Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE PEEK LORDOTIC 8 MM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690570
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

CAGE PEEK LORDOTIC 8 MM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690570
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CAGE PEEK PTC 14X11X7MM

Facility

$11,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695965
Hospital Revenue Code	278
Min. Negotiated Rate	$337.39
Max. Negotiated Rate	$5,940.00
Rate for Payer: Aetna Commercial	$4,514.40
Rate for Payer: Aetna Medicare Advantage	$3,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,029.40
Rate for Payer: Cigna Commercial	$5,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00
Rate for Payer: UnitedHealthcare Community & State	$375.41
Rate for Payer: Wellpoint Medicaid Managed Care	$337.39

CAGE PEEK PTC 14X11X7MM

Facility

$11,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,782.00
Max. Negotiated Rate	$2,874.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00

CAGE PEEK PTC 6X14X11MM

Facility

$11,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695966
Hospital Revenue Code	278
Min. Negotiated Rate	$1,782.00
Max. Negotiated Rate	$2,874.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00

CAGE PEEK PTC 6X14X11MM

Facility

$11,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270695966
Hospital Revenue Code	278
Min. Negotiated Rate	$337.39
Max. Negotiated Rate	$5,940.00
Rate for Payer: Aetna Commercial	$4,514.40
Rate for Payer: Aetna Medicare Advantage	$3,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,029.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,029.40
Rate for Payer: Cigna Commercial	$5,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,874.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,782.00
Rate for Payer: UnitedHealthcare Community & State	$375.41
Rate for Payer: Wellpoint Medicaid Managed Care	$337.39

CAGE PIVOX 20X12X60 12DEG

Facility

$36,145.00

Service Code	HCPCS C1889
Hospital Charge Code	270692665
Hospital Revenue Code	278
Min. Negotiated Rate	$5,421.75
Max. Negotiated Rate	$8,747.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,747.09
Rate for Payer: Qualcare PPO/HMO/WC	$5,421.75

CAGE PIVOX 20X12X60 12DEG

Facility

$36,145.00

Service Code	HCPCS C1889
Hospital Charge Code	270692665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,026.52
Max. Negotiated Rate	$18,072.50
Rate for Payer: Aetna Commercial	$13,735.10
Rate for Payer: Aetna Medicare Advantage	$10,843.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,216.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,216.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,229.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,216.98
Rate for Payer: Cigna Commercial	$18,072.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,747.09
Rate for Payer: Qualcare PPO/HMO/WC	$5,421.75
Rate for Payer: UnitedHealthcare Community & State	$1,142.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1,026.52

CAGE PIVOX 20X12X60 6 DEG

Facility

$36,145.00

Service Code	HCPCS C1889
Hospital Charge Code	270692664
Hospital Revenue Code	278
Min. Negotiated Rate	$1,026.52
Max. Negotiated Rate	$18,072.50
Rate for Payer: Aetna Commercial	$13,735.10
Rate for Payer: Aetna Medicare Advantage	$10,843.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,216.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,216.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,229.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,216.98
Rate for Payer: Cigna Commercial	$18,072.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,747.09
Rate for Payer: Qualcare PPO/HMO/WC	$5,421.75
Rate for Payer: UnitedHealthcare Community & State	$1,142.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1,026.52

CAGE PIVOX 20X12X60 6 DEG

Facility

$36,145.00

Service Code	HCPCS C1889
Hospital Charge Code	270692664
Hospital Revenue Code	278
Min. Negotiated Rate	$5,421.75
Max. Negotiated Rate	$8,747.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,229.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,747.09
Rate for Payer: Qualcare PPO/HMO/WC	$5,421.75

CAGE PK WIDE ACI TI HA 10D8MM

Facility

$9,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693659
Hospital Revenue Code	278
Min. Negotiated Rate	$255.60
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$284.40
Rate for Payer: Wellpoint Medicaid Managed Care	$255.60

CAGE PK WIDE ACI TI HA 10D8MM

Facility

$9,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

CAGE PLATEAU-C TI 7MM

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270699024
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 PLATEAU-C TI 7MM

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270699024
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 PLATEAU-C TI 8MM

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270699025
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 PLATEAU-C TI 8MM

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270699025
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 PLATEAU-C TI 9MM

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270699029
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 PLATEAU-C TI 9MM

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270699029
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 PLATE DAKOTA 14X12X6MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696090
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 PLATE DAKOTA 14X12X6MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696090
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 PLIF 22X9X8MM 7D T3

Facility

$30,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693707
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

CAGE PLIF 22X9X8MM 7D T3

Facility

$30,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693707
Hospital Revenue Code	278
Min. Negotiated Rate	$852.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$11,400.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Community & State	$948.00
Rate for Payer: Wellpoint Medicaid Managed Care	$852.00

CAGE PLIF 30X10MM

Facility

$31,320.00

Service Code	HCPCS C1889
Hospital Charge Code	270699242
Hospital Revenue Code	278
Min. Negotiated Rate	$4,698.00
Max. Negotiated Rate	$7,579.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,579.44
Rate for Payer: Qualcare PPO/HMO/WC	$4,698.00

CAGE PLIF 30X10MM

Facility

$31,320.00

Service Code	HCPCS C1889
Hospital Charge Code	270699242
Hospital Revenue Code	278
Min. Negotiated Rate	$889.49
Max. Negotiated Rate	$15,660.00
Rate for Payer: Aetna Commercial	$11,901.60
Rate for Payer: Aetna Medicare Advantage	$9,396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,986.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,986.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,986.60
Rate for Payer: Cigna Commercial	$15,660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,579.44
Rate for Payer: Qualcare PPO/HMO/WC	$4,698.00
Rate for Payer: UnitedHealthcare Community & State	$989.71
Rate for Payer: Wellpoint Medicaid Managed Care	$889.49

CAGE PLIF PEEK 8X25X9MM

Facility

$14,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697635
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

Know your out-of-pocket cost for care.

All Charges