Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE TAP SYMPHONY 4.0

Facility

$2,160.00

Hospital Charge Code	270693361
Hospital Revenue Code	272
Min. Negotiated Rate	$61.34
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$820.80
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.60
Rate for Payer: Oxford Commercial	$432.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$432.00
Rate for Payer: UnitedHealthcare Community & State	$68.26
Rate for Payer: Wellpoint Medicaid Managed Care	$61.34

BONE TAP SYMPHONY 4.5

Facility

$2,160.00

Hospital Charge Code	270693362
Hospital Revenue Code	272
Min. Negotiated Rate	$61.34
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$820.80
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.60
Rate for Payer: Oxford Commercial	$432.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$432.00
Rate for Payer: UnitedHealthcare Community & State	$68.26
Rate for Payer: Wellpoint Medicaid Managed Care	$61.34

BONE TAP SYMPHONY 4.5

Facility

$2,160.00

Hospital Charge Code	270693362
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

BONE VOID FILLER 10CC

Facility

$13,433.75

Service Code	HCPCS C1713
Hospital Charge Code	270670728
Hospital Revenue Code	278
Min. Negotiated Rate	$2,015.06
Max. Negotiated Rate	$3,250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06

BONE VOID FILLER 10CC

Facility

$13,433.75

Service Code	HCPCS C1713
Hospital Charge Code	270670728
Hospital Revenue Code	278
Min. Negotiated Rate	$381.52
Max. Negotiated Rate	$6,716.88
Rate for Payer: Aetna Commercial	$5,104.82
Rate for Payer: Aetna Medicare Advantage	$4,030.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,425.61
Rate for Payer: Cigna Commercial	$6,716.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06
Rate for Payer: UnitedHealthcare Community & State	$424.51
Rate for Payer: Wellpoint Medicaid Managed Care	$381.52

BONE VOID FILLER 10CC

Facility

$10,752.50

Hospital Charge Code	270671241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.88
Max. Negotiated Rate	$2,602.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,602.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.88

BONE VOID FILLER 10CC

Facility

$10,752.50

Hospital Charge Code	270671241
Hospital Revenue Code	278
Min. Negotiated Rate	$305.37
Max. Negotiated Rate	$5,376.25
Rate for Payer: Aetna Commercial	$4,085.95
Rate for Payer: Aetna Medicare Advantage	$3,225.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.89
Rate for Payer: Cigna Commercial	$5,376.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,602.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.88
Rate for Payer: UnitedHealthcare Community & State	$339.78
Rate for Payer: Wellpoint Medicaid Managed Care	$305.37

BONE VOID FILLER 10CC 25X100X4

Facility

$13,433.75

Hospital Charge Code	270671236
Hospital Revenue Code	278
Min. Negotiated Rate	$2,015.06
Max. Negotiated Rate	$3,250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06

BONE VOID FILLER 10CC 25X100X4

Facility

$13,433.75

Hospital Charge Code	270671236
Hospital Revenue Code	278
Min. Negotiated Rate	$381.52
Max. Negotiated Rate	$6,716.88
Rate for Payer: Aetna Commercial	$5,104.82
Rate for Payer: Aetna Medicare Advantage	$4,030.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,425.61
Rate for Payer: Cigna Commercial	$6,716.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06
Rate for Payer: UnitedHealthcare Community & State	$424.51
Rate for Payer: Wellpoint Medicaid Managed Care	$381.52

BONE VOID FILLER 10ML

Facility

$13,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270669259
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 VOID FILLER 10ML

Facility

$13,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270669259
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 VOID FILLER 1CC

Facility

$2,626.25

Hospital Charge Code	270671238
Hospital Revenue Code	278
Min. Negotiated Rate	$74.59
Max. Negotiated Rate	$1,313.12
Rate for Payer: Aetna Commercial	$997.98
Rate for Payer: Aetna Medicare Advantage	$787.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.69
Rate for Payer: Cigna Commercial	$1,313.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.55
Rate for Payer: Qualcare PPO/HMO/WC	$393.94
Rate for Payer: UnitedHealthcare Community & State	$82.99
Rate for Payer: Wellpoint Medicaid Managed Care	$74.59

BONE VOID FILLER 1CC

Facility

$2,626.25

Hospital Charge Code	270671238
Hospital Revenue Code	278
Min. Negotiated Rate	$393.94
Max. Negotiated Rate	$635.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.55
Rate for Payer: Qualcare PPO/HMO/WC	$393.94

BONE VOID FILLER 20CC

Facility

$19,868.75

Hospital Charge Code	270671232
Hospital Revenue Code	278
Min. Negotiated Rate	$2,980.31
Max. Negotiated Rate	$4,808.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,973.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,808.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,980.31

BONE VOID FILLER 20CC

Facility

$19,868.75

Hospital Charge Code	270671232
Hospital Revenue Code	278
Min. Negotiated Rate	$564.27
Max. Negotiated Rate	$9,934.38
Rate for Payer: Aetna Commercial	$7,550.12
Rate for Payer: Aetna Medicare Advantage	$5,960.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,066.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,066.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,973.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,066.53
Rate for Payer: Cigna Commercial	$9,934.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,808.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,980.31
Rate for Payer: UnitedHealthcare Community & State	$627.85
Rate for Payer: Wellpoint Medicaid Managed Care	$564.27

BONE VOID FILLER 2CC

Facility

$3,148.75

Hospital Charge Code	270671239
Hospital Revenue Code	278
Min. Negotiated Rate	$472.31
Max. Negotiated Rate	$762.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.31

BONE VOID FILLER 2CC

Facility

$3,148.75

Hospital Charge Code	270671239
Hospital Revenue Code	278
Min. Negotiated Rate	$89.42
Max. Negotiated Rate	$1,574.38
Rate for Payer: Aetna Commercial	$1,196.53
Rate for Payer: Aetna Medicare Advantage	$944.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$802.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$802.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$629.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$802.93
Rate for Payer: Cigna Commercial	$1,574.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.00
Rate for Payer: Qualcare PPO/HMO/WC	$472.31
Rate for Payer: UnitedHealthcare Community & State	$99.50
Rate for Payer: Wellpoint Medicaid Managed Care	$89.42

BONE VOID FILLER 5CC

Facility

$11,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270701475
Hospital Revenue Code	278
Min. Negotiated Rate	$328.02
Max. Negotiated Rate	$5,775.00
Rate for Payer: Aetna Commercial	$4,389.00
Rate for Payer: Aetna Medicare Advantage	$3,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,945.25
Rate for Payer: Cigna Commercial	$5,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,795.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50
Rate for Payer: UnitedHealthcare Community & State	$364.98
Rate for Payer: Wellpoint Medicaid Managed Care	$328.02

BONE VOID FILLER 5CC

Facility

$6,668.75

Service Code	HCPCS C1713
Hospital Charge Code	270671240
Hospital Revenue Code	278
Min. Negotiated Rate	$189.39
Max. Negotiated Rate	$3,334.38
Rate for Payer: Aetna Commercial	$2,534.12
Rate for Payer: Aetna Medicare Advantage	$2,000.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,333.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.53
Rate for Payer: Cigna Commercial	$3,334.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,613.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.31
Rate for Payer: UnitedHealthcare Community & State	$210.73
Rate for Payer: Wellpoint Medicaid Managed Care	$189.39

BONE VOID FILLER 5CC

Facility

$11,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270701475
Hospital Revenue Code	278
Min. Negotiated Rate	$1,732.50
Max. Negotiated Rate	$2,795.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,795.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50

BONE VOID FILLER 5CC

Facility

$6,668.75

Service Code	HCPCS C1713
Hospital Charge Code	270671240
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.31
Max. Negotiated Rate	$1,613.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,333.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,613.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.31

BONE VOID FILLER 5CC 25X50X4

Facility

$8,332.50

Hospital Charge Code	270671237
Hospital Revenue Code	278
Min. Negotiated Rate	$1,249.88
Max. Negotiated Rate	$2,016.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,666.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,016.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,249.88

BONE VOID FILLER 5CC 25X50X4

Facility

$8,332.50

Hospital Charge Code	270671237
Hospital Revenue Code	278
Min. Negotiated Rate	$236.64
Max. Negotiated Rate	$4,166.25
Rate for Payer: Aetna Commercial	$3,166.35
Rate for Payer: Aetna Medicare Advantage	$2,499.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,124.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,124.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,124.79
Rate for Payer: Cigna Commercial	$4,166.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,016.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,249.88
Rate for Payer: UnitedHealthcare Community & State	$263.31
Rate for Payer: Wellpoint Medicaid Managed Care	$236.64

BONE WAX

Facility

$23.90

Hospital Charge Code	270604717
Hospital Revenue Code	272
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$3.58

BONE WAX

Facility

$72.00

Hospital Charge Code	270335098
Hospital Revenue Code	272
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

Know your out-of-pocket cost for care.

All Charges