Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

16MM SD FIXED SCREWS

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270703880
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

16MM SELF DRILLING SCREW

Facility

$425.00

Service Code	HCPCS C1713
Hospital Charge Code	270703789
Hospital Revenue Code	278
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

16MM SELF DRILLING SCREW

Facility

$425.00

Service Code	HCPCS C1713
Hospital Charge Code	270703789
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

1.6MM THREADED GUIDE WIRE 150M

Facility

$148.00

Service Code	HCPCS C1769
Hospital Charge Code	270604929
Hospital Revenue Code	278
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$35.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.82
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

1.6MM THREADED GUIDE WIRE 150M

Facility

$148.00

Service Code	HCPCS C1769
Hospital Charge Code	270604929
Hospital Revenue Code	278
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$74.00
Rate for Payer: Aetna Commercial	$56.24
Rate for Payer: Aetna Medicare Advantage	$44.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.74
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.82
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Community & State	$4.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

16MM UNIPLATE

Facility

$5,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270669799
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

16MM UNIPLATE

Facility

$5,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270669799
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75
Rate for Payer: UnitedHealthcare Community & State	$177.75
Rate for Payer: Wellpoint Medicaid Managed Care	$159.75

16MM VARIABLE SELF DRILLSCREW

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705107
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

16MM VARIABLE SELF DRILLSCREW

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705107
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

1.6MMX6IN PRTIL THRED TIP GIDE

Facility

$479.70

Hospital Charge Code	270663177
Hospital Revenue Code	270
Min. Negotiated Rate	$71.95
Max. Negotiated Rate	$71.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.95

1.6MMX6IN PRTIL THRED TIP GIDE

Facility

$479.70

Hospital Charge Code	270663177
Hospital Revenue Code	270
Min. Negotiated Rate	$13.62
Max. Negotiated Rate	$239.85
Rate for Payer: Aetna Commercial	$182.29
Rate for Payer: Aetna Medicare Advantage	$143.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.32
Rate for Payer: Cigna Commercial	$239.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.72
Rate for Payer: Oxford Commercial	$95.94
Rate for Payer: Qualcare PPO/HMO/WC	$71.95
Rate for Payer: UnitedHealthcare Commercial	$95.94
Rate for Payer: UnitedHealthcare Community & State	$15.16
Rate for Payer: Wellpoint Medicaid Managed Care	$13.62

16X65MM HEADLESS SCREW

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704037
Hospital Revenue Code	278
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$834.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.90
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

16X65MM HEADLESS SCREW

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704037
Hospital Revenue Code	278
Min. Negotiated Rate	$97.98
Max. Negotiated Rate	$1,725.00
Rate for Payer: Aetna Commercial	$1,311.00
Rate for Payer: Aetna Medicare Advantage	$1,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.75
Rate for Payer: Cigna Commercial	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.90
Rate for Payer: Qualcare PPO/HMO/WC	$517.50
Rate for Payer: UnitedHealthcare Community & State	$109.02
Rate for Payer: Wellpoint Medicaid Managed Care	$97.98

17 HYDROXYCORTICOSTEROIDS

Facility

$404.00

Service Code	HCPCS 83491
Hospital Charge Code	38472380
Hospital Revenue Code	301
Min. Negotiated Rate	$60.60
Max. Negotiated Rate	$60.60
Rate for Payer: Qualcare PPO/HMO/WC	$60.60

17 HYDROXYCORTICOSTEROIDS

Facility

$404.00

Service Code	HCPCS 83491
Hospital Charge Code	38472380
Hospital Revenue Code	301
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$202.00
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: Aetna Medicare Advantage	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.93
Rate for Payer: Cigna Commercial	$202.00
Rate for Payer: Cigna Medicare Advantage	$17.90
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.04
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Medicare Advantage	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$11.47

17-HYDROXYPREGNENOLONE

Facility

$308.00

Service Code	HCPCS 84143
Hospital Charge Code	38472900
Hospital Revenue Code	301
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$62.04
Rate for Payer: Aetna Medicare Advantage	$73.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.74
Rate for Payer: Cigna Commercial	$154.00
Rate for Payer: Cigna Medicare Advantage	$22.81
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Medicare Advantage	$22.81
Rate for Payer: Wellpoint Medicaid Managed Care	$8.75

17-HYDROXYPREGNENOLONE

Facility

$308.00

Service Code	HCPCS 84143
Hospital Charge Code	38472900
Hospital Revenue Code	301
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

17-HYDROXYPROGESTERONE

Facility

$729.00

Service Code	HCPCS 83498
Hospital Charge Code	38472901
Hospital Revenue Code	301
Min. Negotiated Rate	$109.35
Max. Negotiated Rate	$109.35
Rate for Payer: Qualcare PPO/HMO/WC	$109.35

17-HYDROXYPROGESTERONE

Facility

$729.00

Service Code	HCPCS 83498
Hospital Charge Code	38472901
Hospital Revenue Code	301
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$364.50
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$88.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.56
Rate for Payer: Cigna Commercial	$364.50
Rate for Payer: Cigna Medicare Advantage	$27.17
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Medicare Advantage	$27.17
Rate for Payer: Wellpoint Medicaid Managed Care	$20.70

17-HYDROXYPROGESTERONE

Facility

$390.00

Service Code	HCPCS 83498
Hospital Charge Code	39900095
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

17-HYDROXYPROGESTERONE

Facility

$390.00

Service Code	HCPCS 83498
Hospital Charge Code	39900095
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$88.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.56
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$27.17
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$21.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Medicare Advantage	$27.17
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

17 KETOSTEROIDS,URINE

Facility

$390.00

Service Code	HCPCS 83586
Hospital Charge Code	38472383
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

17 KETOSTEROIDS,URINE

Facility

$390.00

Service Code	HCPCS 83586
Hospital Charge Code	38472383
Hospital Revenue Code	301
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.82
Rate for Payer: Aetna Medicare Advantage	$41.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.43
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.80
Rate for Payer: Clover Medicare Advantage	$12.16
Rate for Payer: EmblemHealth Commercial	$38.40
Rate for Payer: Humana Medicare Advantage	$13.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.80
Rate for Payer: Wellcare Medicare Advantage	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

1.7MM DRILL BIT

Facility

$875.00

Hospital Charge Code	270681047
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

1.7MM DRILL BIT

Facility

$875.00

Hospital Charge Code	270681047
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

Know your out-of-pocket cost for care.

All Charges