Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RELIATACK FIXATION DEVICE 3X10

Facility

$4,317.55

Hospital Charge Code	270672733
Hospital Revenue Code	272
Min. Negotiated Rate	$647.63
Max. Negotiated Rate	$647.63
Rate for Payer: Qualcare PPO/HMO/WC	$647.63

RELIATACK FIXATION DEVICE 3X10

Facility

$4,317.55

Hospital Charge Code	270672733
Hospital Revenue Code	272
Min. Negotiated Rate	$122.62
Max. Negotiated Rate	$2,158.78
Rate for Payer: Aetna Commercial	$1,640.67
Rate for Payer: Aetna Medicare Advantage	$1,295.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,100.98
Rate for Payer: Cigna Commercial	$2,158.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,122.56
Rate for Payer: Oxford Commercial	$863.51
Rate for Payer: Qualcare PPO/HMO/WC	$647.63
Rate for Payer: UnitedHealthcare Commercial	$863.51
Rate for Payer: UnitedHealthcare Community & State	$136.43
Rate for Payer: Wellpoint Medicaid Managed Care	$122.62

RELINE MAS TAP 5.5MM CANN

Facility

$3,290.05

Hospital Charge Code	270696209
Hospital Revenue Code	272
Min. Negotiated Rate	$493.51
Max. Negotiated Rate	$493.51
Rate for Payer: Qualcare PPO/HMO/WC	$493.51

RELINE MAS TAP 5.5MM CANN

Facility

$3,290.05

Hospital Charge Code	270696209
Hospital Revenue Code	272
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$1,645.03
Rate for Payer: Aetna Commercial	$1,250.22
Rate for Payer: Aetna Medicare Advantage	$987.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$838.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$838.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$838.96
Rate for Payer: Cigna Commercial	$1,645.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$855.41
Rate for Payer: Oxford Commercial	$658.01
Rate for Payer: Qualcare PPO/HMO/WC	$493.51
Rate for Payer: UnitedHealthcare Commercial	$658.01
Rate for Payer: UnitedHealthcare Community & State	$103.97
Rate for Payer: Wellpoint Medicaid Managed Care	$93.44

RELINE O TI ROD 5.5 X 40 MM LO

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270691446
Hospital Revenue Code	278
Min. Negotiated Rate	$594.00
Max. Negotiated Rate	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: Qualcare PPO/HMO/WC	$594.00

RELINE O TI ROD 5.5 X 40 MM LO

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270691446
Hospital Revenue Code	278
Min. Negotiated Rate	$112.46
Max. Negotiated Rate	$1,980.00
Rate for Payer: Aetna Commercial	$1,504.80
Rate for Payer: Aetna Medicare Advantage	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.80
Rate for Payer: Cigna Commercial	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: Qualcare PPO/HMO/WC	$594.00
Rate for Payer: UnitedHealthcare Community & State	$125.14
Rate for Payer: Wellpoint Medicaid Managed Care	$112.46

RELINE O TI ROD 5.5X45 MM LORD

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270692796
Hospital Revenue Code	278
Min. Negotiated Rate	$594.00
Max. Negotiated Rate	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: Qualcare PPO/HMO/WC	$594.00

RELINE O TI ROD 5.5X45 MM LORD

Facility

$3,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270692796
Hospital Revenue Code	278
Min. Negotiated Rate	$112.46
Max. Negotiated Rate	$1,980.00
Rate for Payer: Aetna Commercial	$1,504.80
Rate for Payer: Aetna Medicare Advantage	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.80
Rate for Payer: Cigna Commercial	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: Qualcare PPO/HMO/WC	$594.00
Rate for Payer: UnitedHealthcare Community & State	$125.14
Rate for Payer: Wellpoint Medicaid Managed Care	$112.46

RELINE TULIP MOD

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691445
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

RELINE TULIP MOD

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691445
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

RELOAD 45MM (6ROW, X-LONG)

Facility

$184.00

Hospital Charge Code	270338718
Hospital Revenue Code	272
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

RELOAD 45MM (6ROW, X-LONG)

Facility

$184.00

Hospital Charge Code	270338718
Hospital Revenue Code	272
Min. Negotiated Rate	$5.23
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$69.92
Rate for Payer: Aetna Medicare Advantage	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.92
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.84
Rate for Payer: Oxford Commercial	$36.80
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$36.80
Rate for Payer: UnitedHealthcare Community & State	$5.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.23

RELOADABLE LINEAR STAPLER 30MM

Facility

$585.00

Hospital Charge Code	270334722
Hospital Revenue Code	272
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

RELOADABLE LINEAR STAPLER 30MM

Facility

$585.00

Hospital Charge Code	270334722
Hospital Revenue Code	272
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) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.10
Rate for Payer: Oxford Commercial	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$117.00
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

RELOAD ARTICUL CUTTER 35MM WHT

Facility

$274.48

Hospital Charge Code	270608644
Hospital Revenue Code	272
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$41.17
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

RELOAD ARTICUL CUTTER 35MM WHT

Facility

$274.48

Hospital Charge Code	270608644
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$137.24
Rate for Payer: Aetna Commercial	$104.30
Rate for Payer: Aetna Medicare Advantage	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.99
Rate for Payer: Cigna Commercial	$137.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.36
Rate for Payer: Oxford Commercial	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Commercial	$54.90
Rate for Payer: UnitedHealthcare Community & State	$8.67
Rate for Payer: Wellpoint Medicaid Managed Care	$7.80

RELOAD ECHELON 35MM WHITE

Facility

$792.08

Hospital Charge Code	270676633
Hospital Revenue Code	272
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$118.81
Rate for Payer: Qualcare PPO/HMO/WC	$118.81

RELOAD ECHELON 35MM WHITE

Facility

$792.08

Hospital Charge Code	270676633
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$396.04
Rate for Payer: Aetna Commercial	$300.99
Rate for Payer: Aetna Medicare Advantage	$237.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.98
Rate for Payer: Cigna Commercial	$396.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.94
Rate for Payer: Oxford Commercial	$158.42
Rate for Payer: Qualcare PPO/HMO/WC	$118.81
Rate for Payer: UnitedHealthcare Commercial	$158.42
Rate for Payer: UnitedHealthcare Community & State	$25.03
Rate for Payer: Wellpoint Medicaid Managed Care	$22.50

RELOAD ECHELON 45 BLUE

Facility

$879.45

Hospital Charge Code	270662759
Hospital Revenue Code	272
Min. Negotiated Rate	$131.92
Max. Negotiated Rate	$131.92
Rate for Payer: Qualcare PPO/HMO/WC	$131.92

RELOAD ECHELON 45 BLUE

Facility

$879.45

Hospital Charge Code	270662759
Hospital Revenue Code	272
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$439.73
Rate for Payer: Aetna Commercial	$334.19
Rate for Payer: Aetna Medicare Advantage	$263.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.26
Rate for Payer: Cigna Commercial	$439.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.66
Rate for Payer: Oxford Commercial	$175.89
Rate for Payer: Qualcare PPO/HMO/WC	$131.92
Rate for Payer: UnitedHealthcare Commercial	$175.89
Rate for Payer: UnitedHealthcare Community & State	$27.79
Rate for Payer: Wellpoint Medicaid Managed Care	$24.98

RELOAD ECHELON 45 GOLD

Facility

$1,367.20

Hospital Charge Code	270662921
Hospital Revenue Code	272
Min. Negotiated Rate	$38.83
Max. Negotiated Rate	$683.60
Rate for Payer: Aetna Commercial	$519.54
Rate for Payer: Aetna Medicare Advantage	$410.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.64
Rate for Payer: Cigna Commercial	$683.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.47
Rate for Payer: Oxford Commercial	$273.44
Rate for Payer: Qualcare PPO/HMO/WC	$205.08
Rate for Payer: UnitedHealthcare Commercial	$273.44
Rate for Payer: UnitedHealthcare Community & State	$43.20
Rate for Payer: Wellpoint Medicaid Managed Care	$38.83

RELOAD ECHELON 45 GOLD

Facility

$1,367.20

Hospital Charge Code	270662921
Hospital Revenue Code	272
Min. Negotiated Rate	$205.08
Max. Negotiated Rate	$205.08
Rate for Payer: Qualcare PPO/HMO/WC	$205.08

RELOAD ECHELON 45 GRAY

Facility

$879.45

Hospital Charge Code	270662923
Hospital Revenue Code	272
Min. Negotiated Rate	$131.92
Max. Negotiated Rate	$131.92
Rate for Payer: Qualcare PPO/HMO/WC	$131.92

RELOAD ECHELON 45 GRAY

Facility

$879.45

Hospital Charge Code	270662923
Hospital Revenue Code	272
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$439.73
Rate for Payer: Aetna Commercial	$334.19
Rate for Payer: Aetna Medicare Advantage	$263.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.26
Rate for Payer: Cigna Commercial	$439.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.66
Rate for Payer: Oxford Commercial	$175.89
Rate for Payer: Qualcare PPO/HMO/WC	$131.92
Rate for Payer: UnitedHealthcare Commercial	$175.89
Rate for Payer: UnitedHealthcare Community & State	$27.79
Rate for Payer: Wellpoint Medicaid Managed Care	$24.98

RELOAD ECHELON 45 GREEN

Facility

$877.45

Hospital Charge Code	270662922
Hospital Revenue Code	272
Min. Negotiated Rate	$131.62
Max. Negotiated Rate	$131.62
Rate for Payer: Qualcare PPO/HMO/WC	$131.62

Know your out-of-pocket cost for care.

All Charges