Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COMP PRIMARY STEM 13MM MINI

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687427
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

COMP PRIMARY STEM 13MM MINI

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270687427
Hospital Revenue Code	278
Min. Negotiated Rate	$411.80
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$458.20
Rate for Payer: Wellpoint Medicaid Managed Care	$411.80

COMP PRIMARY STEM 8MM MINI

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688616
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

COMP PRIMARY STEM 8MM MINI

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688616
Hospital Revenue Code	278
Min. Negotiated Rate	$411.80
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$458.20
Rate for Payer: Wellpoint Medicaid Managed Care	$411.80

COMP PRIMARY STEM 9MM MINI

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679750
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

COMP PRIMARY STEM 9MM MINI

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679750
Hospital Revenue Code	278
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

COMPR 10MM HUM FRACTURE STM PP

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680410
Hospital Revenue Code	278
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

COMPR 10MM HUM FRACTURE STM PP

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680410
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

COMPR14MM HUM FRACT STEM PPS

Facility

$19,000.00

Hospital Charge Code	270678236
Hospital Revenue Code	278
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

COMPR14MM HUM FRACT STEM PPS

Facility

$19,000.00

Hospital Charge Code	270678236
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

COMPR AUG 2.7 DRL W STOP

Facility

$820.00

Hospital Charge Code	270690729
Hospital Revenue Code	272
Min. Negotiated Rate	$23.29
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.20
Rate for Payer: Oxford Commercial	$164.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Commercial	$164.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

COMPR AUG 2.7 DRL W STOP

Facility

$820.00

Hospital Charge Code	270690729
Hospital Revenue Code	272
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

COMPR AUG BSPLT ADP

Facility

$13,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690720
Hospital Revenue Code	278
Min. Negotiated Rate	$372.75
Max. Negotiated Rate	$6,562.50
Rate for Payer: Aetna Commercial	$4,987.50
Rate for Payer: Aetna Medicare Advantage	$3,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,346.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,346.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,346.88
Rate for Payer: Cigna Commercial	$6,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,176.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.75
Rate for Payer: UnitedHealthcare Community & State	$414.75
Rate for Payer: Wellpoint Medicaid Managed Care	$372.75

COMPR AUG BSPLT ADP

Facility

$13,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690720
Hospital Revenue Code	278
Min. Negotiated Rate	$1,968.75
Max. Negotiated Rate	$3,176.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,176.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.75

COMPR AUG REAM BUSHING

Facility

$410.00

Hospital Charge Code	270690731
Hospital Revenue Code	272
Min. Negotiated Rate	$11.64
Max. Negotiated Rate	$205.00
Rate for Payer: Aetna Commercial	$155.80
Rate for Payer: Aetna Medicare Advantage	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.55
Rate for Payer: Cigna Commercial	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.60
Rate for Payer: Oxford Commercial	$82.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Community & State	$12.96
Rate for Payer: Wellpoint Medicaid Managed Care	$11.64

COMPR AUG REAM BUSHING

Facility

$410.00

Hospital Charge Code	270690731
Hospital Revenue Code	272
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

COMPR AUG REAM GD SCREW

Facility

$410.00

Hospital Charge Code	270690730
Hospital Revenue Code	272
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

COMPR AUG REAM GD SCREW

Facility

$410.00

Hospital Charge Code	270690730
Hospital Revenue Code	272
Min. Negotiated Rate	$11.64
Max. Negotiated Rate	$205.00
Rate for Payer: Aetna Commercial	$155.80
Rate for Payer: Aetna Medicare Advantage	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.55
Rate for Payer: Cigna Commercial	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.60
Rate for Payer: Oxford Commercial	$82.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$82.00
Rate for Payer: UnitedHealthcare Community & State	$12.96
Rate for Payer: Wellpoint Medicaid Managed Care	$11.64

COMPREHENSIVE ANTIGEN

Facility

$667.59

Service Code	HCPCS 86160
Hospital Charge Code	39708042C
Hospital Revenue Code	306
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$32.64
Rate for Payer: Aetna Medicare Advantage	$38.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.53
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$12.00
Rate for Payer: Clover Medicare Advantage	$11.40
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$12.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.00
Rate for Payer: Wellcare Medicare Advantage	$12.00
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

COMPREHENSIVE ANTIGEN

Facility

$667.59

Service Code	HCPCS 86160
Hospital Charge Code	39708042C
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

COMPREHENSIVE METABOLIC PANEL

Facility

$789.60

Service Code	HCPCS 80053
Hospital Charge Code	38472001
Hospital Revenue Code	301
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$394.80
Rate for Payer: Aetna Commercial	$28.72
Rate for Payer: Aetna Medicare Advantage	$34.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.31
Rate for Payer: Cigna Commercial	$394.80
Rate for Payer: Cigna Medicare Advantage	$10.56
Rate for Payer: Clover Medicare Advantage	$10.03
Rate for Payer: EmblemHealth Commercial	$31.68
Rate for Payer: Humana Medicare Advantage	$10.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.30
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.44
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.56
Rate for Payer: Wellcare Medicare Advantage	$10.56
Rate for Payer: Wellpoint Medicaid Managed Care	$22.42

COMPREHENSIVE METABOLIC PANEL

Facility

$789.60

Service Code	HCPCS 80053
Hospital Charge Code	38472001
Hospital Revenue Code	301
Min. Negotiated Rate	$118.44
Max. Negotiated Rate	$118.44
Rate for Payer: Qualcare PPO/HMO/WC	$118.44

COMPREHENSIVE METABOLIC PROFIL

Facility

$1,406.54

Service Code	HCPCS 80053
Hospital Charge Code	3001049
Hospital Revenue Code	301
Min. Negotiated Rate	$210.98
Max. Negotiated Rate	$210.98
Rate for Payer: Qualcare PPO/HMO/WC	$210.98

COMPREHENSIVE METABOLIC PROFIL

Facility

$1,406.54

Service Code	HCPCS 80053
Hospital Charge Code	3001049
Hospital Revenue Code	301
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$703.27
Rate for Payer: Aetna Commercial	$28.72
Rate for Payer: Aetna Medicare Advantage	$34.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.31
Rate for Payer: Cigna Commercial	$703.27
Rate for Payer: Cigna Medicare Advantage	$10.56
Rate for Payer: Clover Medicare Advantage	$10.03
Rate for Payer: EmblemHealth Commercial	$31.68
Rate for Payer: Humana Medicare Advantage	$10.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.70
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.98
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.56
Rate for Payer: Wellcare Medicare Advantage	$10.56
Rate for Payer: Wellpoint Medicaid Managed Care	$39.95

COMPRESSION BONE SCREW

Facility

$162.00

Hospital Charge Code	270335082
Hospital Revenue Code	278
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$39.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

Know your out-of-pocket cost for care.

All Charges