Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

CAGE IRIX-C CERV 13X16X6MM 7D

Facility

$31,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695413
Hospital Revenue Code	278
Min. Negotiated Rate	$4,710.00
Max. Negotiated Rate	$7,598.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,598.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,710.00

CAGE IRIX-C CERV 13X16X6MM 7D

Facility

$31,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695413
Hospital Revenue Code	278
Min. Negotiated Rate	$891.76
Max. Negotiated Rate	$15,700.00
Rate for Payer: Aetna Commercial	$11,932.00
Rate for Payer: Aetna Medicare Advantage	$9,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,007.00
Rate for Payer: Cigna Commercial	$15,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,598.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,710.00
Rate for Payer: UnitedHealthcare Community & State	$992.24
Rate for Payer: Wellpoint Medicaid Managed Care	$891.76

CAGE JULIET TI PO 24X8X8MM 6D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270699471
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 JULIET TI PO 24X8X8MM 6D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270699471
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 LATERAL 18WX50LX12H 8D

Facility

$29,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693622
Hospital Revenue Code	278
Min. Negotiated Rate	$844.90
Max. Negotiated Rate	$14,875.00
Rate for Payer: Aetna Commercial	$11,305.00
Rate for Payer: Aetna Medicare Advantage	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,586.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,586.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,586.25
Rate for Payer: Cigna Commercial	$14,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,199.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,462.50
Rate for Payer: UnitedHealthcare Community & State	$940.10
Rate for Payer: Wellpoint Medicaid Managed Care	$844.90

CAGE LATERAL 18WX50LX12H 8D

Facility

$29,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693622
Hospital Revenue Code	278
Min. Negotiated Rate	$4,462.50
Max. Negotiated Rate	$7,199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,199.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,462.50

CAGE LATERAL 22X55X12MM 18D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270695823
Hospital Revenue Code	278
Min. Negotiated Rate	$602.08
Max. Negotiated Rate	$10,600.00
Rate for Payer: Aetna Commercial	$8,056.00
Rate for Payer: Aetna Medicare Advantage	$6,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,406.00
Rate for Payer: Cigna Commercial	$10,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00
Rate for Payer: UnitedHealthcare Community & State	$669.92
Rate for Payer: Wellpoint Medicaid Managed Care	$602.08

CAGE LATERAL 22X55X12MM 18D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270695823
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$5,130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00

CAGE LAT PC 18X55X8MM 12D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270698013
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$5,130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00

CAGE LAT PC 18X55X8MM 12D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270698013
Hospital Revenue Code	278
Min. Negotiated Rate	$602.08
Max. Negotiated Rate	$10,600.00
Rate for Payer: Aetna Commercial	$8,056.00
Rate for Payer: Aetna Medicare Advantage	$6,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,406.00
Rate for Payer: Cigna Commercial	$10,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00
Rate for Payer: UnitedHealthcare Community & State	$669.92
Rate for Payer: Wellpoint Medicaid Managed Care	$602.08

CAGE LLIF 3DR 10X50144MM

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698896
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

CAGE LLIF 3DR 10X50144MM

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698896
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

CAGELORDOTCOROENT7X11X14MM5D

Facility

$5,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694723
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

CAGELORDOTCOROENT7X11X14MM5D

Facility

$5,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694723
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CAGE LORDOTIC 18MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681519
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 LORDOTIC 18MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681519
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 LORDOTIC 9MMX11MMX27MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688239
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 LORDOTIC 9MMX11MMX27MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688239
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 LORDOTIC AIS 17X14X6MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697995
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 LORDOTIC AIS 17X14X6MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697995
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 LORDOTIC CERV D14217H06

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698814
Hospital Revenue Code	278
Min. Negotiated Rate	$599.17
Max. Negotiated Rate	$10,548.75
Rate for Payer: Aetna Commercial	$8,017.05
Rate for Payer: Aetna Medicare Advantage	$6,329.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,379.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,379.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,379.86
Rate for Payer: Cigna Commercial	$10,548.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62
Rate for Payer: UnitedHealthcare Community & State	$666.68
Rate for Payer: Wellpoint Medicaid Managed Care	$599.17

CAGE LORDOTIC CERV D14217H06

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698814
Hospital Revenue Code	278
Min. Negotiated Rate	$3,164.62
Max. Negotiated Rate	$5,105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62

CAGE LORDOTIC COALESCE 10X28X1

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270691455
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

CAGE LORDOTIC COALESCE 10X28X1

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270691455
Hospital Revenue Code	278
Min. Negotiated Rate	$687.28
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$764.72
Rate for Payer: Wellpoint Medicaid Managed Care	$687.28

Know your out-of-pocket cost for care.

All Charges