Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CEMENT BONE ACTIVOS

Facility

$1,342.00

Service Code	HCPCS C1713
Hospital Charge Code	270657326S
Hospital Revenue Code	278
Min. Negotiated Rate	$201.30
Max. Negotiated Rate	$324.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.76
Rate for Payer: Qualcare PPO/HMO/WC	$201.30

CEMENT BONE ACTIVOS

Facility

$1,342.00

Service Code	HCPCS C1713
Hospital Charge Code	270657326O
Hospital Revenue Code	278
Min. Negotiated Rate	$38.11
Max. Negotiated Rate	$671.00
Rate for Payer: Aetna Commercial	$509.96
Rate for Payer: Aetna Medicare Advantage	$402.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.21
Rate for Payer: Cigna Commercial	$671.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.76
Rate for Payer: Qualcare PPO/HMO/WC	$201.30
Rate for Payer: UnitedHealthcare Community & State	$42.41
Rate for Payer: Wellpoint Medicaid Managed Care	$38.11

CEMENT BONE ACTIVOS

Facility

$1,342.00

Service Code	HCPCS C1713
Hospital Charge Code	270657326O
Hospital Revenue Code	278
Min. Negotiated Rate	$201.30
Max. Negotiated Rate	$324.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.76
Rate for Payer: Qualcare PPO/HMO/WC	$201.30

CEMENT BONE ACTIVOS

Facility

$1,342.00

Service Code	HCPCS C1713
Hospital Charge Code	270657326
Hospital Revenue Code	278
Min. Negotiated Rate	$38.11
Max. Negotiated Rate	$671.00
Rate for Payer: Aetna Commercial	$509.96
Rate for Payer: Aetna Medicare Advantage	$402.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.21
Rate for Payer: Cigna Commercial	$671.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.76
Rate for Payer: Qualcare PPO/HMO/WC	$201.30
Rate for Payer: UnitedHealthcare Community & State	$42.41
Rate for Payer: Wellpoint Medicaid Managed Care	$38.11

CEMENT BONE ACTIVOS

Facility

$1,342.00

Service Code	HCPCS C1713
Hospital Charge Code	270657326S
Hospital Revenue Code	278
Min. Negotiated Rate	$38.11
Max. Negotiated Rate	$671.00
Rate for Payer: Aetna Commercial	$509.96
Rate for Payer: Aetna Medicare Advantage	$402.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.21
Rate for Payer: Cigna Commercial	$671.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.76
Rate for Payer: Qualcare PPO/HMO/WC	$201.30
Rate for Payer: UnitedHealthcare Community & State	$42.41
Rate for Payer: Wellpoint Medicaid Managed Care	$38.11

CEMENT BONE COBALT G-HV

Facility

$3,810.00

Service Code	HCPCS C1713
Hospital Charge Code	270692264
Hospital Revenue Code	278
Min. Negotiated Rate	$108.20
Max. Negotiated Rate	$1,905.00
Rate for Payer: Aetna Commercial	$1,447.80
Rate for Payer: Aetna Medicare Advantage	$1,143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$971.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$971.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$762.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$971.55
Rate for Payer: Cigna Commercial	$1,905.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$922.02
Rate for Payer: Qualcare PPO/HMO/WC	$571.50
Rate for Payer: UnitedHealthcare Community & State	$120.40
Rate for Payer: Wellpoint Medicaid Managed Care	$108.20

CEMENT BONE COBALT G-HV

Facility

$3,810.00

Service Code	HCPCS C1713
Hospital Charge Code	270692264
Hospital Revenue Code	278
Min. Negotiated Rate	$571.50
Max. Negotiated Rate	$922.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$762.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$922.02
Rate for Payer: Qualcare PPO/HMO/WC	$571.50

CEMENT BONE COBALT HV

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270642312
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$24.96
Rate for Payer: Wellpoint Medicaid Managed Care	$22.44

CEMENT BONE COBALT HV

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270642312
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

CEMENT BONE COBALT HV W/GENT

Facility

$1,830.00

Service Code	HCPCS C1713
Hospital Charge Code	270645007
Hospital Revenue Code	278
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$915.00
Rate for Payer: Aetna Commercial	$695.40
Rate for Payer: Aetna Medicare Advantage	$549.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$466.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$466.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$466.65
Rate for Payer: Cigna Commercial	$915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.86
Rate for Payer: Qualcare PPO/HMO/WC	$274.50
Rate for Payer: UnitedHealthcare Community & State	$57.83
Rate for Payer: Wellpoint Medicaid Managed Care	$51.97

CEMENT BONE COBALT HV W/GENT

Facility

$1,830.00

Service Code	HCPCS C1713
Hospital Charge Code	270645007
Hospital Revenue Code	278
Min. Negotiated Rate	$274.50
Max. Negotiated Rate	$442.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$366.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.86
Rate for Payer: Qualcare PPO/HMO/WC	$274.50

CEMENT BONE CONFLOW

Facility

$414.45

Service Code	HCPCS C1713
Hospital Charge Code	270695534
Hospital Revenue Code	278
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$100.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.30
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

CEMENT BONE CONFLOW

Facility

$414.45

Service Code	HCPCS C1713
Hospital Charge Code	270695534
Hospital Revenue Code	278
Min. Negotiated Rate	$11.77
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.30
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Community & State	$13.10
Rate for Payer: Wellpoint Medicaid Managed Care	$11.77

CEMENT BONE DOUGH REGULAR

Facility

$653.00

Hospital Charge Code	270335159
Hospital Revenue Code	278
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$326.50
Rate for Payer: Aetna Commercial	$248.14
Rate for Payer: Aetna Medicare Advantage	$195.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.51
Rate for Payer: Cigna Commercial	$326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.03
Rate for Payer: Qualcare PPO/HMO/WC	$97.95
Rate for Payer: UnitedHealthcare Community & State	$20.63
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

CEMENT BONE DOUGH REGULAR

Facility

$653.00

Hospital Charge Code	270335159
Hospital Revenue Code	278
Min. Negotiated Rate	$97.95
Max. Negotiated Rate	$158.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.03
Rate for Payer: Qualcare PPO/HMO/WC	$97.95

CEMENT BONE HYDROSET XT 10CC

Facility

$25,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696729
Hospital Revenue Code	278
Min. Negotiated Rate	$3,825.00
Max. Negotiated Rate	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,171.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,825.00

CEMENT BONE HYDROSET XT 10CC

Facility

$25,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696729
Hospital Revenue Code	278
Min. Negotiated Rate	$724.20
Max. Negotiated Rate	$12,750.00
Rate for Payer: Aetna Commercial	$9,690.00
Rate for Payer: Aetna Medicare Advantage	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,502.50
Rate for Payer: Cigna Commercial	$12,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,171.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,825.00
Rate for Payer: UnitedHealthcare Community & State	$805.80
Rate for Payer: Wellpoint Medicaid Managed Care	$724.20

CEMENT BONE MIXER PACK

Facility

$1,236.15

Hospital Charge Code	270669783
Hospital Revenue Code	272
Min. Negotiated Rate	$185.42
Max. Negotiated Rate	$185.42
Rate for Payer: Qualcare PPO/HMO/WC	$185.42

CEMENT BONE MIXER PACK

Facility

$1,474.00

Hospital Charge Code	270669783O
Hospital Revenue Code	272
Min. Negotiated Rate	$221.10
Max. Negotiated Rate	$221.10
Rate for Payer: Qualcare PPO/HMO/WC	$221.10

CEMENT BONE MIXER PACK

Facility

$1,236.15

Hospital Charge Code	270669783
Hospital Revenue Code	272
Min. Negotiated Rate	$35.11
Max. Negotiated Rate	$618.08
Rate for Payer: Aetna Commercial	$469.74
Rate for Payer: Aetna Medicare Advantage	$370.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.22
Rate for Payer: Cigna Commercial	$618.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.40
Rate for Payer: Oxford Commercial	$247.23
Rate for Payer: Qualcare PPO/HMO/WC	$185.42
Rate for Payer: UnitedHealthcare Commercial	$247.23
Rate for Payer: UnitedHealthcare Community & State	$39.06
Rate for Payer: Wellpoint Medicaid Managed Care	$35.11

CEMENT BONE MIXER PACK

Facility

$1,474.00

Hospital Charge Code	270669783O
Hospital Revenue Code	272
Min. Negotiated Rate	$41.86
Max. Negotiated Rate	$737.00
Rate for Payer: Aetna Commercial	$560.12
Rate for Payer: Aetna Medicare Advantage	$442.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.87
Rate for Payer: Cigna Commercial	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.24
Rate for Payer: Oxford Commercial	$294.80
Rate for Payer: Qualcare PPO/HMO/WC	$221.10
Rate for Payer: UnitedHealthcare Commercial	$294.80
Rate for Payer: UnitedHealthcare Community & State	$46.58
Rate for Payer: Wellpoint Medicaid Managed Care	$41.86

CEMENT BONE MIXING BOWL

Facility

$274.05

Service Code	HCPCS C1713
Hospital Charge Code	270658120
Hospital Revenue Code	278
Min. Negotiated Rate	$41.11
Max. Negotiated Rate	$66.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.32
Rate for Payer: Qualcare PPO/HMO/WC	$41.11

CEMENT BONE MIXING BOWL

Facility

$274.05

Service Code	HCPCS C1713
Hospital Charge Code	270658120
Hospital Revenue Code	278
Min. Negotiated Rate	$7.78
Max. Negotiated Rate	$137.03
Rate for Payer: Aetna Commercial	$104.14
Rate for Payer: Aetna Medicare Advantage	$82.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.88
Rate for Payer: Cigna Commercial	$137.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.32
Rate for Payer: Qualcare PPO/HMO/WC	$41.11
Rate for Payer: UnitedHealthcare Community & State	$8.66
Rate for Payer: Wellpoint Medicaid Managed Care	$7.78

CEMENT BONE PLACOS G 424810

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270635590
Hospital Revenue Code	278
Min. Negotiated Rate	$56.09
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$750.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25
Rate for Payer: UnitedHealthcare Community & State	$62.41
Rate for Payer: Wellpoint Medicaid Managed Care	$56.09

CEMENT BONE PLACOS G 424810

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270635590
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

Know your out-of-pocket cost for care.

All Charges