Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE FLREHWK SHIM 14MMX29MM

Facility

$18,925.00

Service Code	HCPCS C1889
Hospital Charge Code	270693873
Hospital Revenue Code	278
Min. Negotiated Rate	$2,838.75
Max. Negotiated Rate	$4,579.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,579.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,838.75

CAGE FORTILINK 12MM 8MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270690755
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 FORTILINK 12MM 8MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270690755
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 FORTILINK 14.5X17X8MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270690022
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

CAGE FORTILINK 14.5X17X8MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270690022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE FORTILINK 18X13X55MM 6D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697267
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

CAGE FORTILINK 18X13X55MM 6D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697267
Hospital Revenue Code	278
Min. Negotiated Rate	$1,065.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$14,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00
Rate for Payer: UnitedHealthcare Community & State	$1,185.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,065.00

CAGEFORTILINKIBFSYS15X22MM6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694318
Hospital Revenue Code	278
Min. Negotiated Rate	$610.60
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$8,170.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00
Rate for Payer: UnitedHealthcare Community & State	$679.40
Rate for Payer: Wellpoint Medicaid Managed Care	$610.60

CAGEFORTILINKIBFSYS15X22MM6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694318
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CAGE FORTLINK TET 12X14X7MM 6D

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694860
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE FORTLINK TET 12X14X7MM 6D

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694860
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

CAGE GLENOID CEMENTED MED

Facility

$7,405.00

Service Code	HCPCS C1776
Hospital Charge Code	270682811
Hospital Revenue Code	278
Min. Negotiated Rate	$1,110.75
Max. Negotiated Rate	$1,792.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75

CAGE GLENOID CEMENTED MED

Facility

$7,405.00

Service Code	HCPCS C1776
Hospital Charge Code	270682811
Hospital Revenue Code	278
Min. Negotiated Rate	$210.30
Max. Negotiated Rate	$3,702.50
Rate for Payer: Aetna Commercial	$2,813.90
Rate for Payer: Aetna Medicare Advantage	$2,221.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,888.28
Rate for Payer: Cigna Commercial	$3,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75
Rate for Payer: UnitedHealthcare Community & State	$234.00
Rate for Payer: Wellpoint Medicaid Managed Care	$210.30

CAGE GLENOID CEMENTED SM

Facility

$7,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270681775
Hospital Revenue Code	278
Min. Negotiated Rate	$210.30
Max. Negotiated Rate	$3,702.50
Rate for Payer: Aetna Commercial	$2,813.90
Rate for Payer: Aetna Medicare Advantage	$2,221.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,888.28
Rate for Payer: Cigna Commercial	$3,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75
Rate for Payer: UnitedHealthcare Community & State	$234.00
Rate for Payer: Wellpoint Medicaid Managed Care	$210.30

CAGE GLENOID CEMENTED SM

Facility

$7,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270681775
Hospital Revenue Code	278
Min. Negotiated Rate	$1,110.75
Max. Negotiated Rate	$1,792.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75

CAGE HP 6 DEG 12 X 5 MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270689732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE HP 6 DEG 12 X 5 MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270689732
Hospital Revenue Code	278
Min. Negotiated Rate	$467.89
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$6,260.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25
Rate for Payer: UnitedHealthcare Community & State	$520.61
Rate for Payer: Wellpoint Medicaid Managed Care	$467.89

CAGE IBD PLAN 8X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693712
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 IBD PLAN 8X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693712
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 INC LORD14MMX12MMX24MM10D

Facility

$19,250.00

Service Code	HCPCS L8699
Hospital Charge Code	270693003
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CAGE INC LORD14MMX12MMX24MM10D

Facility

$19,250.00

Service Code	HCPCS L8699
Hospital Charge Code	270693003
Hospital Revenue Code	278
Min. Negotiated Rate	$546.70
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$608.30
Rate for Payer: Wellpoint Medicaid Managed Care	$546.70

CAGE INST KIT

Facility

$2,500.00

Hospital Charge Code	270701866
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

CAGE INST KIT

Facility

$2,500.00

Hospital Charge Code	270701866
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CAGE INTBDY ALIF 37X27X16MM18D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698450
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

CAGE INTBDY ALIF 37X27X16MM18D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698450
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$7,600.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00
Rate for Payer: UnitedHealthcare Community & State	$632.00
Rate for Payer: Wellpoint Medicaid Managed Care	$568.00

Know your out-of-pocket cost for care.

All Charges