Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY DBM W/CHIPS 2CC

Facility

$1,715.00

Hospital Charge Code	270671249
Hospital Revenue Code	278
Min. Negotiated Rate	$257.25
Max. Negotiated Rate	$415.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.03
Rate for Payer: Qualcare PPO/HMO/WC	$257.25

PUTTY DBM W/CHIPS 2CC

Facility

$1,715.00

Hospital Charge Code	270671249
Hospital Revenue Code	278
Min. Negotiated Rate	$48.71
Max. Negotiated Rate	$857.50
Rate for Payer: Aetna Commercial	$651.70
Rate for Payer: Aetna Medicare Advantage	$514.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$343.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.32
Rate for Payer: Cigna Commercial	$857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.03
Rate for Payer: Qualcare PPO/HMO/WC	$257.25
Rate for Payer: UnitedHealthcare Community & State	$54.19
Rate for Payer: Wellpoint Medicaid Managed Care	$48.71

PUTTY DBM W/CHIPS .5CC

Facility

$455.00

Hospital Charge Code	270671247
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$110.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

PUTTY DBM W/CHIPS .5CC

Facility

$455.00

Hospital Charge Code	270671247
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$172.90
Rate for Payer: Aetna Medicare Advantage	$136.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.03
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.11
Rate for Payer: Qualcare PPO/HMO/WC	$68.25
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.92

PUTTY DBM W/CHIPS 5CC

Facility

$3,360.00

Hospital Charge Code	270671250
Hospital Revenue Code	278
Min. Negotiated Rate	$95.42
Max. Negotiated Rate	$1,680.00
Rate for Payer: Aetna Commercial	$1,276.80
Rate for Payer: Aetna Medicare Advantage	$1,008.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$856.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$856.80
Rate for Payer: Cigna Commercial	$1,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$813.12
Rate for Payer: Qualcare PPO/HMO/WC	$504.00
Rate for Payer: UnitedHealthcare Community & State	$106.18
Rate for Payer: Wellpoint Medicaid Managed Care	$95.42

PUTTY DBM W/CHIPS 5CC

Facility

$3,360.00

Hospital Charge Code	270671250
Hospital Revenue Code	278
Min. Negotiated Rate	$504.00
Max. Negotiated Rate	$813.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$672.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$813.12
Rate for Payer: Qualcare PPO/HMO/WC	$504.00

PUTTY DBX 10CC

Facility

$5,630.00

Service Code	HCPCS C1713
Hospital Charge Code	270634796
Hospital Revenue Code	278
Min. Negotiated Rate	$844.50
Max. Negotiated Rate	$1,362.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,362.46
Rate for Payer: Qualcare PPO/HMO/WC	$844.50

PUTTY DBX 10CC

Facility

$5,630.00

Service Code	HCPCS C1713
Hospital Charge Code	270634796
Hospital Revenue Code	278
Min. Negotiated Rate	$159.89
Max. Negotiated Rate	$2,815.00
Rate for Payer: Aetna Commercial	$2,139.40
Rate for Payer: Aetna Medicare Advantage	$1,689.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,435.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,435.65
Rate for Payer: Cigna Commercial	$2,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,362.46
Rate for Payer: Qualcare PPO/HMO/WC	$844.50
Rate for Payer: UnitedHealthcare Community & State	$177.91
Rate for Payer: Wellpoint Medicaid Managed Care	$159.89

PUTTY DBX 10CC

Facility

$7,800.00

Hospital Charge Code	270670905
Hospital Revenue Code	278
Min. Negotiated Rate	$1,170.00
Max. Negotiated Rate	$1,887.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,887.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,170.00

PUTTY DBX 10CC

Facility

$7,800.00

Hospital Charge Code	270670905
Hospital Revenue Code	278
Min. Negotiated Rate	$221.52
Max. Negotiated Rate	$3,900.00
Rate for Payer: Aetna Commercial	$2,964.00
Rate for Payer: Aetna Medicare Advantage	$2,340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,989.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,989.00
Rate for Payer: Cigna Commercial	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,887.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,170.00
Rate for Payer: UnitedHealthcare Community & State	$246.48
Rate for Payer: Wellpoint Medicaid Managed Care	$221.52

PUTTY DBX 1.CC

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270651986
Hospital Revenue Code	278
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$34.76
Rate for Payer: Wellpoint Medicaid Managed Care	$31.24

PUTTY DBX 1.CC

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270651986
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

PUTTY DBX 2.5CC

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270634795
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

PUTTY DBX 2.5CC

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270634795
Hospital Revenue Code	278
Min. Negotiated Rate	$68.16
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$68.16

PUTTY DBX 5.0CC

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270676227
Hospital Revenue Code	278
Min. Negotiated Rate	$783.75
Max. Negotiated Rate	$1,264.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: Qualcare PPO/HMO/WC	$783.75

PUTTY DBX 5.0CC

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270676227
Hospital Revenue Code	278
Min. Negotiated Rate	$148.39
Max. Negotiated Rate	$2,612.50
Rate for Payer: Aetna Commercial	$1,985.50
Rate for Payer: Aetna Medicare Advantage	$1,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,332.38
Rate for Payer: Cigna Commercial	$2,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: Qualcare PPO/HMO/WC	$783.75
Rate for Payer: UnitedHealthcare Community & State	$165.11
Rate for Payer: Wellpoint Medicaid Managed Care	$148.39

PUTTY DBX .5CC

Facility

$695.00

Service Code	HCPCS C1713
Hospital Charge Code	270651984
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

PUTTY DBX .5CC

Facility

$695.00

Service Code	HCPCS C1713
Hospital Charge Code	270651984
Hospital Revenue Code	278
Min. Negotiated Rate	$19.74
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Community & State	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

PUTTY DMB MATRIXOSTEOSELECT5CC

Facility

$3,081.25

Service Code	HCPCS C1713
Hospital Charge Code	270698901
Hospital Revenue Code	278
Min. Negotiated Rate	$87.51
Max. Negotiated Rate	$1,540.62
Rate for Payer: Aetna Commercial	$1,170.88
Rate for Payer: Aetna Medicare Advantage	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$785.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$785.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$785.72
Rate for Payer: Cigna Commercial	$1,540.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.19
Rate for Payer: UnitedHealthcare Community & State	$97.37
Rate for Payer: Wellpoint Medicaid Managed Care	$87.51

PUTTY DMB MATRIXOSTEOSELECT5CC

Facility

$3,081.25

Service Code	HCPCS C1713
Hospital Charge Code	270698901
Hospital Revenue Code	278
Min. Negotiated Rate	$462.19
Max. Negotiated Rate	$745.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.19

PUTTY DPM SYRINGE 1 CC

Facility

$2,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270680748
Hospital Revenue Code	278
Min. Negotiated Rate	$68.87
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$921.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.85
Rate for Payer: Qualcare PPO/HMO/WC	$363.75
Rate for Payer: UnitedHealthcare Community & State	$76.63
Rate for Payer: Wellpoint Medicaid Managed Care	$68.87

PUTTY DPM SYRINGE 1 CC

Facility

$2,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270680748
Hospital Revenue Code	278
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$586.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.85
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

PUTTY FIBER APEX 10CC

Facility

$16,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697835
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

PUTTY FIBER APEX 10CC

Facility

$16,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697835
Hospital Revenue Code	278
Min. Negotiated Rate	$454.40
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$6,080.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$505.60
Rate for Payer: Wellpoint Medicaid Managed Care	$454.40

PUTTY FIBERGRAFT BG 1CC

Facility

$2,049.00

Service Code	HCPCS C1713
Hospital Charge Code	270698988
Hospital Revenue Code	278
Min. Negotiated Rate	$58.19
Max. Negotiated Rate	$1,024.50
Rate for Payer: Aetna Commercial	$778.62
Rate for Payer: Aetna Medicare Advantage	$614.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.50
Rate for Payer: Cigna Commercial	$1,024.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.86
Rate for Payer: Qualcare PPO/HMO/WC	$307.35
Rate for Payer: UnitedHealthcare Community & State	$64.75
Rate for Payer: Wellpoint Medicaid Managed Care	$58.19

Know your out-of-pocket cost for care.

All Charges