Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CAGE TILIF-O 8X10X30MM 4D

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698042
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

CAGE TI STALIF-C 6.5X12MM 6D

Facility

$22,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693735
Hospital Revenue Code	278
Min. Negotiated Rate	$624.80
Max. Negotiated Rate	$11,000.00
Rate for Payer: Aetna Commercial	$8,360.00
Rate for Payer: Aetna Medicare Advantage	$6,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,610.00
Rate for Payer: Cigna Commercial	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00
Rate for Payer: UnitedHealthcare Community & State	$695.20
Rate for Payer: Wellpoint Medicaid Managed Care	$624.80

CAGE TI STALIF-C 6.5X12MM 6D

Facility

$22,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693735
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$5,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

CAGE TLX20 11X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699307
Hospital Revenue Code	278
Min. Negotiated Rate	$5,850.00
Max. Negotiated Rate	$9,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00

CAGE TLX20 11X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,107.60
Max. Negotiated Rate	$19,500.00
Rate for Payer: Aetna Commercial	$14,820.00
Rate for Payer: Aetna Medicare Advantage	$11,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,945.00
Rate for Payer: Cigna Commercial	$19,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00
Rate for Payer: UnitedHealthcare Community & State	$1,232.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,107.60

CAGE TLX20 11X11X31 MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691826
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

CAGE TLX20 11X11X31 MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691826
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

CAGE TLX20 12X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699308
Hospital Revenue Code	278
Min. Negotiated Rate	$1,107.60
Max. Negotiated Rate	$19,500.00
Rate for Payer: Aetna Commercial	$14,820.00
Rate for Payer: Aetna Medicare Advantage	$11,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,945.00
Rate for Payer: Cigna Commercial	$19,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00
Rate for Payer: UnitedHealthcare Community & State	$1,232.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,107.60

CAGE TLX20 12X11X26MM 20D

Facility

$39,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270699308
Hospital Revenue Code	278
Min. Negotiated Rate	$5,850.00
Max. Negotiated Rate	$9,438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,438.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,850.00

CAGE TLX20 9X11X26MM 20 DEG

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691369
Hospital Revenue Code	278
Min. Negotiated Rate	$880.40
Max. Negotiated Rate	$15,500.00
Rate for Payer: Aetna Commercial	$11,780.00
Rate for Payer: Aetna Medicare Advantage	$9,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,905.00
Rate for Payer: Cigna Commercial	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00
Rate for Payer: UnitedHealthcare Community & State	$979.60
Rate for Payer: Wellpoint Medicaid Managed Care	$880.40

CAGE TLX20 9X11X26MM 20 DEG

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691369
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$7,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

CAGE TRANQUIL-C IBD 7X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693713
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 TRANQUIL-C IBD 7X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693713
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 TRANQUIL-C IBD 8X16X3MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696676
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 TRANQUIL-C IBD 8X16X3MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696676
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 VARILIFT LX IBFD 28X10MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693006
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

CAGE VARILIFT LX IBFD 28X10MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693006
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

CAGE VBR INCORP 14X12X20MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696994
Hospital Revenue Code	278
Min. Negotiated Rate	$437.36
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$5,852.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$486.64
Rate for Payer: Wellpoint Medicaid Managed Care	$437.36

CAGE VBR INCORP 14X12X20MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696994
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696845
Hospital Revenue Code	278
Min. Negotiated Rate	$437.36
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$5,852.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$486.64
Rate for Payer: Wellpoint Medicaid Managed Care	$437.36

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696945
Hospital Revenue Code	278
Min. Negotiated Rate	$437.36
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$5,852.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00
Rate for Payer: UnitedHealthcare Community & State	$486.64
Rate for Payer: Wellpoint Medicaid Managed Care	$437.36

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696945
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VEO LATERAL 6D 17X11X55MM

Facility

$36,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695256
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.50
Max. Negotiated Rate	$18,125.00
Rate for Payer: Aetna Commercial	$13,775.00
Rate for Payer: Aetna Medicare Advantage	$10,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,243.75
Rate for Payer: Cigna Commercial	$18,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50
Rate for Payer: UnitedHealthcare Community & State	$1,145.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1,029.50

CAGE VEO LATERAL 6D 17X11X55MM

Facility

$36,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695256
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$8,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

Know your out-of-pocket cost for care.

All Charges