Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	16000164
Hospital Revenue Code	360
Min. Negotiated Rate	$191.71
Max. Negotiated Rate	$191.71
Rate for Payer: Qualcare PPO/HMO/WC	$191.71

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	1600000335
Hospital Revenue Code	360
Min. Negotiated Rate	$191.71
Max. Negotiated Rate	$191.71
Rate for Payer: Qualcare PPO/HMO/WC	$191.71

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	16000164
Hospital Revenue Code	360
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.29
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.71
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$40.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	1600000335
Hospital Revenue Code	360
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,185.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,185.09
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.29
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.71
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$40.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

NCB CABL BUTTON POLY LOCK PLT

Facility

$714.00

Service Code	HCPCS C1713
Hospital Charge Code	270679953
Hospital Revenue Code	278
Min. Negotiated Rate	$20.28
Max. Negotiated Rate	$357.00
Rate for Payer: Aetna Commercial	$271.32
Rate for Payer: Aetna Medicare Advantage	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.07
Rate for Payer: Cigna Commercial	$357.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.79
Rate for Payer: Qualcare PPO/HMO/WC	$107.10
Rate for Payer: UnitedHealthcare Community & State	$22.56
Rate for Payer: Wellpoint Medicaid Managed Care	$20.28

NCB CABL BUTTON POLY LOCK PLT

Facility

$714.00

Service Code	HCPCS C1713
Hospital Charge Code	270679953
Hospital Revenue Code	278
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$172.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.79
Rate for Payer: Qualcare PPO/HMO/WC	$107.10

NCB CORT SCREW 5.0X38MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704130
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X38MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704130
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X40MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704131
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X40MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704131
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X42MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704133
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X42MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704133
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X46MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704134
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X46MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704134
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X48MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704135
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X48MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704135
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X50MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704132
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X50MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704132
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X65MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704136
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5.0X65MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704136
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5 X34MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679961
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5 X34MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679961
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5X36MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679962
Hospital Revenue Code	278
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$38.66
Rate for Payer: Wellpoint Medicaid Managed Care	$34.74

NCB CORT SCREW 5X36MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679962
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB DRILL BIT 4.3MM X 195MM

Facility

$901.45

Hospital Charge Code	270679965
Hospital Revenue Code	272
Min. Negotiated Rate	$135.22
Max. Negotiated Rate	$135.22
Rate for Payer: Qualcare PPO/HMO/WC	$135.22

Know your out-of-pocket cost for care.

All Charges