Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE CERVICAL 14.5X12X7MM7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697762
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

CAGE CERVICAL 14mm x 15.5 mm H

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270688648
Hospital Revenue Code	278
Min. Negotiated Rate	$1,749.75
Max. Negotiated Rate	$2,822.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75

CAGE CERVICAL 14mm x 15.5 mm H

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270688648
Hospital Revenue Code	278
Min. Negotiated Rate	$331.29
Max. Negotiated Rate	$5,832.50
Rate for Payer: Aetna Commercial	$4,432.70
Rate for Payer: Aetna Medicare Advantage	$3,499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,974.57
Rate for Payer: Cigna Commercial	$5,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75
Rate for Payer: UnitedHealthcare Community & State	$368.61
Rate for Payer: Wellpoint Medicaid Managed Care	$331.29

CAGE CERVICAL 14mm X 17mm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678668
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

CAGE CERVICAL 14mm X 17mm

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678668
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

CAGE CERVICAL 14MM X 17MM H6

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270679736
Hospital Revenue Code	278
Min. Negotiated Rate	$331.29
Max. Negotiated Rate	$5,832.50
Rate for Payer: Aetna Commercial	$4,432.70
Rate for Payer: Aetna Medicare Advantage	$3,499.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,974.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,974.57
Rate for Payer: Cigna Commercial	$5,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75
Rate for Payer: UnitedHealthcare Community & State	$368.61
Rate for Payer: Wellpoint Medicaid Managed Care	$331.29

CAGE CERVICAL 14MM X 17MM H6

Facility

$11,665.00

Service Code	HCPCS C1713
Hospital Charge Code	270679736
Hospital Revenue Code	278
Min. Negotiated Rate	$1,749.75
Max. Negotiated Rate	$2,822.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,822.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,749.75

CAGE CERVICAL 14mmx17mm H7

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680519
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

CAGE CERVICAL 14mmx17mm H7

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680519
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

CAGE CERVICAL 14mmx17mm H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

CAGE CERVICAL 14mmx17mm H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270680520
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

CAGE CERVICAL 14mm X 17mm H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678669
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

CAGE CERVICAL 14mm X 17mm H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678669
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

CAGE CERVICAL 14X11X7MM 7D

Facility

$7,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270695440
Hospital Revenue Code	278
Min. Negotiated Rate	$207.32
Max. Negotiated Rate	$3,650.00
Rate for Payer: Aetna Commercial	$2,774.00
Rate for Payer: Aetna Medicare Advantage	$2,190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,861.50
Rate for Payer: Cigna Commercial	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,095.00
Rate for Payer: UnitedHealthcare Community & State	$230.68
Rate for Payer: Wellpoint Medicaid Managed Care	$207.32

CAGE CERVICAL 14X11X7MM 7D

Facility

$7,300.00

Service Code	HCPCS C1889
Hospital Charge Code	270695440
Hospital Revenue Code	278
Min. Negotiated Rate	$1,095.00
Max. Negotiated Rate	$1,766.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,766.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,095.00

CAGE CERVICAL 7X16X13MM 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270694339
Hospital Revenue Code	278
Min. Negotiated Rate	$312.40
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$4,180.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

CAGE CERVICAL 7X16X13MM 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270694339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE CERVICAL CAVUX

Facility

$23,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692493
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$5,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

CAGE CERVICAL CAVUX

Facility

$23,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692493
Hospital Revenue Code	278
Min. Negotiated Rate	$653.20
Max. Negotiated Rate	$11,500.00
Rate for Payer: Aetna Commercial	$8,740.00
Rate for Payer: Aetna Medicare Advantage	$6,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,865.00
Rate for Payer: Cigna Commercial	$11,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00
Rate for Payer: UnitedHealthcare Community & State	$726.80
Rate for Payer: Wellpoint Medicaid Managed Care	$653.20

CAGE CERVICAL CAVUX X LTX

Facility

$9,025.00

Service Code	HCPCS C1889
Hospital Charge Code	270693673
Hospital Revenue Code	278
Min. Negotiated Rate	$256.31
Max. Negotiated Rate	$4,512.50
Rate for Payer: Aetna Commercial	$3,429.50
Rate for Payer: Aetna Medicare Advantage	$2,707.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,301.38
Rate for Payer: Cigna Commercial	$4,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75
Rate for Payer: UnitedHealthcare Community & State	$285.19
Rate for Payer: Wellpoint Medicaid Managed Care	$256.31

CAGE CERVICAL CAVUX X LTX

Facility

$9,025.00

Service Code	HCPCS C1889
Hospital Charge Code	270693673
Hospital Revenue Code	278
Min. Negotiated Rate	$1,353.75
Max. Negotiated Rate	$2,184.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75

CAGE CERVICAL COHERE 12X14X8MM

Facility

$9,075.00

Service Code	HCPCS C1889
Hospital Charge Code	270692447
Hospital Revenue Code	278
Min. Negotiated Rate	$257.73
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$286.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.73

CAGE CERVICAL COHERE 12X14X8MM

Facility

$9,075.00

Service Code	HCPCS C1889
Hospital Charge Code	270692447
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

CAGE CERVICAL PC 16X13X7MM 7D

Facility

$7,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693521
Hospital Revenue Code	278
Min. Negotiated Rate	$198.80
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$221.20
Rate for Payer: Wellpoint Medicaid Managed Care	$198.80

CAGE CERVICAL PC 16X13X7MM 7D

Facility

$7,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693521
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

Know your out-of-pocket cost for care.

All Charges