMP

Facility

$37,651.65

Hospital Charge Code	270677411
Hospital Revenue Code	278
Min. Negotiated Rate	$5,647.75
Max. Negotiated Rate	$9,111.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,530.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,111.70
Rate for Payer: Qualcare PPO/HMO/WC	$5,647.75

BONE STIMULATOR

Facility

$16,000.00

Service Code	HCPCS E0749
Hospital Charge Code	270657137
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

BONE STIMULATOR

Facility

$16,000.00

Service Code	HCPCS E0749
Hospital Charge Code	270657137
Hospital Revenue Code	278
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

BONE STIMULATOR IMPLANTABLE

Facility

$44,350.00

Hospital Charge Code	270671560
Hospital Revenue Code	278
Min. Negotiated Rate	$1,259.54
Max. Negotiated Rate	$22,175.00
Rate for Payer: Aetna Commercial	$16,853.00
Rate for Payer: Aetna Medicare Advantage	$13,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,309.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,309.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,309.25
Rate for Payer: Cigna Commercial	$22,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,732.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,652.50
Rate for Payer: UnitedHealthcare Community & State	$1,401.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1,259.54

BONE STIMULATOR IMPLANTABLE

Facility

$44,350.00

Hospital Charge Code	270671560
Hospital Revenue Code	278
Min. Negotiated Rate	$6,652.50
Max. Negotiated Rate	$10,732.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,732.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,652.50

BONE STIMULATOR (MACHINE)

Facility

$11,990.00

Hospital Charge Code	270335434
Hospital Revenue Code	270
Min. Negotiated Rate	$1,798.50
Max. Negotiated Rate	$1,798.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,798.50

BONE STIMULATOR (MACHINE)

Facility

$11,990.00

Hospital Charge Code	270335434
Hospital Revenue Code	270
Min. Negotiated Rate	$340.52
Max. Negotiated Rate	$5,995.00
Rate for Payer: Aetna Commercial	$4,556.20
Rate for Payer: Aetna Medicare Advantage	$3,597.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,057.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,057.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,057.45
Rate for Payer: Cigna Commercial	$5,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,117.40
Rate for Payer: Oxford Commercial	$2,398.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,798.50
Rate for Payer: UnitedHealthcare Commercial	$2,398.00
Rate for Payer: UnitedHealthcare Community & State	$378.88
Rate for Payer: Wellpoint Medicaid Managed Care	$340.52

BONE SUBSTUTE 10CC

Facility

$20,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270687085
Hospital Revenue Code	278
Min. Negotiated Rate	$577.94
Max. Negotiated Rate	$10,175.00
Rate for Payer: Aetna Commercial	$7,733.00
Rate for Payer: Aetna Medicare Advantage	$6,105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,189.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,189.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,189.25
Rate for Payer: Cigna Commercial	$10,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,924.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,052.50
Rate for Payer: UnitedHealthcare Community & State	$643.06
Rate for Payer: Wellpoint Medicaid Managed Care	$577.94

BONE SUBSTUTE 10CC

Facility

$20,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270687085
Hospital Revenue Code	278
Min. Negotiated Rate	$3,052.50
Max. Negotiated Rate	$4,924.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,924.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,052.50

BONE SURVEY COMPL

Facility

$5,100.00

Service Code	HCPCS 77075
Hospital Charge Code	94061197
Hospital Revenue Code	320
Min. Negotiated Rate	$46.22
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
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: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

BONE SURVEY COMPL

Facility

$5,100.00

Service Code	HCPCS 77075
Hospital Charge Code	94061197
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BONESYNC 3CC

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687862
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

BONESYNC 3CC

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687862
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

BONE TAMP/KYPHON EXPRESS II 15

Facility

$14,962.50

Service Code	HCPCS C1713
Hospital Charge Code	270669630
Hospital Revenue Code	278
Min. Negotiated Rate	$2,244.38
Max. Negotiated Rate	$3,620.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,620.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38

BONE TAMP/KYPHON EXPRESS II 15

Facility

$14,962.50

Service Code	HCPCS C1713
Hospital Charge Code	270669630
Hospital Revenue Code	278
Min. Negotiated Rate	$424.94
Max. Negotiated Rate	$7,481.25
Rate for Payer: Aetna Commercial	$5,685.75
Rate for Payer: Aetna Medicare Advantage	$4,488.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,815.44
Rate for Payer: Cigna Commercial	$7,481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,620.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38
Rate for Payer: UnitedHealthcare Community & State	$472.81
Rate for Payer: Wellpoint Medicaid Managed Care	$424.94

BONE TAP

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688421
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

BONE TAP

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688421
Hospital Revenue Code	278
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

BONE TAP 3.5MM X100MM

Facility

$1,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270704606
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$391.40
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.26
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Community & State	$32.55
Rate for Payer: Wellpoint Medicaid Managed Care	$29.25

BONE TAP 3.5MM X100MM

Facility

$1,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270704606
Hospital Revenue Code	278
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$249.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.26
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

BONE TAP 5.5 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690565
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BONE TAP 5.5 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690565
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

BONE TAP SYMPHONY 4.0

Facility

$2,160.00

Hospital Charge Code	270693361
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

Know your out-of-pocket cost for care.

All Charges