Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

FIXATOR DISTAL RADIUS 240MM

Facility

$11,547.00

Hospital Charge Code	270677335
Hospital Revenue Code	278
Min. Negotiated Rate	$1,732.05
Max. Negotiated Rate	$2,794.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,309.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,794.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.05

FIXED 4.0MM SELF TAPPING 12MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693407
Hospital Revenue Code	278
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) NJ Health	$450.00
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	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

FIXED 4.0MM SELF TAPPING 12MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693407
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

FIXED SCREW 4X16MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705474
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

FIXED SCREW 4X16MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705474
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

FIXOS SCREW 4X36MM.

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270703680
Hospital Revenue Code	278
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$425.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.92
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

FIXOS SCREW 4X36MM.

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270703680
Hospital Revenue Code	278
Min. Negotiated Rate	$49.98
Max. Negotiated Rate	$880.00
Rate for Payer: Aetna Commercial	$668.80
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.92
Rate for Payer: Qualcare PPO/HMO/WC	$264.00
Rate for Payer: UnitedHealthcare Community & State	$55.62
Rate for Payer: Wellpoint Medicaid Managed Care	$49.98

FIX PIN

Facility

$543.80

Service Code	HCPCS C1713
Hospital Charge Code	270689205
Hospital Revenue Code	278
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$271.90
Rate for Payer: Aetna Commercial	$206.64
Rate for Payer: Aetna Medicare Advantage	$163.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.67
Rate for Payer: Cigna Commercial	$271.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.60
Rate for Payer: Qualcare PPO/HMO/WC	$81.57
Rate for Payer: UnitedHealthcare Community & State	$17.18
Rate for Payer: Wellpoint Medicaid Managed Care	$15.44

FIX PIN

Facility

$543.80

Service Code	HCPCS C1713
Hospital Charge Code	270689205
Hospital Revenue Code	278
Min. Negotiated Rate	$81.57
Max. Negotiated Rate	$131.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.60
Rate for Payer: Qualcare PPO/HMO/WC	$81.57

FLANGE BREAST 2 BREAST CUST

Facility

$28.33

Hospital Charge Code	270665662
Hospital Revenue Code	278
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$14.16
Rate for Payer: Aetna Commercial	$10.77
Rate for Payer: Aetna Medicare Advantage	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.22
Rate for Payer: Cigna Commercial	$14.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.25
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

FLANGE BREAST 2 BREAST CUST

Facility

$28.33

Hospital Charge Code	270665662
Hospital Revenue Code	278
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.25

FLAREHAWK 11MM SHIM, 29MM

Facility

$10,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703876
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

FLAREHAWK 11MM SHIM, 29MM

Facility

$10,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703876
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FLAREHAWK 7 SHORT SHELL

Facility

$18,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270692138
Hospital Revenue Code	278
Min. Negotiated Rate	$2,767.50
Max. Negotiated Rate	$4,464.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,464.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,767.50

FLAREHAWK 7 SHORT SHELL

Facility

$18,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270692138
Hospital Revenue Code	278
Min. Negotiated Rate	$523.98
Max. Negotiated Rate	$9,225.00
Rate for Payer: Aetna Commercial	$7,011.00
Rate for Payer: Aetna Medicare Advantage	$5,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,704.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,704.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,704.75
Rate for Payer: Cigna Commercial	$9,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,464.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,767.50
Rate for Payer: UnitedHealthcare Community & State	$583.02
Rate for Payer: Wellpoint Medicaid Managed Care	$523.98

FLAREHAWK 7 SHORT SHIM

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270692139
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$4,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

FLAREHAWK 7 SHORT SHIM

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270692139
Hospital Revenue Code	278
Min. Negotiated Rate	$538.89
Max. Negotiated Rate	$9,487.50
Rate for Payer: Aetna Commercial	$7,210.50
Rate for Payer: Aetna Medicare Advantage	$5,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,838.62
Rate for Payer: Cigna Commercial	$9,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25
Rate for Payer: UnitedHealthcare Community & State	$599.61
Rate for Payer: Wellpoint Medicaid Managed Care	$538.89

FLAREHWK SHELL TALL 25MM TIH11

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270697086
Hospital Revenue Code	278
Min. Negotiated Rate	$538.89
Max. Negotiated Rate	$9,487.50
Rate for Payer: Aetna Commercial	$7,210.50
Rate for Payer: Aetna Medicare Advantage	$5,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,838.62
Rate for Payer: Cigna Commercial	$9,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25
Rate for Payer: UnitedHealthcare Community & State	$599.61
Rate for Payer: Wellpoint Medicaid Managed Care	$538.89

FLAREHWK SHELL TALL 25MM TIH11

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270697086
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$4,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

FLAREHWK SHIM 11/13X23/25MM 0D

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270697087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

FLAREHWK SHIM 11/13X23/25MM 0D

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270697087
Hospital Revenue Code	278
Min. Negotiated Rate	$560.90
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$7,505.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50
Rate for Payer: UnitedHealthcare Community & State	$624.10
Rate for Payer: Wellpoint Medicaid Managed Care	$560.90

FLAREHWK SHIM 11/14X23/25MM 0D

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270697088
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

FLAREHWK SHIM 11/14X23/25MM 0D

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270697088
Hospital Revenue Code	278
Min. Negotiated Rate	$560.90
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$7,505.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50
Rate for Payer: UnitedHealthcare Community & State	$624.10
Rate for Payer: Wellpoint Medicaid Managed Care	$560.90

FLAT WASHER

Facility

$400.00

Hospital Charge Code	270680499
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

FLAT WASHER

Facility

$400.00

Hospital Charge Code	270680499
Hospital Revenue Code	278
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

Know your out-of-pocket cost for care.

All Charges