Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROSTEP MICA SCREW

Facility

$2,845.25

Hospital Charge Code	270703026
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCREW 3.0 X 34MM

Facility

$5,762.85

Service Code	HCPCS C1713
Hospital Charge Code	270704139
Hospital Revenue Code	278
Min. Negotiated Rate	$163.66
Max. Negotiated Rate	$2,881.43
Rate for Payer: Aetna Commercial	$2,189.88
Rate for Payer: Aetna Medicare Advantage	$1,728.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,469.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,469.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,152.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,469.53
Rate for Payer: Cigna Commercial	$2,881.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.61
Rate for Payer: Qualcare PPO/HMO/WC	$864.43
Rate for Payer: UnitedHealthcare Community & State	$182.11
Rate for Payer: Wellpoint Medicaid Managed Care	$163.66

PROSTEP MICA SCREW 3.0 X 34MM

Facility

$5,762.85

Service Code	HCPCS C1713
Hospital Charge Code	270704139
Hospital Revenue Code	278
Min. Negotiated Rate	$864.43
Max. Negotiated Rate	$1,394.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,152.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.61
Rate for Payer: Qualcare PPO/HMO/WC	$864.43

PROSTEP MICA SCREW 3X20MM

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270703851
Hospital Revenue Code	278
Min. Negotiated Rate	$81.22
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$1,086.80
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

PROSTEP MICA SCREW 3X20MM

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270703851
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

PROSTEP MICA SCREW 3X32MM

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270703852
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

PROSTEP MICA SCREW 3X32MM

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270703852
Hospital Revenue Code	278
Min. Negotiated Rate	$81.22
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$1,086.80
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

PROSTEP MICA SCREW 3X36MM ST

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702608
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCREW 3X36MM ST

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702608
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCREW 4X44 STER

Facility

$5,762.85

Service Code	HCPCS C1713
Hospital Charge Code	270702609
Hospital Revenue Code	278
Min. Negotiated Rate	$163.66
Max. Negotiated Rate	$2,881.43
Rate for Payer: Aetna Commercial	$2,189.88
Rate for Payer: Aetna Medicare Advantage	$1,728.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,469.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,469.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,152.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,469.53
Rate for Payer: Cigna Commercial	$2,881.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.61
Rate for Payer: Qualcare PPO/HMO/WC	$864.43
Rate for Payer: UnitedHealthcare Community & State	$182.11
Rate for Payer: Wellpoint Medicaid Managed Care	$163.66

PROSTEP MICA SCREW 4X44 STER

Facility

$5,762.85

Service Code	HCPCS C1713
Hospital Charge Code	270702609
Hospital Revenue Code	278
Min. Negotiated Rate	$864.43
Max. Negotiated Rate	$1,394.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,152.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.61
Rate for Payer: Qualcare PPO/HMO/WC	$864.43

PROSTEP MICA SCREW 4X46MM

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270703853
Hospital Revenue Code	278
Min. Negotiated Rate	$81.22
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$1,086.80
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$81.22

PROSTEP MICA SCREW 4X46MM

Facility

$2,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270703853
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

PROSTEP MICA SCRW 4X38 STER

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702619
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCRW 4X38 STER

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702619
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTEP MICA SCRW 4X48 ST

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702614
Hospital Revenue Code	278
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$1,081.19
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79
Rate for Payer: UnitedHealthcare Community & State	$89.91
Rate for Payer: Wellpoint Medicaid Managed Care	$80.81

PROSTEP MICA SCRW 4X48 ST

Facility

$2,845.25

Service Code	HCPCS C1713
Hospital Charge Code	270702614
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

PROSTHCERVINTERB 9X28X11MM 5D

Facility

$34,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270694928
Hospital Revenue Code	278
Min. Negotiated Rate	$5,137.50
Max. Negotiated Rate	$8,288.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50

PROSTHCERVINTERB 9X28X11MM 5D

Facility

$34,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270694928
Hospital Revenue Code	278
Min. Negotiated Rate	$972.70
Max. Negotiated Rate	$17,125.00
Rate for Payer: Aetna Commercial	$13,015.00
Rate for Payer: Aetna Medicare Advantage	$10,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,733.75
Rate for Payer: Cigna Commercial	$17,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50
Rate for Payer: UnitedHealthcare Community & State	$1,082.30
Rate for Payer: Wellpoint Medicaid Managed Care	$972.70

PROSTHESIS CUP BI-POLAR 49MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270615751
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

PROSTHESIS CUP BI-POLAR 49MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270615751
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

PROSTHESIS-PENILE AMS700PEN.PR

Facility

$7,608.00

Hospital Charge Code	270335374
Hospital Revenue Code	278
Min. Negotiated Rate	$1,141.20
Max. Negotiated Rate	$1,841.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,841.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.20

PROSTHESIS-PENILE AMS700PEN.PR

Facility

$7,608.00

Hospital Charge Code	270335374
Hospital Revenue Code	278
Min. Negotiated Rate	$216.07
Max. Negotiated Rate	$3,804.00
Rate for Payer: Aetna Commercial	$2,891.04
Rate for Payer: Aetna Medicare Advantage	$2,282.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,940.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,940.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,940.04
Rate for Payer: Cigna Commercial	$3,804.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,841.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.20
Rate for Payer: UnitedHealthcare Community & State	$240.41
Rate for Payer: Wellpoint Medicaid Managed Care	$216.07

PROSTHESIS SPECTRA 9.5MM 20CM

Facility

$37,840.90

Service Code	HCPCS C1776
Hospital Charge Code	270674898
Hospital Revenue Code	278
Min. Negotiated Rate	$5,676.14
Max. Negotiated Rate	$9,157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,568.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,157.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,676.14

PROSTHESIS SPECTRA 9.5MM 20CM

Facility

$37,840.90

Service Code	HCPCS C1776
Hospital Charge Code	270674898
Hospital Revenue Code	278
Min. Negotiated Rate	$1,074.68
Max. Negotiated Rate	$18,920.45
Rate for Payer: Aetna Commercial	$14,379.54
Rate for Payer: Aetna Medicare Advantage	$11,352.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,649.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,649.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,568.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,649.43
Rate for Payer: Cigna Commercial	$18,920.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,157.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,676.14
Rate for Payer: UnitedHealthcare Community & State	$1,195.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1,074.68

Know your out-of-pocket cost for care.

All Charges