Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NCB DRILL BIT 4.3MM X 195MM

Facility

$901.45

Hospital Charge Code	270679965
Hospital Revenue Code	272
Min. Negotiated Rate	$25.60
Max. Negotiated Rate	$450.73
Rate for Payer: Aetna Commercial	$342.55
Rate for Payer: Aetna Medicare Advantage	$270.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.87
Rate for Payer: Cigna Commercial	$450.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.38
Rate for Payer: Oxford Commercial	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$135.22
Rate for Payer: UnitedHealthcare Commercial	$180.29
Rate for Payer: UnitedHealthcare Community & State	$28.49
Rate for Payer: Wellpoint Medicaid Managed Care	$25.60

NCB LOCKING SCREW CAP

Facility

$637.50

Service Code	HCPCS C1713
Hospital Charge Code	270679963
Hospital Revenue Code	278
Min. Negotiated Rate	$95.62
Max. Negotiated Rate	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.28
Rate for Payer: Qualcare PPO/HMO/WC	$95.62

NCB LOCKING SCREW CAP

Facility

$637.50

Service Code	HCPCS C1713
Hospital Charge Code	270679963
Hospital Revenue Code	278
Min. Negotiated Rate	$18.11
Max. Negotiated Rate	$318.75
Rate for Payer: Aetna Commercial	$242.25
Rate for Payer: Aetna Medicare Advantage	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.56
Rate for Payer: Cigna Commercial	$318.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.28
Rate for Payer: Qualcare PPO/HMO/WC	$95.62
Rate for Payer: UnitedHealthcare Community & State	$20.14
Rate for Payer: Wellpoint Medicaid Managed Care	$18.11

NCB PP PROX FEM PLT R,L 245MM

Facility

$5,482.50

Service Code	HCPCS C1713
Hospital Charge Code	270679955
Hospital Revenue Code	278
Min. Negotiated Rate	$822.38
Max. Negotiated Rate	$1,326.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,096.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.77
Rate for Payer: Qualcare PPO/HMO/WC	$822.38

NCB PP PROX FEM PLT R,L 245MM

Facility

$5,482.50

Service Code	HCPCS C1713
Hospital Charge Code	270679955
Hospital Revenue Code	278
Min. Negotiated Rate	$155.70
Max. Negotiated Rate	$2,741.25
Rate for Payer: Aetna Commercial	$2,083.35
Rate for Payer: Aetna Medicare Advantage	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,398.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,398.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,398.04
Rate for Payer: Cigna Commercial	$2,741.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.77
Rate for Payer: Qualcare PPO/HMO/WC	$822.38
Rate for Payer: UnitedHealthcare Community & State	$173.25
Rate for Payer: Wellpoint Medicaid Managed Care	$155.70

NCB SCR 5.0 L = 90MM

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704137
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 SCR 5.0 L = 90MM

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704137
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 TROC PLATE RIGHT NARROW

Facility

$4,054.50

Service Code	HCPCS C1713
Hospital Charge Code	270679954
Hospital Revenue Code	278
Min. Negotiated Rate	$115.15
Max. Negotiated Rate	$2,027.25
Rate for Payer: Aetna Commercial	$1,540.71
Rate for Payer: Aetna Medicare Advantage	$1,216.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,033.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,033.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,033.90
Rate for Payer: Cigna Commercial	$2,027.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$981.19
Rate for Payer: Qualcare PPO/HMO/WC	$608.17
Rate for Payer: UnitedHealthcare Community & State	$128.12
Rate for Payer: Wellpoint Medicaid Managed Care	$115.15

NCB TROC PLATE RIGHT NARROW

Facility

$4,054.50

Service Code	HCPCS C1713
Hospital Charge Code	270679954
Hospital Revenue Code	278
Min. Negotiated Rate	$608.17
Max. Negotiated Rate	$981.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$981.19
Rate for Payer: Qualcare PPO/HMO/WC	$608.17

NC NEO TREK RX 1.50 X 15

Facility

$500.00

Hospital Charge Code	270704282
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC NEO TREK RX 1.50 X 15

Facility

$500.00

Hospital Charge Code	270704282
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX

Facility

$500.00

Hospital Charge Code	270705316
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC TREK NEO RX

Facility

$500.00

Hospital Charge Code	270705316
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 1.50 X 12

Facility

$500.00

Hospital Charge Code	270704281
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 1.50 X 12

Facility

$500.00

Hospital Charge Code	270704281
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC TREK NEO RX 1.50 X 20

Facility

$500.00

Hospital Charge Code	270704283
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 1.50 X 20

Facility

$500.00

Hospital Charge Code	270704283
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC TREK NEO RX 1.50X6

Facility

$500.00

Hospital Charge Code	270704278
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 1.50X6

Facility

$500.00

Hospital Charge Code	270704278
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC TREK NEO RX 1.50 X 8

Facility

$500.00

Hospital Charge Code	270704280
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 1.50 X 8

Facility

$500.00

Hospital Charge Code	270704280
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC TREK NEO RX 2.00 X 12

Facility

$500.00

Hospital Charge Code	270704291
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 2.00 X 12

Facility

$500.00

Hospital Charge Code	270704291
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

NC TREK NEO RX 2.00 X 15

Facility

$500.00

Hospital Charge Code	270704292
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

NC TREK NEO RX 2.00 X 15

Facility

$500.00

Hospital Charge Code	270704292
Hospital Revenue Code	272
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) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

Know your out-of-pocket cost for care.

All Charges