Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE 3D CERV 14.5X12X10MM 7D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696613
Hospital Revenue Code	278
Min. Negotiated Rate	$5,137.50
Max. Negotiated Rate	$8,288.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50

CAGE 3D CERV 14.5X12X10MM 7D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696613
Hospital Revenue Code	278
Min. Negotiated Rate	$972.70
Max. Negotiated Rate	$17,125.00
Rate for Payer: Aetna Commercial	$13,015.00
Rate for Payer: Aetna Medicare Advantage	$10,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,733.75
Rate for Payer: Cigna Commercial	$17,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50
Rate for Payer: UnitedHealthcare Community & State	$1,082.30
Rate for Payer: Wellpoint Medicaid Managed Care	$972.70

CAGE 4MM LARGE

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681009
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE 4MM LARGE

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681009
Hospital Revenue Code	278
Min. Negotiated Rate	$184.60
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$2,470.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00
Rate for Payer: UnitedHealthcare Community & State	$205.40
Rate for Payer: Wellpoint Medicaid Managed Care	$184.60

CAGE 6MM 6DEG

Facility

$19,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705703
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

CAGE 6MM 6DEG

Facility

$19,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705703
Hospital Revenue Code	278
Min. Negotiated Rate	$553.80
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$7,410.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00
Rate for Payer: UnitedHealthcare Community & State	$616.20
Rate for Payer: Wellpoint Medicaid Managed Care	$553.80

CAGE 6MM LARGE

Facility

$9,080.00

Service Code	HCPCS C1889
Hospital Charge Code	270705060
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

CAGE 6MM LARGE

Facility

$9,080.00

Service Code	HCPCS C1889
Hospital Charge Code	270705060
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

CAGE 7MM. 6DEG

Facility

$19,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705704
Hospital Revenue Code	279
Min. Negotiated Rate	$553.80
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$7,410.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,070.00
Rate for Payer: Oxford Commercial	$3,900.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00
Rate for Payer: UnitedHealthcare Commercial	$3,900.00
Rate for Payer: UnitedHealthcare Community & State	$616.20
Rate for Payer: Wellpoint Medicaid Managed Care	$553.80

CAGE 7MM. 6DEG

Facility

$19,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705704
Hospital Revenue Code	279
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$2,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

CAGE 7 MM PEEK

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270691453
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

CAGE 7 MM PEEK

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270691453
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

CAGE 7MM PEEL

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689964
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

CAGE 7MM PEEL

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270689964
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

CAGE 7 MM REG

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693117
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE 7 MM REG

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693117
Hospital Revenue Code	278
Min. Negotiated Rate	$268.38
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$3,591.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50
Rate for Payer: UnitedHealthcare Community & State	$298.62
Rate for Payer: Wellpoint Medicaid Managed Care	$268.38

CAGE 7MM REGULAR

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690759
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

CAGE 7MM REGULAR

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690759
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

CAGE 7MX14MMX17M

Facility

$9,150.00

Hospital Charge Code	270703300
Hospital Revenue Code	278
Min. Negotiated Rate	$259.86
Max. Negotiated Rate	$4,575.00
Rate for Payer: Aetna Commercial	$3,477.00
Rate for Payer: Aetna Medicare Advantage	$2,745.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,333.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,333.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,333.25
Rate for Payer: Cigna Commercial	$4,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,214.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,372.50
Rate for Payer: UnitedHealthcare Community & State	$289.14
Rate for Payer: Wellpoint Medicaid Managed Care	$259.86

CAGE 7MX14MMX17M

Facility

$9,150.00

Hospital Charge Code	270703300
Hospital Revenue Code	278
Min. Negotiated Rate	$1,372.50
Max. Negotiated Rate	$2,214.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,830.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,214.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,372.50

CAGE 7X11MM

Facility

$6,535.00

Service Code	HCPCS L8699
Hospital Charge Code	270693042
Hospital Revenue Code	278
Min. Negotiated Rate	$980.25
Max. Negotiated Rate	$1,581.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: Qualcare PPO/HMO/WC	$980.25

CAGE 7X11MM

Facility

$6,535.00

Service Code	HCPCS L8699
Hospital Charge Code	270693042
Hospital Revenue Code	278
Min. Negotiated Rate	$185.59
Max. Negotiated Rate	$3,267.50
Rate for Payer: Aetna Commercial	$2,483.30
Rate for Payer: Aetna Medicare Advantage	$1,960.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,666.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,307.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,666.42
Rate for Payer: Cigna Commercial	$3,267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,581.47
Rate for Payer: Qualcare PPO/HMO/WC	$980.25
Rate for Payer: UnitedHealthcare Community & State	$206.51
Rate for Payer: Wellpoint Medicaid Managed Care	$185.59

CAGE 7 X 12 X 14 CM

Facility

$18,839.95

Service Code	HCPCS C1889
Hospital Charge Code	270690117
Hospital Revenue Code	278
Min. Negotiated Rate	$2,825.99
Max. Negotiated Rate	$4,559.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,767.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,559.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,825.99

CAGE 7 X 12 X 14 CM

Facility

$18,839.95

Service Code	HCPCS C1889
Hospital Charge Code	270690117
Hospital Revenue Code	278
Min. Negotiated Rate	$535.05
Max. Negotiated Rate	$9,419.98
Rate for Payer: Aetna Commercial	$7,159.18
Rate for Payer: Aetna Medicare Advantage	$5,651.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,804.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,804.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,767.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,804.19
Rate for Payer: Cigna Commercial	$9,419.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,559.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,825.99
Rate for Payer: UnitedHealthcare Community & State	$595.34
Rate for Payer: Wellpoint Medicaid Managed Care	$535.05

CAGE 7X14X12MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704540
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

Know your out-of-pocket cost for care.

All Charges