Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE ANT LUMBAR MONTEREY

Facility

$44,975.00

Hospital Charge Code	270702924
Hospital Revenue Code	278
Min. Negotiated Rate	$6,746.25
Max. Negotiated Rate	$10,883.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE BANGAL 28MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686282
Hospital Revenue Code	278
Min. Negotiated Rate	$639.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$711.00
Rate for Payer: Wellpoint Medicaid Managed Care	$639.00

CAGE BANGAL 28MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686282
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

CAGE BENGAL 20MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689202
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 20MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689202
Hospital Revenue Code	278
Min. Negotiated Rate	$571.98
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$636.42
Rate for Payer: Wellpoint Medicaid Managed Care	$571.98

CAGE BENGAL 26MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689201
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 26MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689201
Hospital Revenue Code	278
Min. Negotiated Rate	$571.98
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$7,653.20
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00
Rate for Payer: UnitedHealthcare Community & State	$636.42
Rate for Payer: Wellpoint Medicaid Managed Care	$571.98

CAGE BENGAL 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663294
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 BENGAL 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663294
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 BENGAL7MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680083
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 BENGAL7MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680083
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 BENGAL CAGE 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270683533
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 BENGAL CAGE 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270683533
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 BENGAL STACK STD LOR 32MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270674899
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

CAGE BENGAL STACK STD LOR 32MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270674899
Hospital Revenue Code	278
Min. Negotiated Rate	$639.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00
Rate for Payer: UnitedHealthcare Community & State	$711.00
Rate for Payer: Wellpoint Medicaid Managed Care	$639.00

CAGE BENGAL STACK STD LOR 38MM

Facility

$23,830.00

Hospital Charge Code	270666239
Hospital Revenue Code	278
Min. Negotiated Rate	$676.77
Max. Negotiated Rate	$11,915.00
Rate for Payer: Aetna Commercial	$9,055.40
Rate for Payer: Aetna Medicare Advantage	$7,149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,076.65
Rate for Payer: Cigna Commercial	$11,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50
Rate for Payer: UnitedHealthcare Community & State	$753.03
Rate for Payer: Wellpoint Medicaid Managed Care	$676.77

CAGE BENGAL STACK STD LOR 38MM

Facility

$23,830.00

Hospital Charge Code	270666239
Hospital Revenue Code	278
Min. Negotiated Rate	$3,574.50
Max. Negotiated Rate	$5,766.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50

CAGE BENGAL STACK STD LOR 40MM

Facility

$23,830.00

Service Code	HCPCS C1713
Hospital Charge Code	270665834
Hospital Revenue Code	278
Min. Negotiated Rate	$676.77
Max. Negotiated Rate	$11,915.00
Rate for Payer: Aetna Commercial	$9,055.40
Rate for Payer: Aetna Medicare Advantage	$7,149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,076.65
Rate for Payer: Cigna Commercial	$11,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50
Rate for Payer: UnitedHealthcare Community & State	$753.03
Rate for Payer: Wellpoint Medicaid Managed Care	$676.77

CAGE BENGAL STACK STD LOR 40MM

Facility

$23,830.00

Service Code	HCPCS C1713
Hospital Charge Code	270665834
Hospital Revenue Code	278
Min. Negotiated Rate	$3,574.50
Max. Negotiated Rate	$5,766.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50

CAGE BENGAL STACK STD LOR 44MM

Facility

$23,830.00

Hospital Charge Code	270676203
Hospital Revenue Code	278
Min. Negotiated Rate	$3,574.50
Max. Negotiated Rate	$5,766.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50

CAGE BENGAL STACK STD LOR 44MM

Facility

$23,830.00

Hospital Charge Code	270676203
Hospital Revenue Code	278
Min. Negotiated Rate	$676.77
Max. Negotiated Rate	$11,915.00
Rate for Payer: Aetna Commercial	$9,055.40
Rate for Payer: Aetna Medicare Advantage	$7,149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,076.65
Rate for Payer: Cigna Commercial	$11,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50
Rate for Payer: UnitedHealthcare Community & State	$753.03
Rate for Payer: Wellpoint Medicaid Managed Care	$676.77

CAGE BENGAL STD 4MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270667000
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 BENGAL STD 4MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270667000
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 BENGAL STD 5MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663102
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 BENGAL STD 5MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663102
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

Know your out-of-pocket cost for care.

All Charges