Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE LORDOTIC LG 14X17X7MM

Facility

$16,747.50

Service Code	HCPCS C1889
Hospital Charge Code	270698923
Hospital Revenue Code	278
Min. Negotiated Rate	$475.63
Max. Negotiated Rate	$8,373.75
Rate for Payer: Aetna Commercial	$6,364.05
Rate for Payer: Aetna Medicare Advantage	$5,024.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,270.61
Rate for Payer: Cigna Commercial	$8,373.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12
Rate for Payer: UnitedHealthcare Community & State	$529.22
Rate for Payer: Wellpoint Medicaid Managed Care	$475.63

CAGE LORDOTIC LG 14X17X7MM

Facility

$16,747.50

Service Code	HCPCS C1889
Hospital Charge Code	270698923
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$4,052.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

CAGE LORDOTIC TI H11 29MM

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270695888
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CAGE LORDOTIC TI H11 29MM

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270695888
Hospital Revenue Code	278
Min. Negotiated Rate	$560.90
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$7,505.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50
Rate for Payer: UnitedHealthcare Community & State	$624.10
Rate for Payer: Wellpoint Medicaid Managed Care	$560.90

CAGE LUCENT 10MMX27MMX10MM 5D

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693044
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

CAGE LUCENT 10MMX27MMX10MM 5D

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693044
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

CAGE LUCENT 10X22X13MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695589
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 LUCENT 10X22X13MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695589
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 LUCENT 10X22X8 5D

Facility

$8,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693988
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

CAGE LUCENT 10X22X8 5D

Facility

$8,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693988
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

CAGE LUCENT12MMX27MMX10MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692995
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT12MMX27MMX10MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692995
Hospital Revenue Code	278
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

CAGE LUCENT 12MMX27MMX11MM 5D

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693037
Hospital Revenue Code	278
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

CAGE LUCENT 12MMX27MMX11MM 5D

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693037
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGELUCENT12MMX27MMX12MM 5D PC

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693035
Hospital Revenue Code	278
Min. Negotiated Rate	$227.20
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$252.80
Rate for Payer: Wellpoint Medicaid Managed Care	$227.20

CAGELUCENT12MMX27MMX12MM 5D PC

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693035
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

CAGE LUCENT 12X27X12MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693007
Hospital Revenue Code	278
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

CAGE LUCENT 12X27X12MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693007
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT 12X27X9MM 5D PC

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697141
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$3,097.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT 12X27X9MM 5D PC

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697141
Hospital Revenue Code	278
Min. Negotiated Rate	$363.52
Max. Negotiated Rate	$6,400.00
Rate for Payer: Aetna Commercial	$4,864.00
Rate for Payer: Aetna Medicare Advantage	$3,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,264.00
Rate for Payer: Cigna Commercial	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00
Rate for Payer: UnitedHealthcare Community & State	$404.48
Rate for Payer: Wellpoint Medicaid Managed Care	$363.52

CAGE LUCENT 12X37X11MM 5D PC

Facility

$17,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696832
Hospital Revenue Code	278
Min. Negotiated Rate	$499.84
Max. Negotiated Rate	$8,800.00
Rate for Payer: Aetna Commercial	$6,688.00
Rate for Payer: Aetna Medicare Advantage	$5,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,488.00
Rate for Payer: Cigna Commercial	$8,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,259.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,640.00
Rate for Payer: UnitedHealthcare Community & State	$556.16
Rate for Payer: Wellpoint Medicaid Managed Care	$499.84

CAGE LUCENT 12X37X11MM 5D PC

Facility

$17,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696832
Hospital Revenue Code	278
Min. Negotiated Rate	$2,640.00
Max. Negotiated Rate	$4,259.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,259.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,640.00

CAGE LUCENT 12X37X13MM 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697980
Hospital Revenue Code	278
Min. Negotiated Rate	$363.52
Max. Negotiated Rate	$6,400.00
Rate for Payer: Aetna Commercial	$4,864.00
Rate for Payer: Aetna Medicare Advantage	$3,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,264.00
Rate for Payer: Cigna Commercial	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00
Rate for Payer: UnitedHealthcare Community & State	$404.48
Rate for Payer: Wellpoint Medicaid Managed Care	$363.52

CAGE LUCENT 12X37X13MM 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$3,097.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT 22X60X10MM 12D LAT

Facility

$26,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694362
Hospital Revenue Code	278
Min. Negotiated Rate	$752.60
Max. Negotiated Rate	$13,250.00
Rate for Payer: Aetna Commercial	$10,070.00
Rate for Payer: Aetna Medicare Advantage	$7,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,757.50
Rate for Payer: Cigna Commercial	$13,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,413.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,975.00
Rate for Payer: UnitedHealthcare Community & State	$837.40
Rate for Payer: Wellpoint Medicaid Managed Care	$752.60

Know your out-of-pocket cost for care.

All Charges