Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

.035 KWIRE

Facility

$75.00

Hospital Charge Code	270684633
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

.035 KWIRE

Facility

$75.00

Hospital Charge Code	270684633
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

03.5 X 26MM POLYAXIAL SCREW

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697209
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

03.5 X 26MM POLYAXIAL SCREW

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697209
Hospital Revenue Code	278
Min. Negotiated Rate	$68.16
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$68.16

.045 GUIDEWIRE

Facility

$50.00

Hospital Charge Code	270656146
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

.045 GUIDEWIRE

Facility

$50.00

Hospital Charge Code	270656146
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

.045 K-WIRE

Facility

$2,250.00

Hospital Charge Code	270656148
Hospital Revenue Code	272
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

.045 K-WIRE

Facility

$2,250.00

Hospital Charge Code	270656148
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

0.8X100 K-WIRE

Facility

$121.75

Hospital Charge Code	270668753
Hospital Revenue Code	272
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$60.88
Rate for Payer: Aetna Commercial	$46.27
Rate for Payer: Aetna Medicare Advantage	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.05
Rate for Payer: Cigna Commercial	$60.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.66
Rate for Payer: Oxford Commercial	$24.35
Rate for Payer: Qualcare PPO/HMO/WC	$18.26
Rate for Payer: UnitedHealthcare Commercial	$24.35
Rate for Payer: UnitedHealthcare Community & State	$3.85
Rate for Payer: Wellpoint Medicaid Managed Care	$3.46

0.8X100 K-WIRE

Facility

$121.75

Hospital Charge Code	270668753
Hospital Revenue Code	272
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$18.26
Rate for Payer: Qualcare PPO/HMO/WC	$18.26

0.9MM ANTI SKIVE PIN PROSTEP

Facility

$427.45

Service Code	HCPCS C1713
Hospital Charge Code	270702758
Hospital Revenue Code	278
Min. Negotiated Rate	$64.12
Max. Negotiated Rate	$103.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.44
Rate for Payer: Qualcare PPO/HMO/WC	$64.12

0.9MM ANTI SKIVE PIN PROSTEP

Facility

$427.45

Service Code	HCPCS C1713
Hospital Charge Code	270702758
Hospital Revenue Code	278
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$213.72
Rate for Payer: Aetna Commercial	$162.43
Rate for Payer: Aetna Medicare Advantage	$128.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.00
Rate for Payer: Cigna Commercial	$213.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.44
Rate for Payer: Qualcare PPO/HMO/WC	$64.12
Rate for Payer: UnitedHealthcare Community & State	$13.51
Rate for Payer: Wellpoint Medicaid Managed Care	$12.14

.09% NACL 1000cc BOTTLE

Facility

$5.10

Hospital Charge Code	270650059
Hospital Revenue Code	258
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

.09% NACL 1000cc BOTTLE

Facility

$5.10

Hospital Charge Code	270650059
Hospital Revenue Code	258
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.55
Rate for Payer: Aetna Commercial	$1.94
Rate for Payer: Aetna Medicare Advantage	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.30
Rate for Payer: Cigna Commercial	$2.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.33
Rate for Payer: Oxford Commercial	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$1.02
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

0 DEG ECCENTRIC INSERT 36MM.

Facility

$4,529.05

Service Code	HCPCS C1713
Hospital Charge Code	270705130
Hospital Revenue Code	278
Min. Negotiated Rate	$128.63
Max. Negotiated Rate	$2,264.53
Rate for Payer: Aetna Commercial	$1,721.04
Rate for Payer: Aetna Medicare Advantage	$1,358.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,154.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,154.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,154.91
Rate for Payer: Cigna Commercial	$2,264.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.03
Rate for Payer: Qualcare PPO/HMO/WC	$679.36
Rate for Payer: UnitedHealthcare Community & State	$143.12
Rate for Payer: Wellpoint Medicaid Managed Care	$128.63

0 DEG ECCENTRIC INSERT 36MM.

Facility

$4,529.05

Service Code	HCPCS C1713
Hospital Charge Code	270705130
Hospital Revenue Code	278
Min. Negotiated Rate	$679.36
Max. Negotiated Rate	$1,096.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.03
Rate for Payer: Qualcare PPO/HMO/WC	$679.36

0DM LINER 28MM

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270677461
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

0DM LINER 28MM

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270677461
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

10.2MM CANN DRILL BIT LENGTH 2

Facility

$3,300.00

Hospital Charge Code	270686947
Hospital Revenue Code	272
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

10.2MM CANN DRILL BIT LENGTH 2

Facility

$3,300.00

Hospital Charge Code	270686947
Hospital Revenue Code	272
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.00
Rate for Payer: Oxford Commercial	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Commercial	$660.00
Rate for Payer: UnitedHealthcare Community & State	$104.28
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

10.5MM X 80MM LAG SCREW

Facility

$4,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270704115
Hospital Revenue Code	278
Min. Negotiated Rate	$647.62
Max. Negotiated Rate	$1,044.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$863.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.84
Rate for Payer: Qualcare PPO/HMO/WC	$647.62

10.5MM X 80MM LAG SCREW

Facility

$4,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270704115
Hospital Revenue Code	278
Min. Negotiated Rate	$122.62
Max. Negotiated Rate	$2,158.75
Rate for Payer: Aetna Commercial	$1,640.65
Rate for Payer: Aetna Medicare Advantage	$1,295.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,100.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,100.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$863.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,100.96
Rate for Payer: Cigna Commercial	$2,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.84
Rate for Payer: Qualcare PPO/HMO/WC	$647.62
Rate for Payer: UnitedHealthcare Community & State	$136.43
Rate for Payer: Wellpoint Medicaid Managed Care	$122.62

10CC PROTEIOS GROWTH FACTOR

Facility

$14,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270703846
Hospital Revenue Code	278
Min. Negotiated Rate	$418.19
Max. Negotiated Rate	$7,362.50
Rate for Payer: Aetna Commercial	$5,595.50
Rate for Payer: Aetna Medicare Advantage	$4,417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,754.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,754.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,754.88
Rate for Payer: Cigna Commercial	$7,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,208.75
Rate for Payer: UnitedHealthcare Community & State	$465.31
Rate for Payer: Wellpoint Medicaid Managed Care	$418.19

10CC PROTEIOS GROWTH FACTOR

Facility

$14,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270703846
Hospital Revenue Code	278
Min. Negotiated Rate	$2,208.75
Max. Negotiated Rate	$3,563.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,208.75

10 CM X15 CM OVA

Facility

$3,665.00

Service Code	HCPCS C1781
Hospital Charge Code	270684332
Hospital Revenue Code	278
Min. Negotiated Rate	$549.75
Max. Negotiated Rate	$886.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: Qualcare PPO/HMO/WC	$549.75

Know your out-of-pocket cost for care.

All Charges