Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

AFFIXUS CORTICAL BONE SCREW 4X

Facility

$1,323.00

Service Code	HCPCS C1713
Hospital Charge Code	270704513
Hospital Revenue Code	278
Min. Negotiated Rate	$198.45
Max. Negotiated Rate	$320.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.17
Rate for Payer: Qualcare PPO/HMO/WC	$198.45

AFFIXUS HIP FRAC NAIL 125D 13X

Facility

$9,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270705120
Hospital Revenue Code	278
Min. Negotiated Rate	$1,476.75
Max. Negotiated Rate	$2,382.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,969.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,382.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,476.75

AFFIXUS HIP FRAC NAIL 125D 13X

Facility

$9,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270705120
Hospital Revenue Code	278
Min. Negotiated Rate	$279.60
Max. Negotiated Rate	$4,922.50
Rate for Payer: Aetna Commercial	$3,741.10
Rate for Payer: Aetna Medicare Advantage	$2,953.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,510.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,510.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,969.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,510.47
Rate for Payer: Cigna Commercial	$4,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,382.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,476.75
Rate for Payer: UnitedHealthcare Community & State	$311.10
Rate for Payer: Wellpoint Medicaid Managed Care	$279.60

AFFIXUS In cap flush impinging

Facility

$790.00

Hospital Charge Code	270679375
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

AFFIXUS In cap flush impinging

Facility

$790.00

Hospital Charge Code	270679375
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

AFFIXUS PROXIMAL HUMERUS RIGHT

Facility

$13,147.30

Service Code	HCPCS C1713
Hospital Charge Code	270704514
Hospital Revenue Code	278
Min. Negotiated Rate	$373.38
Max. Negotiated Rate	$6,573.65
Rate for Payer: Aetna Commercial	$4,995.97
Rate for Payer: Aetna Medicare Advantage	$3,944.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,352.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,352.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,629.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,352.56
Rate for Payer: Cigna Commercial	$6,573.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,181.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,972.10
Rate for Payer: UnitedHealthcare Community & State	$415.45
Rate for Payer: Wellpoint Medicaid Managed Care	$373.38

AFFIXUS PROXIMAL HUMERUS RIGHT

Facility

$13,147.30

Service Code	HCPCS C1713
Hospital Charge Code	270704514
Hospital Revenue Code	278
Min. Negotiated Rate	$1,972.10
Max. Negotiated Rate	$3,181.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,629.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,181.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,972.10

AFFIXUX BLUNT TIP SCREW 4 X 40

Facility

$965.00

Service Code	HCPCS C1713
Hospital Charge Code	270688147
Hospital Revenue Code	278
Min. Negotiated Rate	$144.75
Max. Negotiated Rate	$233.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$144.75

AFFIXUX BLUNT TIP SCREW 4 X 40

Facility

$965.00

Service Code	HCPCS C1713
Hospital Charge Code	270688147
Hospital Revenue Code	278
Min. Negotiated Rate	$27.41
Max. Negotiated Rate	$482.50
Rate for Payer: Aetna Commercial	$366.70
Rate for Payer: Aetna Medicare Advantage	$289.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.07
Rate for Payer: Cigna Commercial	$482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$144.75
Rate for Payer: UnitedHealthcare Community & State	$30.49
Rate for Payer: Wellpoint Medicaid Managed Care	$27.41

AFFIXUX HUM CALIB DRILL 3.3MM

Facility

$2,240.00

Hospital Charge Code	270688154
Hospital Revenue Code	272
Min. Negotiated Rate	$63.62
Max. Negotiated Rate	$1,120.00
Rate for Payer: Aetna Commercial	$851.20
Rate for Payer: Aetna Medicare Advantage	$672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.20
Rate for Payer: Cigna Commercial	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.40
Rate for Payer: Oxford Commercial	$448.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00
Rate for Payer: UnitedHealthcare Commercial	$448.00
Rate for Payer: UnitedHealthcare Community & State	$70.78
Rate for Payer: Wellpoint Medicaid Managed Care	$63.62

AFFIXUX HUM CALIB DRILL 3.3MM

Facility

$2,240.00

Hospital Charge Code	270688154
Hospital Revenue Code	272
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$336.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00

AFIXIS NAIL AR HUMUNIV 7.5 X 2

Facility

$8,765.00

Service Code	HCPCS C1713
Hospital Charge Code	270688146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,314.75
Max. Negotiated Rate	$2,121.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,753.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,314.75

AFIXIS NAIL AR HUMUNIV 7.5 X 2

Facility

$8,765.00

Service Code	HCPCS C1713
Hospital Charge Code	270688146
Hospital Revenue Code	278
Min. Negotiated Rate	$248.93
Max. Negotiated Rate	$4,382.50
Rate for Payer: Aetna Commercial	$3,330.70
Rate for Payer: Aetna Medicare Advantage	$2,629.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,235.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,235.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,753.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,235.07
Rate for Payer: Cigna Commercial	$4,382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,314.75
Rate for Payer: UnitedHealthcare Community & State	$276.97
Rate for Payer: Wellpoint Medicaid Managed Care	$248.93

AFIXIX HUM BALL NOSE GW ST

Facility

$1,885.00

Hospital Charge Code	270688143
Hospital Revenue Code	272
Min. Negotiated Rate	$282.75
Max. Negotiated Rate	$282.75
Rate for Payer: Qualcare PPO/HMO/WC	$282.75

AFIXIX HUM BALL NOSE GW ST

Facility

$1,885.00

Hospital Charge Code	270688143
Hospital Revenue Code	272
Min. Negotiated Rate	$53.53
Max. Negotiated Rate	$942.50
Rate for Payer: Aetna Commercial	$716.30
Rate for Payer: Aetna Medicare Advantage	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.68
Rate for Payer: Cigna Commercial	$942.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.10
Rate for Payer: Oxford Commercial	$377.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.75
Rate for Payer: UnitedHealthcare Commercial	$377.00
Rate for Payer: UnitedHealthcare Community & State	$59.57
Rate for Payer: Wellpoint Medicaid Managed Care	$53.53

AFLEX GRAFT

Facility

$11,750.00

Hospital Charge Code	270339467
Hospital Revenue Code	636
Min. Negotiated Rate	$1,762.50
Max. Negotiated Rate	$2,843.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50

AFLEX GRAFT

Facility

$11,750.00

Hospital Charge Code	270339467
Hospital Revenue Code	636
Min. Negotiated Rate	$333.70
Max. Negotiated Rate	$5,875.00
Rate for Payer: Aetna Commercial	$4,465.00
Rate for Payer: Aetna Medicare Advantage	$3,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,996.25
Rate for Payer: Cigna Commercial	$5,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50
Rate for Payer: UnitedHealthcare Community & State	$371.30
Rate for Payer: Wellpoint Medicaid Managed Care	$333.70

AFLURIA TRIVALENT 0.5ML SYRING

Facility

$105.66

Service Code	NDC 33332002403
Hospital Charge Code	6063943391
Hospital Revenue Code	250
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

AFLURIA TRIVALENT 0.5ML SYRING

Facility

$105.66

Service Code	NDC 33332002403
Hospital Charge Code	6063943391
Hospital Revenue Code	250
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$52.83
Rate for Payer: Aetna Commercial	$40.15
Rate for Payer: Aetna Medicare Advantage	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.94
Rate for Payer: Cigna Commercial	$52.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.47
Rate for Payer: Oxford Commercial	$21.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$21.13
Rate for Payer: UnitedHealthcare Community & State	$3.34
Rate for Payer: Wellpoint Medicaid Managed Care	$3.00

AFP AND AFP-L3

Facility

$399.70

Service Code	HCPCS 82107
Hospital Charge Code	3038544
Hospital Revenue Code	301
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$233.65
Rate for Payer: Aetna Commercial	$175.20
Rate for Payer: Aetna Medicare Advantage	$208.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$64.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.65
Rate for Payer: Cigna Commercial	$199.85
Rate for Payer: Cigna Medicare Advantage	$64.41
Rate for Payer: Clover Medicare Advantage	$61.19
Rate for Payer: EmblemHealth Commercial	$193.23
Rate for Payer: Humana Medicare Advantage	$66.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$64.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.92
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$51.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.41
Rate for Payer: Wellcare Medicare Advantage	$64.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.35

AFP AND AFP-L3

Facility

$399.70

Service Code	HCPCS 82107
Hospital Charge Code	3038544
Hospital Revenue Code	301
Min. Negotiated Rate	$59.95
Max. Negotiated Rate	$59.95
Rate for Payer: Qualcare PPO/HMO/WC	$59.95

AFP,MATERNAL,INITIAL,SERU

Facility

$390.00

Service Code	HCPCS 82105
Hospital Charge Code	39900039
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.83
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
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	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

AFP,MATERNAL,INITIAL,SERU

Facility

$390.00

Service Code	HCPCS 82105
Hospital Charge Code	39900039
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

AFP TUMOR MARKER

Facility

$115.30

Service Code	HCPCS 82105
Hospital Charge Code	39900422
Hospital Revenue Code	301
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.83
Rate for Payer: Cigna Commercial	$57.65
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.98
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.30
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

AFP TUMOR MARKER

Facility

$115.30

Service Code	HCPCS 82105
Hospital Charge Code	39900422
Hospital Revenue Code	301
Min. Negotiated Rate	$17.30
Max. Negotiated Rate	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.30

Know your out-of-pocket cost for care.

All Charges