Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687786
Hospital Revenue Code	278
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$264.33
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34
Rate for Payer: UnitedHealthcare Community & State	$21.98
Rate for Payer: Wellpoint Medicaid Managed Care	$19.76

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687788
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	270687788
Hospital Revenue Code	278
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$264.33
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34
Rate for Payer: UnitedHealthcare Community & State	$21.98
Rate for Payer: Wellpoint Medicaid Managed Care	$19.76

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687787
Hospital Revenue Code	278
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$264.33
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34
Rate for Payer: UnitedHealthcare Community & State	$21.98
Rate for Payer: Wellpoint Medicaid Managed Care	$19.76

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

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	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	270687784
Hospital Revenue Code	278
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$264.33
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34
Rate for Payer: UnitedHealthcare Community & State	$21.98
Rate for Payer: Wellpoint Medicaid Managed Care	$19.76

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687785
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

2.4MM X 12MM CORTEX SCREW

Facility

$568.40

Service Code	HCPCS C1713
Hospital Charge Code	270704347
Hospital Revenue Code	278
Min. Negotiated Rate	$85.26
Max. Negotiated Rate	$137.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.55
Rate for Payer: Qualcare PPO/HMO/WC	$85.26

2.4MM X 12MM CORTEX SCREW

Facility

$568.40

Service Code	HCPCS C1713
Hospital Charge Code	270704347
Hospital Revenue Code	278
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$284.20
Rate for Payer: Aetna Commercial	$215.99
Rate for Payer: Aetna Medicare Advantage	$170.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.94
Rate for Payer: Cigna Commercial	$284.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.55
Rate for Payer: Qualcare PPO/HMO/WC	$85.26
Rate for Payer: UnitedHealthcare Community & State	$17.96
Rate for Payer: Wellpoint Medicaid Managed Care	$16.14

2.4MM X12MM LOCKING SCREW

Facility

$1,146.60

Service Code	HCPCS C1713
Hospital Charge Code	270704348
Hospital Revenue Code	278
Min. Negotiated Rate	$32.56
Max. Negotiated Rate	$573.30
Rate for Payer: Aetna Commercial	$435.71
Rate for Payer: Aetna Medicare Advantage	$343.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.38
Rate for Payer: Cigna Commercial	$573.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.48
Rate for Payer: Qualcare PPO/HMO/WC	$171.99
Rate for Payer: UnitedHealthcare Community & State	$36.23
Rate for Payer: Wellpoint Medicaid Managed Care	$32.56

2.4MM X12MM LOCKING SCREW

Facility

$1,146.60

Service Code	HCPCS C1713
Hospital Charge Code	270704348
Hospital Revenue Code	278
Min. Negotiated Rate	$171.99
Max. Negotiated Rate	$277.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.48
Rate for Payer: Qualcare PPO/HMO/WC	$171.99

2.4 VA LCP TWO COLUM RADIUS PL

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270687794
Hospital Revenue Code	278
Min. Negotiated Rate	$243.67
Max. Negotiated Rate	$4,290.00
Rate for Payer: Aetna Commercial	$3,260.40
Rate for Payer: Aetna Medicare Advantage	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,187.90
Rate for Payer: Cigna Commercial	$4,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00
Rate for Payer: UnitedHealthcare Community & State	$271.13
Rate for Payer: Wellpoint Medicaid Managed Care	$243.67

2.4 VA LCP TWO COLUM RADIUS PL

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270687794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$2,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

2.4 X 10MM LOCKING

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270686300
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

2.4 X 10MM LOCKING

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270686300
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

2.4X12MM AMBASSADOR DRILL BIT

Facility

$375.00

Hospital Charge Code	270704978
Hospital Revenue Code	279
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

2.4X12MM AMBASSADOR DRILL BIT

Facility

$375.00

Hospital Charge Code	270704978
Hospital Revenue Code	279
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

2.4 X 18 CANNULA SCREW

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270686592
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

2.4 X 18 CANNULA SCREW

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270686592
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

2.4 X 18MM VAL SCREW TI

Facility

$720.00

Hospital Charge Code	270702932
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

2.4 X 18MM VAL SCREW TI

Facility

$720.00

Hospital Charge Code	270702932
Hospital Revenue Code	278
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

24X36X12MM CAGE, 12 DEGREES

Facility

$31,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704954
Hospital Revenue Code	278
Min. Negotiated Rate	$4,725.00
Max. Negotiated Rate	$7,623.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,623.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,725.00

24X36X12MM CAGE, 12 DEGREES

Facility

$31,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704954
Hospital Revenue Code	278
Min. Negotiated Rate	$894.60
Max. Negotiated Rate	$15,750.00
Rate for Payer: Aetna Commercial	$11,970.00
Rate for Payer: Aetna Medicare Advantage	$9,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,032.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,032.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,032.50
Rate for Payer: Cigna Commercial	$15,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,623.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,725.00
Rate for Payer: UnitedHealthcare Community & State	$995.40
Rate for Payer: Wellpoint Medicaid Managed Care	$894.60

Know your out-of-pocket cost for care.

All Charges