Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

longevity dm bearing 28 x 40mm

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270690807
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

LONG FEMUR SCREW

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270688192
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$86.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

LONG FEMUR SCREW

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270688192
Hospital Revenue Code	278
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$178.50
Rate for Payer: Aetna Commercial	$135.66
Rate for Payer: Aetna Medicare Advantage	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.03
Rate for Payer: Cigna Commercial	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.14

LONG LEFT PERC PLATE

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270681319
Hospital Revenue Code	278
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$1,324.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

LONG LEFT PERC PLATE

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270681319
Hospital Revenue Code	278
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$2,080.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Community & State	$173.01
Rate for Payer: Wellpoint Medicaid Managed Care	$155.49

LONG NAIL 10MMX440MM LEFT 125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705156
Hospital Revenue Code	278
Min. Negotiated Rate	$533.74
Max. Negotiated Rate	$9,396.90
Rate for Payer: Aetna Commercial	$7,141.64
Rate for Payer: Aetna Medicare Advantage	$5,638.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,792.42
Rate for Payer: Cigna Commercial	$9,396.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07
Rate for Payer: UnitedHealthcare Community & State	$593.88
Rate for Payer: Wellpoint Medicaid Managed Care	$533.74

LONG NAIL 10MMX440MM LEFT 125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705156
Hospital Revenue Code	278
Min. Negotiated Rate	$2,819.07
Max. Negotiated Rate	$4,548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07

LONG NAIL 10x360MM 130 DEG

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270673643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.16
Max. Negotiated Rate	$3,160.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16

LONG NAIL 10x360MM 130 DEG

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270673643
Hospital Revenue Code	278
Min. Negotiated Rate	$370.94
Max. Negotiated Rate	$6,530.55
Rate for Payer: Aetna Commercial	$4,963.22
Rate for Payer: Aetna Medicare Advantage	$3,918.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.58
Rate for Payer: Cigna Commercial	$6,530.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16
Rate for Payer: UnitedHealthcare Community & State	$412.73
Rate for Payer: Wellpoint Medicaid Managed Care	$370.94

LONG NAIL KIT RT 11x340MMx125

Facility

$13,060.00

Hospital Charge Code	270675304
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.00
Max. Negotiated Rate	$3,160.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.00

LONG NAIL KIT RT 11x340MMx125

Facility

$13,060.00

Hospital Charge Code	270675304
Hospital Revenue Code	278
Min. Negotiated Rate	$370.90
Max. Negotiated Rate	$6,530.00
Rate for Payer: Aetna Commercial	$4,962.80
Rate for Payer: Aetna Medicare Advantage	$3,918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.30
Rate for Payer: Cigna Commercial	$6,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.00
Rate for Payer: UnitedHealthcare Community & State	$412.70
Rate for Payer: Wellpoint Medicaid Managed Care	$370.90

LONG NAIL LEFT

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705862
Hospital Revenue Code	278
Min. Negotiated Rate	$533.74
Max. Negotiated Rate	$9,396.90
Rate for Payer: Aetna Commercial	$7,141.64
Rate for Payer: Aetna Medicare Advantage	$5,638.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,792.42
Rate for Payer: Cigna Commercial	$9,396.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07
Rate for Payer: UnitedHealthcare Community & State	$593.88
Rate for Payer: Wellpoint Medicaid Managed Care	$533.74

LONG NAIL LEFT

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705862
Hospital Revenue Code	278
Min. Negotiated Rate	$2,819.07
Max. Negotiated Rate	$4,548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07

LONG NAIL, RIGHT 10X380MMX125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705682
Hospital Revenue Code	278
Min. Negotiated Rate	$533.74
Max. Negotiated Rate	$9,396.90
Rate for Payer: Aetna Commercial	$7,141.64
Rate for Payer: Aetna Medicare Advantage	$5,638.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,792.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,792.42
Rate for Payer: Cigna Commercial	$9,396.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07
Rate for Payer: UnitedHealthcare Community & State	$593.88
Rate for Payer: Wellpoint Medicaid Managed Care	$533.74

LONG NAIL, RIGHT 10X380MMX125D

Facility

$18,793.80

Service Code	HCPCS C1713
Hospital Charge Code	270705682
Hospital Revenue Code	278
Min. Negotiated Rate	$2,819.07
Max. Negotiated Rate	$4,548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,758.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,548.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,819.07

LONG POST

Facility

$1,020.00

Hospital Charge Code	270339500
Hospital Revenue Code	272
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$153.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

LONG POST

Facility

$1,020.00

Hospital Charge Code	270339500
Hospital Revenue Code	272
Min. Negotiated Rate	$28.97
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.20
Rate for Payer: Oxford Commercial	$204.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Commercial	$204.00
Rate for Payer: UnitedHealthcare Community & State	$32.23
Rate for Payer: Wellpoint Medicaid Managed Care	$28.97

LONITEN/10MG/TAB

Facility

$11.32

Service Code	NDC 49884025701
Hospital Charge Code	60633314
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.66
Rate for Payer: Aetna Commercial	$4.30
Rate for Payer: Aetna Medicare Advantage	$3.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.89
Rate for Payer: Cigna Commercial	$5.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.94
Rate for Payer: Oxford Commercial	$2.26
Rate for Payer: Qualcare PPO/HMO/WC	$1.70
Rate for Payer: UnitedHealthcare Commercial	$2.26
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

LONITEN/10MG/TAB

Facility

$11.32

Service Code	NDC 49884025701
Hospital Charge Code	60633314
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.70

LOOP CUTTING 24FR

Facility

$337.50

Hospital Charge Code	270658548
Hospital Revenue Code	272
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$50.62
Rate for Payer: Qualcare PPO/HMO/WC	$50.62

LOOP CUTTING 24FR

Facility

$337.50

Hospital Charge Code	270658548
Hospital Revenue Code	272
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$168.75
Rate for Payer: Aetna Commercial	$128.25
Rate for Payer: Aetna Medicare Advantage	$101.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.06
Rate for Payer: Cigna Commercial	$168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Oxford Commercial	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$50.62
Rate for Payer: UnitedHealthcare Commercial	$67.50
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.59

LOOP CUT TUR 24F 27050G-6

Facility

$561.75

Hospital Charge Code	270601253
Hospital Revenue Code	272
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$280.88
Rate for Payer: Aetna Commercial	$213.47
Rate for Payer: Aetna Medicare Advantage	$168.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.25
Rate for Payer: Cigna Commercial	$280.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.06
Rate for Payer: Oxford Commercial	$112.35
Rate for Payer: Qualcare PPO/HMO/WC	$84.26
Rate for Payer: UnitedHealthcare Commercial	$112.35
Rate for Payer: UnitedHealthcare Community & State	$17.75
Rate for Payer: Wellpoint Medicaid Managed Care	$15.95

LOOP CUT TUR 24F 27050G-6

Facility

$561.75

Hospital Charge Code	270601253
Hospital Revenue Code	272
Min. Negotiated Rate	$84.26
Max. Negotiated Rate	$84.26
Rate for Payer: Qualcare PPO/HMO/WC	$84.26

LOOP ELECTRODE

Facility

$389.00

Hospital Charge Code	270335247
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$194.50
Rate for Payer: Aetna Commercial	$147.82
Rate for Payer: Aetna Medicare Advantage	$116.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.19
Rate for Payer: Cigna Commercial	$194.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.14
Rate for Payer: Oxford Commercial	$77.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.35
Rate for Payer: UnitedHealthcare Commercial	$77.80
Rate for Payer: UnitedHealthcare Community & State	$12.29
Rate for Payer: Wellpoint Medicaid Managed Care	$11.05

LOOP ELECTRODE

Facility

$389.00

Hospital Charge Code	270335247
Hospital Revenue Code	272
Min. Negotiated Rate	$58.35
Max. Negotiated Rate	$58.35
Rate for Payer: Qualcare PPO/HMO/WC	$58.35

Know your out-of-pocket cost for care.

All Charges