Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

KWIRE W STOP F/T10 2X150MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270700727
Hospital Revenue Code	278
Min. Negotiated Rate	$39.76
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$44.24
Rate for Payer: Wellpoint Medicaid Managed Care	$39.76

K-WIRE W/THD TROCAR PT 280MM

Facility

$72.89

Hospital Charge Code	270604428
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

K-WIRE W/THD TROCAR PT 280MM

Facility

$72.89

Hospital Charge Code	270604428
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$36.45
Rate for Payer: Aetna Commercial	$27.70
Rate for Payer: Aetna Medicare Advantage	$21.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.59
Rate for Payer: Cigna Commercial	$36.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.95
Rate for Payer: Oxford Commercial	$14.58
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$14.58
Rate for Payer: UnitedHealthcare Community & State	$2.30
Rate for Payer: Wellpoint Medicaid Managed Care	$2.07

K-WIRE W/THRD TIP 1.25x100MM

Facility

$195.29

Service Code	HCPCS C1769
Hospital Charge Code	270622480
Hospital Revenue Code	278
Min. Negotiated Rate	$29.29
Max. Negotiated Rate	$47.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.26
Rate for Payer: Qualcare PPO/HMO/WC	$29.29

K-WIRE W/THRD TIP 1.25x100MM

Facility

$195.29

Service Code	HCPCS C1769
Hospital Charge Code	270622480
Hospital Revenue Code	278
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$97.64
Rate for Payer: Aetna Commercial	$74.21
Rate for Payer: Aetna Medicare Advantage	$58.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.80
Rate for Payer: Cigna Commercial	$97.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.26
Rate for Payer: Qualcare PPO/HMO/WC	$29.29
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: Wellpoint Medicaid Managed Care	$5.55

K-WIRE W/TROCAR TIP 0.6x70MM

Facility

$327.55

Service Code	HCPCS C1713
Hospital Charge Code	270604408
Hospital Revenue Code	278
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$163.78
Rate for Payer: Aetna Commercial	$124.47
Rate for Payer: Aetna Medicare Advantage	$98.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.53
Rate for Payer: Cigna Commercial	$163.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.13
Rate for Payer: UnitedHealthcare Community & State	$10.35
Rate for Payer: Wellpoint Medicaid Managed Care	$9.30

K-WIRE W/TROCAR TIP 0.6x70MM

Facility

$327.55

Service Code	HCPCS C1713
Hospital Charge Code	270604408
Hospital Revenue Code	278
Min. Negotiated Rate	$49.13
Max. Negotiated Rate	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.13

K-WIRE W/TROCAR TIP 0.8x70MM

Facility

$32.76

Service Code	HCPCS C1713
Hospital Charge Code	270604411
Hospital Revenue Code	278
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$7.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

K-WIRE W/TROCAR TIP 0.8x70MM

Facility

$32.76

Service Code	HCPCS C1713
Hospital Charge Code	270604411
Hospital Revenue Code	278
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$12.45
Rate for Payer: Aetna Medicare Advantage	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.91
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

K-WIRE W/TROCAR TIP 1.6x150MM

Facility

$38.83

Hospital Charge Code	270601824
Hospital Revenue Code	272
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$5.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

K-WIRE W/TROCAR TIP 1.6x150MM

Facility

$38.83

Hospital Charge Code	270601824
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$19.41
Rate for Payer: Aetna Commercial	$14.76
Rate for Payer: Aetna Medicare Advantage	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.90
Rate for Payer: Cigna Commercial	$19.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.10
Rate for Payer: Oxford Commercial	$7.77
Rate for Payer: Qualcare PPO/HMO/WC	$5.82
Rate for Payer: UnitedHealthcare Commercial	$7.77
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

K-WIRE W/TROCAR TIP 2.0x150MM

Facility

$38.83

Service Code	HCPCS C1713
Hospital Charge Code	270603558
Hospital Revenue Code	278
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$19.41
Rate for Payer: Aetna Commercial	$14.76
Rate for Payer: Aetna Medicare Advantage	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.90
Rate for Payer: Cigna Commercial	$19.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.82
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

K-WIRE W/TROCAR TIP 2.0x150MM

Facility

$38.83

Service Code	HCPCS C1713
Hospital Charge Code	270603558
Hospital Revenue Code	278
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

K-WIRE W/TROCAR TIP 2.5x285MM

Facility

$483.80

Hospital Charge Code	270637807
Hospital Revenue Code	272
Min. Negotiated Rate	$13.74
Max. Negotiated Rate	$241.90
Rate for Payer: Aetna Commercial	$183.84
Rate for Payer: Aetna Medicare Advantage	$145.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.37
Rate for Payer: Cigna Commercial	$241.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.79
Rate for Payer: Oxford Commercial	$96.76
Rate for Payer: Qualcare PPO/HMO/WC	$72.57
Rate for Payer: UnitedHealthcare Commercial	$96.76
Rate for Payer: UnitedHealthcare Community & State	$15.29
Rate for Payer: Wellpoint Medicaid Managed Care	$13.74

K-WIRE W/TROCAR TIP 2.5x285MM

Facility

$483.80

Hospital Charge Code	270637807
Hospital Revenue Code	272
Min. Negotiated Rate	$72.57
Max. Negotiated Rate	$72.57
Rate for Payer: Qualcare PPO/HMO/WC	$72.57

KYPHON ACTIVOS BONE CEMENT

Facility

$1,525.00

Hospital Charge Code	270339542
Hospital Revenue Code	272
Min. Negotiated Rate	$228.75
Max. Negotiated Rate	$228.75
Rate for Payer: Qualcare PPO/HMO/WC	$228.75

KYPHON ACTIVOS BONE CEMENT

Facility

$1,525.00

Hospital Charge Code	270339542
Hospital Revenue Code	272
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$762.50
Rate for Payer: Aetna Commercial	$579.50
Rate for Payer: Aetna Medicare Advantage	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.88
Rate for Payer: Cigna Commercial	$762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.50
Rate for Payer: Oxford Commercial	$305.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.75
Rate for Payer: UnitedHealthcare Commercial	$305.00
Rate for Payer: UnitedHealthcare Community & State	$48.19
Rate for Payer: Wellpoint Medicaid Managed Care	$43.31

KYPHON ADVANCED OSTEO INTRODUC

Facility

$21,600.00

Hospital Charge Code	270339545
Hospital Revenue Code	272
Min. Negotiated Rate	$613.44
Max. Negotiated Rate	$10,800.00
Rate for Payer: Aetna Commercial	$8,208.00
Rate for Payer: Aetna Medicare Advantage	$6,480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,508.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,508.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,508.00
Rate for Payer: Cigna Commercial	$10,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,616.00
Rate for Payer: Oxford Commercial	$4,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,240.00
Rate for Payer: UnitedHealthcare Commercial	$4,320.00
Rate for Payer: UnitedHealthcare Community & State	$682.56
Rate for Payer: Wellpoint Medicaid Managed Care	$613.44

KYPHON ADVANCED OSTEO INTRODUC

Facility

$21,600.00

Hospital Charge Code	270339545
Hospital Revenue Code	272
Min. Negotiated Rate	$3,240.00
Max. Negotiated Rate	$3,240.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,240.00

KYPHON BONE BIOPSY DEVICE

Facility

$750.00

Hospital Charge Code	270339544
Hospital Revenue Code	272
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

KYPHON BONE BIOPSY DEVICE

Facility

$750.00

Hospital Charge Code	270339544
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

KYPHON EXPRESS CURETTE T-TIP

Facility

$2,475.00

Hospital Charge Code	270339546
Hospital Revenue Code	272
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

KYPHON EXPRESS CURETTE T-TIP

Facility

$2,475.00

Hospital Charge Code	270339546
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

KYPHON INFLATION SYRINGE

Facility

$900.00

Hospital Charge Code	270339547
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

KYPHON INFLATION SYRINGE

Facility

$900.00

Hospital Charge Code	270339547
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

Know your out-of-pocket cost for care.

All Charges