Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE INTERBODY 10X22X14MM5D PC

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698193
Hospital Revenue Code	278
Min. Negotiated Rate	$181.76
Max. Negotiated Rate	$3,200.00
Rate for Payer: Aetna Commercial	$2,432.00
Rate for Payer: Aetna Medicare Advantage	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,632.00
Rate for Payer: Cigna Commercial	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00
Rate for Payer: UnitedHealthcare Community & State	$202.24
Rate for Payer: Wellpoint Medicaid Managed Care	$181.76

CAGE INTERBODY 10X22X14MM5D PC

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698193
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$1,548.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

CAGE INTERBODY 10X27X9MM 5

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698164
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$1,548.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

CAGE INTERBODY 10X27X9MM 5

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698164
Hospital Revenue Code	278
Min. Negotiated Rate	$181.76
Max. Negotiated Rate	$3,200.00
Rate for Payer: Aetna Commercial	$2,432.00
Rate for Payer: Aetna Medicare Advantage	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,632.00
Rate for Payer: Cigna Commercial	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00
Rate for Payer: UnitedHealthcare Community & State	$202.24
Rate for Payer: Wellpoint Medicaid Managed Care	$181.76

CAGE INTERBODY 16X13X6MM 0D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270695313
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

CAGE INTERBODY 16X13X6MM 0D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270695313
Hospital Revenue Code	278
Min. Negotiated Rate	$159.04
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$2,128.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00
Rate for Payer: UnitedHealthcare Community & State	$176.96
Rate for Payer: Wellpoint Medicaid Managed Care	$159.04

CAGE INTERBODY 16X14X6MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694364
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

CAGE INTERBODY 16X14X6MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694364
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

CAGE INTERBODY 16X14X8MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693405
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

CAGE INTERBODY 16X14X8MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693405
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

CAGE INTERBODY 7D 16X14X6MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694352
Hospital Revenue Code	278
Min. Negotiated Rate	$688.70
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$9,215.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
Rate for Payer: UnitedHealthcare Community & State	$766.30
Rate for Payer: Wellpoint Medicaid Managed Care	$688.70

CAGE INTERBODY 7D 16X14X6MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694352
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

CAGE INTERBODY 7D 16X14X8MM

Facility

$19,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694353
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 INTERBODY 7D 16X14X8MM

Facility

$19,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694353
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 INTERBODY ALIGN 18X55X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696684
Hospital Revenue Code	278
Min. Negotiated Rate	$1,157.30
Max. Negotiated Rate	$20,375.00
Rate for Payer: Aetna Commercial	$15,485.00
Rate for Payer: Aetna Medicare Advantage	$12,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,391.25
Rate for Payer: Cigna Commercial	$20,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50
Rate for Payer: UnitedHealthcare Community & State	$1,287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,157.30

CAGE INTERBODY ALIGN 18X55X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696684
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$9,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

CAGE INTERBODY ALIGN 18X60X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696683
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$9,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

CAGE INTERBODY ALIGN 18X60X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696683
Hospital Revenue Code	278
Min. Negotiated Rate	$1,157.30
Max. Negotiated Rate	$20,375.00
Rate for Payer: Aetna Commercial	$15,485.00
Rate for Payer: Aetna Medicare Advantage	$12,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,391.25
Rate for Payer: Cigna Commercial	$20,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50
Rate for Payer: UnitedHealthcare Community & State	$1,287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,157.30

CAGE IO EXPAND LORDOT 10X19MM

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270699277
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

CAGE IO EXPAND LORDOT 10X19MM

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270699277
Hospital Revenue Code	278
Min. Negotiated Rate	$532.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50
Rate for Payer: UnitedHealthcare Community & State	$592.50
Rate for Payer: Wellpoint Medicaid Managed Care	$532.50

CAGE IRIX-C 13X16X6MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693471
Hospital Revenue Code	278
Min. Negotiated Rate	$887.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$11,875.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50
Rate for Payer: UnitedHealthcare Community & State	$987.50
Rate for Payer: Wellpoint Medicaid Managed Care	$887.50

CAGE IRIX-C 13X16X6MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693471
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$7,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 16X13 X

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693292
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$7,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 16X13 X

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693292
Hospital Revenue Code	278
Min. Negotiated Rate	$887.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$11,875.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50
Rate for Payer: UnitedHealthcare Community & State	$987.50
Rate for Payer: Wellpoint Medicaid Managed Care	$887.50

CAGE IRIX-C 18X14X7MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696486
Hospital Revenue Code	278
Min. Negotiated Rate	$887.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$11,875.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50
Rate for Payer: UnitedHealthcare Community & State	$987.50
Rate for Payer: Wellpoint Medicaid Managed Care	$887.50

Know your out-of-pocket cost for care.

All Charges