Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KWIRE NITINOL BLUNT 1.6X500MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695218
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

KWIRE NITINOL LONG 0.62X21

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696182
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

KWIRE NITINOL LONG 0.62X21

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696182
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

KWIRE NITINOL TROCAR 1.4MM21IN

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698048
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

KWIRE NITINOL TROCAR 1.4MM21IN

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698048
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KWIRE NI TROCAR BLUNT TIP

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696977
Hospital Revenue Code	279
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

KWIRE NI TROCAR BLUNT TIP

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696977
Hospital Revenue Code	279
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) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

K-WIRE NON STERILE 1.4x150MM

Facility

$224.50

Hospital Charge Code	270662556
Hospital Revenue Code	271
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$33.67
Rate for Payer: Qualcare PPO/HMO/WC	$33.67

K-WIRE NON STERILE 1.4x150MM

Facility

$224.50

Hospital Charge Code	270662556
Hospital Revenue Code	271
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$112.25
Rate for Payer: Aetna Commercial	$85.31
Rate for Payer: Aetna Medicare Advantage	$67.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.25
Rate for Payer: Cigna Commercial	$112.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.37
Rate for Payer: Oxford Commercial	$44.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.67
Rate for Payer: UnitedHealthcare Commercial	$44.90
Rate for Payer: UnitedHealthcare Community & State	$7.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.38

KWIRE NON THREADED 1.15MM

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270698691
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$133.82
Rate for Payer: Aetna Commercial	$101.71
Rate for Payer: Aetna Medicare Advantage	$80.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.25
Rate for Payer: Cigna Commercial	$133.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.15
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.60

KWIRE NON THREADED 1.15MM

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270698691
Hospital Revenue Code	278
Min. Negotiated Rate	$40.15
Max. Negotiated Rate	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.15

K-WIRE OLIVE STOP 56-40281

Facility

$171.25

Hospital Charge Code	270640882
Hospital Revenue Code	272
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$85.62
Rate for Payer: Aetna Commercial	$65.08
Rate for Payer: Aetna Medicare Advantage	$51.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.67
Rate for Payer: Cigna Commercial	$85.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.52
Rate for Payer: Oxford Commercial	$34.25
Rate for Payer: Qualcare PPO/HMO/WC	$25.69
Rate for Payer: UnitedHealthcare Commercial	$34.25
Rate for Payer: UnitedHealthcare Community & State	$5.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.86

K-WIRE OLIVE STOP 56-40281

Facility

$171.25

Hospital Charge Code	270640882
Hospital Revenue Code	272
Min. Negotiated Rate	$25.69
Max. Negotiated Rate	$25.69
Rate for Payer: Qualcare PPO/HMO/WC	$25.69

K WIRE OLIVE TIP 1

Facility

$1,115.00

Hospital Charge Code	270703649
Hospital Revenue Code	279
Min. Negotiated Rate	$31.67
Max. Negotiated Rate	$557.50
Rate for Payer: Aetna Commercial	$423.70
Rate for Payer: Aetna Medicare Advantage	$334.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.32
Rate for Payer: Cigna Commercial	$557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.90
Rate for Payer: Oxford Commercial	$223.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.25
Rate for Payer: UnitedHealthcare Commercial	$223.00
Rate for Payer: UnitedHealthcare Community & State	$35.23
Rate for Payer: Wellpoint Medicaid Managed Care	$31.67

K WIRE OLIVE TIP 1

Facility

$1,115.00

Hospital Charge Code	270703649
Hospital Revenue Code	279
Min. Negotiated Rate	$167.25
Max. Negotiated Rate	$167.25
Rate for Payer: Qualcare PPO/HMO/WC	$167.25

K WIRE PANTA2 2.5X150MM

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270699962
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$222.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

K WIRE PANTA2 2.5X150MM

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270699962
Hospital Revenue Code	278
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Community & State	$29.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.13

KWIRE S END TIP THD 2.3X300

Facility

$115.50

Service Code	HCPCS C1713
Hospital Charge Code	270701925
Hospital Revenue Code	278
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$57.75
Rate for Payer: Aetna Commercial	$43.89
Rate for Payer: Aetna Medicare Advantage	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.45
Rate for Payer: Cigna Commercial	$57.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.32
Rate for Payer: UnitedHealthcare Community & State	$3.65
Rate for Payer: Wellpoint Medicaid Managed Care	$3.28

KWIRE S END TIP THD 2.3X300

Facility

$115.50

Service Code	HCPCS C1713
Hospital Charge Code	270701925
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$27.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.32

KWIRE SGL END TRCT TIP 2.3X150

Facility

$115.50

Service Code	HCPCS C1713
Hospital Charge Code	270701898
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$27.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.32

KWIRE SGL END TRCT TIP 2.3X150

Facility

$115.50

Service Code	HCPCS C1713
Hospital Charge Code	270701898
Hospital Revenue Code	278
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$57.75
Rate for Payer: Aetna Commercial	$43.89
Rate for Payer: Aetna Medicare Advantage	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.45
Rate for Payer: Cigna Commercial	$57.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.32
Rate for Payer: UnitedHealthcare Community & State	$3.65
Rate for Payer: Wellpoint Medicaid Managed Care	$3.28

K-WIRE SHARP-ABBOT SPINE

Facility

$220.00

Hospital Charge Code	270339019
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

K-WIRE SHARP-ABBOT SPINE

Facility

$220.00

Hospital Charge Code	270339019
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

K-WIRE SHOULDER DISP 2.5

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691625
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

K-WIRE SHOULDER DISP 2.5

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691625
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

Know your out-of-pocket cost for care.

All Charges