Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PINNACLE 9FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683728S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

PINNACLE 9FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683728N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$21.53
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.73
Rate for Payer: Oxford Commercial	$11.33
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Commercial	$11.33
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

PINNACLE ALREX POLYETHYLENE AC

Facility

$4,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688887
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

PINNACLE ALREX POLYETHYLENE AC

Facility

$4,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688887
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PINNACLE GRIPTION ACETABULAR

Facility

$6,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688886
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

PINNACLE GRIPTION ACETABULAR

Facility

$6,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688886
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

PINNACLE SHEATH PS/5/10

Facility

$187.00

Hospital Charge Code	270330578
Hospital Revenue Code	278
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$93.50
Rate for Payer: Aetna Commercial	$71.06
Rate for Payer: Aetna Medicare Advantage	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.69
Rate for Payer: Cigna Commercial	$93.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.25
Rate for Payer: Qualcare PPO/HMO/WC	$28.05
Rate for Payer: UnitedHealthcare Community & State	$5.91
Rate for Payer: Wellpoint Medicaid Managed Care	$5.31

PINNACLE SHEATH PS/5/10

Facility

$187.00

Hospital Charge Code	270330578
Hospital Revenue Code	278
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$45.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.25
Rate for Payer: Qualcare PPO/HMO/WC	$28.05

PIN NITINOL ORIENTATION 1.5MM

Facility

$1,000.00

Hospital Charge Code	270680223
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PIN NITINOL ORIENTATION 1.5MM

Facility

$1,000.00

Hospital Charge Code	270680223
Hospital Revenue Code	272
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

PIN ORTHOSORB 1.3MM TAPERED

Facility

$1,310.00

Hospital Charge Code	270676359
Hospital Revenue Code	278
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$317.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.02
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

PIN ORTHOSORB 1.3MM TAPERED

Facility

$1,310.00

Hospital Charge Code	270676359
Hospital Revenue Code	278
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$655.00
Rate for Payer: Aetna Commercial	$497.80
Rate for Payer: Aetna Medicare Advantage	$393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.05
Rate for Payer: Cigna Commercial	$655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.02
Rate for Payer: Qualcare PPO/HMO/WC	$196.50
Rate for Payer: UnitedHealthcare Community & State	$41.40
Rate for Payer: Wellpoint Medicaid Managed Care	$37.20

PIN ORTHOSORB KIT 2.0MM STR

Facility

$1,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270676360
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$343.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.64
Rate for Payer: Qualcare PPO/HMO/WC	$213.00

PIN ORTHOSORB KIT 2.0MM STR

Facility

$1,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270676360
Hospital Revenue Code	278
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$710.00
Rate for Payer: Aetna Commercial	$539.60
Rate for Payer: Aetna Medicare Advantage	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.10
Rate for Payer: Cigna Commercial	$710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.64
Rate for Payer: Qualcare PPO/HMO/WC	$213.00
Rate for Payer: UnitedHealthcare Community & State	$44.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.33

PIN POSITIONING VA 5.0MM

Facility

$976.45

Service Code	HCPCS C1713
Hospital Charge Code	270693773
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

PIN POSITIONING VA 5.0MM

Facility

$976.45

Service Code	HCPCS C1713
Hospital Charge Code	270693773
Hospital Revenue Code	278
Min. Negotiated Rate	$27.73
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$371.05
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Community & State	$30.86
Rate for Payer: Wellpoint Medicaid Managed Care	$27.73

PIN PRECISION TM 3.9X450MM

Facility

$1,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270698905
Hospital Revenue Code	278
Min. Negotiated Rate	$39.62
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$530.10
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Community & State	$44.08
Rate for Payer: Wellpoint Medicaid Managed Care	$39.62

PIN PRECISION TM 3.9X450MM

Facility

$1,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270698905
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

PIN ROD TO SCREW 14600

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270637345
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

PIN ROD TO SCREW 14600

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270637345
Hospital Revenue Code	278
Min. Negotiated Rate	$85.91
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$1,149.50
Rate for Payer: Aetna Medicare Advantage	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.38
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75
Rate for Payer: UnitedHealthcare Community & State	$95.59
Rate for Payer: Wellpoint Medicaid Managed Care	$85.91

PIN ROD TO SCREW 14605

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270637346
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

PIN ROD TO SCREW 14605

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270637346
Hospital Revenue Code	278
Min. Negotiated Rate	$53.39
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$714.40
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: Qualcare PPO/HMO/WC	$282.00
Rate for Payer: UnitedHealthcare Community & State	$59.41
Rate for Payer: Wellpoint Medicaid Managed Care	$53.39

PINS 3.2 X 110 MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270691008
Hospital Revenue Code	278
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$256.88
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.40
Rate for Payer: UnitedHealthcare Community & State	$21.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.20

PINS 3.2 X 110 MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270691008
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

PINS 5.0MM FIXATION CAPS

Facility

$176.65

Service Code	HCPCS C1713
Hospital Charge Code	270638105
Hospital Revenue Code	278
Min. Negotiated Rate	$26.50
Max. Negotiated Rate	$42.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$26.50

Know your out-of-pocket cost for care.

All Charges