Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

2.3X20 CORTICAL SCREW

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270656440
Hospital Revenue Code	278
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$123.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Community & State	$10.27
Rate for Payer: Wellpoint Medicaid Managed Care	$9.23

2.3X20 CORTICAL SCREW

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270656440
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

2.3 X 20 LOCKING SCREW

Facility

$520.00

Hospital Charge Code	270665466
Hospital Revenue Code	278
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$260.00
Rate for Payer: Aetna Commercial	$197.60
Rate for Payer: Aetna Medicare Advantage	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.60
Rate for Payer: Cigna Commercial	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Community & State	$16.43
Rate for Payer: Wellpoint Medicaid Managed Care	$14.77

2.3 X 20 LOCKING SCREW

Facility

$520.00

Hospital Charge Code	270665466
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.84
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

2.3 X 22 CORTICAL SCREW

Facility

$465.00

Service Code	HCPCS C1713
Hospital Charge Code	270656427
Hospital Revenue Code	278
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$176.70
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Community & State	$14.69
Rate for Payer: Wellpoint Medicaid Managed Care	$13.21

2.3 X 22 CORTICAL SCREW

Facility

$465.00

Service Code	HCPCS C1713
Hospital Charge Code	270656427
Hospital Revenue Code	278
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$112.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.53
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

2.4/2.7 VA FUSION PLATE

Facility

$3,948.85

Service Code	HCPCS C1713
Hospital Charge Code	270681955
Hospital Revenue Code	278
Min. Negotiated Rate	$112.15
Max. Negotiated Rate	$1,974.42
Rate for Payer: Aetna Commercial	$1,500.56
Rate for Payer: Aetna Medicare Advantage	$1,184.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,006.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,006.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$789.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,006.96
Rate for Payer: Cigna Commercial	$1,974.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.62
Rate for Payer: Qualcare PPO/HMO/WC	$592.33
Rate for Payer: UnitedHealthcare Community & State	$124.78
Rate for Payer: Wellpoint Medicaid Managed Care	$112.15

2.4/2.7 VA FUSION PLATE

Facility

$3,948.85

Service Code	HCPCS C1713
Hospital Charge Code	270681955
Hospital Revenue Code	278
Min. Negotiated Rate	$592.33
Max. Negotiated Rate	$955.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$789.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.62
Rate for Payer: Qualcare PPO/HMO/WC	$592.33

2.4 CANN SCREW 17MM SRT THRD

Facility

$12,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270688190
Hospital Revenue Code	278
Min. Negotiated Rate	$1,878.75
Max. Negotiated Rate	$3,031.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,031.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,878.75

2.4 CANN SCREW 17MM SRT THRD

Facility

$12,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270688190
Hospital Revenue Code	278
Min. Negotiated Rate	$355.71
Max. Negotiated Rate	$6,262.50
Rate for Payer: Aetna Commercial	$4,759.50
Rate for Payer: Aetna Medicare Advantage	$3,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,193.88
Rate for Payer: Cigna Commercial	$6,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,031.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,878.75
Rate for Payer: UnitedHealthcare Community & State	$395.79
Rate for Payer: Wellpoint Medicaid Managed Care	$355.71

24 HOURS URINE PROTEIN ELECTRO

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990066A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

24 HOURS URINE PROTEIN ELECTRO

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990066A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.79
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
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	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

24 HOURS URINE PROTEIN ELECTRO

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	39990066B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

24 HOURS URINE PROTEIN ELECTRO

Facility

$390.00

Service Code	HCPCS 84166
Hospital Charge Code	39990066C
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.50
Rate for Payer: Aetna Medicare Advantage	$57.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.68
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.83
Rate for Payer: Clover Medicare Advantage	$16.94
Rate for Payer: EmblemHealth Commercial	$53.49
Rate for Payer: Humana Medicare Advantage	$18.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.83
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	$14.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.83
Rate for Payer: Wellcare Medicare Advantage	$17.83
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

24 HOURS URINE PROTEIN ELECTRO

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	39990066B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$9.98
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.31
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$3.67
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.67
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	$2.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Medicare Advantage	$3.67
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

24 HOURS URINE PROTEIN ELECTRO

Facility

$390.00

Service Code	HCPCS 84166
Hospital Charge Code	39990066C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

2.4 LOCK VOLAR PLATE LEFT

Facility

$4,194.80

Service Code	HCPCS C1713
Hospital Charge Code	270685572
Hospital Revenue Code	278
Min. Negotiated Rate	$629.22
Max. Negotiated Rate	$1,015.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$838.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.14
Rate for Payer: Qualcare PPO/HMO/WC	$629.22

2.4 LOCK VOLAR PLATE LEFT

Facility

$4,194.80

Service Code	HCPCS C1713
Hospital Charge Code	270685572
Hospital Revenue Code	278
Min. Negotiated Rate	$119.13
Max. Negotiated Rate	$2,097.40
Rate for Payer: Aetna Commercial	$1,594.02
Rate for Payer: Aetna Medicare Advantage	$1,258.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$838.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.67
Rate for Payer: Cigna Commercial	$2,097.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.14
Rate for Payer: Qualcare PPO/HMO/WC	$629.22
Rate for Payer: UnitedHealthcare Community & State	$132.56
Rate for Payer: Wellpoint Medicaid Managed Care	$119.13

2.4MM CAN SCREWSHORT THREAD 18

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270682924
Hospital Revenue Code	278
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$326.55
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90
Rate for Payer: UnitedHealthcare Community & State	$27.16
Rate for Payer: Wellpoint Medicaid Managed Care	$24.41

2.4MM CAN SCREWSHORT THREAD 18

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270682924
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

2.4MM VA-LCP 2-CLMN PL 7H HD/4

Facility

$4,535.35

Service Code	HCPCS C1713
Hospital Charge Code	270684239
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$2,267.68
Rate for Payer: Aetna Commercial	$1,723.43
Rate for Payer: Aetna Medicare Advantage	$1,360.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,156.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,156.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$907.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,156.51
Rate for Payer: Cigna Commercial	$2,267.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,097.55
Rate for Payer: Qualcare PPO/HMO/WC	$680.30
Rate for Payer: UnitedHealthcare Community & State	$143.32
Rate for Payer: Wellpoint Medicaid Managed Care	$128.80

2.4MM VA-LCP 2-CLMN PL 7H HD/4

Facility

$4,535.35

Service Code	HCPCS C1713
Hospital Charge Code	270684239
Hospital Revenue Code	278
Min. Negotiated Rate	$680.30
Max. Negotiated Rate	$1,097.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$907.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,097.55
Rate for Payer: Qualcare PPO/HMO/WC	$680.30

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687767
Hospital Revenue Code	278
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$168.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687787
Hospital Revenue Code	278
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$168.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687784
Hospital Revenue Code	278
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$168.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

Know your out-of-pocket cost for care.

All Charges