Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

270701711

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701711
Hospital Revenue Code	278
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$34.33
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

270701711

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701711
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

2.75 CANNULATED DRILL

Facility

$935.00

Hospital Charge Code	270687158
Hospital Revenue Code	272
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.10
Rate for Payer: Oxford Commercial	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Commercial	$187.00
Rate for Payer: UnitedHealthcare Community & State	$29.55
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

2.75 CANNULATED DRILL

Facility

$935.00

Hospital Charge Code	270687158
Hospital Revenue Code	272
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$140.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

2.7 DISTAL FIB. PLATE 9 HOLE

Facility

$4,533.05

Service Code	HCPCS C1713
Hospital Charge Code	270677405
Hospital Revenue Code	278
Min. Negotiated Rate	$679.96
Max. Negotiated Rate	$1,097.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,097.00
Rate for Payer: Qualcare PPO/HMO/WC	$679.96

2.7 DISTAL FIB. PLATE 9 HOLE

Facility

$4,533.05

Service Code	HCPCS C1713
Hospital Charge Code	270677405
Hospital Revenue Code	278
Min. Negotiated Rate	$128.74
Max. Negotiated Rate	$2,266.53
Rate for Payer: Aetna Commercial	$1,722.56
Rate for Payer: Aetna Medicare Advantage	$1,359.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,155.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,155.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,155.93
Rate for Payer: Cigna Commercial	$2,266.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,097.00
Rate for Payer: Qualcare PPO/HMO/WC	$679.96
Rate for Payer: UnitedHealthcare Community & State	$143.24
Rate for Payer: Wellpoint Medicaid Managed Care	$128.74

2.7 DRILL

Facility

$1,463.40

Service Code	HCPCS C1713
Hospital Charge Code	270705250
Hospital Revenue Code	278
Min. Negotiated Rate	$41.56
Max. Negotiated Rate	$731.70
Rate for Payer: Aetna Commercial	$556.09
Rate for Payer: Aetna Medicare Advantage	$439.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.17
Rate for Payer: Cigna Commercial	$731.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.14
Rate for Payer: Qualcare PPO/HMO/WC	$219.51
Rate for Payer: UnitedHealthcare Community & State	$46.24
Rate for Payer: Wellpoint Medicaid Managed Care	$41.56

2.7 DRILL

Facility

$1,463.40

Service Code	HCPCS C1713
Hospital Charge Code	270705250
Hospital Revenue Code	278
Min. Negotiated Rate	$219.51
Max. Negotiated Rate	$354.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.14
Rate for Payer: Qualcare PPO/HMO/WC	$219.51

2.7 DRILL

Facility

$1,463.40

Service Code	HCPCS C1713
Hospital Charge Code	270703607
Hospital Revenue Code	278
Min. Negotiated Rate	$219.51
Max. Negotiated Rate	$354.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.14
Rate for Payer: Qualcare PPO/HMO/WC	$219.51

2.7 DRILL

Facility

$1,463.40

Service Code	HCPCS C1713
Hospital Charge Code	270703607
Hospital Revenue Code	278
Min. Negotiated Rate	$41.56
Max. Negotiated Rate	$731.70
Rate for Payer: Aetna Commercial	$556.09
Rate for Payer: Aetna Medicare Advantage	$439.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.17
Rate for Payer: Cigna Commercial	$731.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.14
Rate for Payer: Qualcare PPO/HMO/WC	$219.51
Rate for Payer: UnitedHealthcare Community & State	$46.24
Rate for Payer: Wellpoint Medicaid Managed Care	$41.56

2.7 DRILL BIT

Facility

$610.00

Hospital Charge Code	270672025
Hospital Revenue Code	272
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.60
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

2.7 DRILL BIT

Facility

$610.00

Hospital Charge Code	270672025
Hospital Revenue Code	272
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

2.7 LCP 8 HOLE PLATE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270674355
Hospital Revenue Code	278
Min. Negotiated Rate	$263.73
Max. Negotiated Rate	$425.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: Qualcare PPO/HMO/WC	$263.73

2.7 LCP 8 HOLE PLATE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270674355
Hospital Revenue Code	278
Min. Negotiated Rate	$49.93
Max. Negotiated Rate	$879.10
Rate for Payer: Aetna Commercial	$668.12
Rate for Payer: Aetna Medicare Advantage	$527.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.34
Rate for Payer: Cigna Commercial	$879.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: Qualcare PPO/HMO/WC	$263.73
Rate for Payer: UnitedHealthcare Community & State	$55.56
Rate for Payer: Wellpoint Medicaid Managed Care	$49.93

2.7MM 12MM SCREW

Facility

$190.15

Hospital Charge Code	270604187
Hospital Revenue Code	278
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$95.08
Rate for Payer: Aetna Commercial	$72.26
Rate for Payer: Aetna Medicare Advantage	$57.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.49
Rate for Payer: Cigna Commercial	$95.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.02
Rate for Payer: Qualcare PPO/HMO/WC	$28.52
Rate for Payer: UnitedHealthcare Community & State	$6.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.40

2.7MM 12MM SCREW

Facility

$190.15

Hospital Charge Code	270604187
Hospital Revenue Code	278
Min. Negotiated Rate	$28.52
Max. Negotiated Rate	$46.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.02
Rate for Payer: Qualcare PPO/HMO/WC	$28.52

2.7MM CALIB DRILL BIT

Facility

$495.00

Hospital Charge Code	270648303
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

2.7MM CALIB DRILL BIT

Facility

$495.00

Hospital Charge Code	270648303
Hospital Revenue Code	272
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.70
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

2.7MM CALIB DRILL BIT

Facility

$495.00

Hospital Charge Code	270658916
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

2.7MM CALIB DRILL BIT

Facility

$495.00

Hospital Charge Code	270658916
Hospital Revenue Code	272
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.70
Rate for Payer: Oxford Commercial	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$99.00
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

2.7MM CORTEX SCREW L30MM

Facility

$585.00

Service Code	HCPCS C1713
Hospital Charge Code	270704201
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

2.7MM CORTEX SCREW L30MM

Facility

$585.00

Service Code	HCPCS C1713
Hospital Charge Code	270704201
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

2.7MM CORTICAL SCREW 16MM LONG

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270676507
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

2.7MM CORTICAL SCREW 16MM LONG

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270676507
Hospital Revenue Code	278
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$33.65
Rate for Payer: Wellpoint Medicaid Managed Care	$30.25

2.7MM LOCKING SCREW 16MM

Facility

$558.00

Hospital Charge Code	270665471
Hospital Revenue Code	278
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$279.00
Rate for Payer: Aetna Commercial	$212.04
Rate for Payer: Aetna Medicare Advantage	$167.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.29
Rate for Payer: Cigna Commercial	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.04
Rate for Payer: Qualcare PPO/HMO/WC	$83.70
Rate for Payer: UnitedHealthcare Community & State	$17.63
Rate for Payer: Wellpoint Medicaid Managed Care	$15.85

Know your out-of-pocket cost for care.

All Charges