Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE MODULUS XL 12X18X55MM 10D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695493
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 MODULUS XL 12X18X55MM 10D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270695493
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

CAGE MODULUS XL 8X18X50MM 10D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697553
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

CAGE MODULUS XL 8X18X50MM 10D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697553
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 MODULUS XL 8X18X55MM 10D

Facility

$37,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697063
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

CAGE MODULUS XL 8X18X55MM 10D

Facility

$37,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697063
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 MONET ACIF X WIDE 8MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270700104
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 MONET ACIF X WIDE 8MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270700104
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 MONET WIDE EXTRA 7MM$$N/C

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270696626
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE MONET WIDE EXTRA 7MM$$N/C

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270696626
Hospital Revenue Code	278
Min. Negotiated Rate	$268.38
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$3,591.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50
Rate for Payer: UnitedHealthcare Community & State	$298.62
Rate for Payer: Wellpoint Medicaid Managed Care	$268.38

CAGE MONET XWIDE 8MM

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270697688
Hospital Revenue Code	278
Min. Negotiated Rate	$268.38
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$3,591.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50
Rate for Payer: UnitedHealthcare Community & State	$298.62
Rate for Payer: Wellpoint Medicaid Managed Care	$268.38

CAGE MONET XWIDE 8MM

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270697688
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE MONTECEY 14X28X36 MM

Facility

$44,975.00

Service Code	HCPCS C1716
Hospital Charge Code	270701765
Hospital Revenue Code	278
Min. Negotiated Rate	$567.34
Max. Negotiated Rate	$10,883.95
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.34
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25
Rate for Payer: UnitedHealthcare Community & State	$1,421.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,277.29

CAGE MONTECEY 14X28X36 MM

Facility

$44,975.00

Service Code	HCPCS C1716
Hospital Charge Code	270701765
Hospital Revenue Code	278
Min. Negotiated Rate	$6,746.25
Max. Negotiated Rate	$10,883.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE PARALLEL 9X11X27 MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688237
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 PARALLEL 9X11X27 MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688237
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 PC 10X22X10MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270697668
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 PC 10X22X10MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270697668
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 PC T1 BOND 14X11X6MM 7D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696324
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 PC T1 BOND 14X11X6MM 7D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696324
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 PEEK 12MM X 10MM

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691714
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

CAGE PEEK 12MM X 10MM

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691714
Hospital Revenue Code	278
Min. Negotiated Rate	$837.80
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$11,210.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00
Rate for Payer: UnitedHealthcare Community & State	$932.20
Rate for Payer: Wellpoint Medicaid Managed Care	$837.80

CAGE PEEK 20 X 16MM

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688411
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 PEEK 20 X 16MM

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688411
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 PEEK 2C TPLIF 10X29MM

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270695961
Hospital Revenue Code	278
Min. Negotiated Rate	$1,022.40
Max. Negotiated Rate	$18,000.00
Rate for Payer: Aetna Commercial	$13,680.00
Rate for Payer: Aetna Medicare Advantage	$10,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,180.00
Rate for Payer: Cigna Commercial	$18,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00
Rate for Payer: UnitedHealthcare Community & State	$1,137.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1,022.40

Know your out-of-pocket cost for care.

All Charges