Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LOCKING CAPS

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699243
Hospital Revenue Code	278
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

LOCKING CAPS

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699243
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOCKING CAPS

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	270704008
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

LOCKING CAPS SET SCREW

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697898
Hospital Revenue Code	278
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

LOCKING CAPS SET SCREW

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697898
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOCKING CLIP

Facility

$291.00

Hospital Charge Code	270675630
Hospital Revenue Code	272
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$43.65
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

LOCKING CLIP

Facility

$291.00

Hospital Charge Code	270675630
Hospital Revenue Code	272
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$110.58
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.66
Rate for Payer: Oxford Commercial	$58.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.65
Rate for Payer: UnitedHealthcare Commercial	$58.20
Rate for Payer: UnitedHealthcare Community & State	$9.20
Rate for Payer: Wellpoint Medicaid Managed Care	$8.26

LOCKING COVER INT FUS DEV 7MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694458
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

LOCKING COVER INT FUS DEV 7MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694458
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

LOCKING COVER INT FUS DEV 8MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694459
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

LOCKING COVER INT FUS DEV 8MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694459
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

LOCKING DEVICE BIOPSY CAP OLYM

Facility

$46.13

Hospital Charge Code	270674005
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

LOCKING DEVICE BIOPSY CAP OLYM

Facility

$46.13

Hospital Charge Code	270674005
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna Commercial	$17.53
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.99
Rate for Payer: Oxford Commercial	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$9.23
Rate for Payer: UnitedHealthcare Community & State	$1.46
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

LOCKING GUIDE

Facility

$4,975.00

Hospital Charge Code	270688313
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

LOCKING GUIDE

Facility

$4,975.00

Hospital Charge Code	270688313
Hospital Revenue Code	272
Min. Negotiated Rate	$141.29
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,293.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$157.21
Rate for Payer: Wellpoint Medicaid Managed Care	$141.29

LOCKING HINGE 42 HOLE

Facility

$1,021.65

Service Code	HCPCS C1713
Hospital Charge Code	270683956
Hospital Revenue Code	278
Min. Negotiated Rate	$29.01
Max. Negotiated Rate	$510.82
Rate for Payer: Aetna Commercial	$388.23
Rate for Payer: Aetna Medicare Advantage	$306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: Qualcare PPO/HMO/WC	$153.25
Rate for Payer: UnitedHealthcare Community & State	$32.28
Rate for Payer: Wellpoint Medicaid Managed Care	$29.01

LOCKING HINGE 42 HOLE

Facility

$1,021.65

Service Code	HCPCS C1713
Hospital Charge Code	270683956
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$247.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

LOCKING NUT OCT SYST

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270694399
Hospital Revenue Code	278
Min. Negotiated Rate	$21.41
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$23.83
Rate for Payer: Wellpoint Medicaid Managed Care	$21.41

LOCKING NUT OCT SYST

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270694399
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

LOCKING PIN

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270638569
Hospital Revenue Code	278
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$287.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50

LOCKING PIN

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270638569
Hospital Revenue Code	278
Min. Negotiated Rate	$33.80
Max. Negotiated Rate	$595.00
Rate for Payer: Aetna Commercial	$452.20
Rate for Payer: Aetna Medicare Advantage	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.45
Rate for Payer: Cigna Commercial	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50
Rate for Payer: UnitedHealthcare Community & State	$37.60
Rate for Payer: Wellpoint Medicaid Managed Care	$33.80

LOCKING PLATE 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686455
Hospital Revenue Code	278
Min. Negotiated Rate	$110.05
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$122.45
Rate for Payer: Wellpoint Medicaid Managed Care	$110.05

LOCKING PLATE 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686455
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LOCKING SCREW 2.4X24MM

Facility

$1,146.60

Service Code	HCPCS C1713
Hospital Charge Code	270704718
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

LOCKING SCREW 2.4X24MM

Facility

$1,146.60

Service Code	HCPCS C1713
Hospital Charge Code	270704718
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

Know your out-of-pocket cost for care.

All Charges