Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ROD 80 MM

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693061
Hospital Revenue Code	278
Min. Negotiated Rate	$84.49
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$94.01
Rate for Payer: Wellpoint Medicaid Managed Care	$84.49

ROD 80MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270704748
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

ROD 80MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270704748
Hospital Revenue Code	278
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

ROD 80MM CURVED

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270702586
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

ROD 80MM CURVED

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270702586
Hospital Revenue Code	278
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

ROD 85 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688442
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ROD 85 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688442
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

ROD 90MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270704030
Hospital Revenue Code	278
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$470.00
Rate for Payer: Aetna Commercial	$357.20
Rate for Payer: Aetna Medicare Advantage	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.70
Rate for Payer: Cigna Commercial	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00
Rate for Payer: UnitedHealthcare Community & State	$29.70
Rate for Payer: Wellpoint Medicaid Managed Care	$26.70

ROD 90MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270704030
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$227.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00

ROD ATTACH LG MULTIPIN CLAMP

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699856
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD ATTACH LG MULTIPIN CLAMP

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699856
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

ROD ATTCHMT EX-FIX LG MULTI

Facility

$1,931.25

Service Code	HCPCS C1713
Hospital Charge Code	270635609
Hospital Revenue Code	272
Min. Negotiated Rate	$289.69
Max. Negotiated Rate	$289.69
Rate for Payer: Qualcare PPO/HMO/WC	$289.69

ROD ATTCHMT EX-FIX LG MULTI

Facility

$1,931.25

Service Code	HCPCS C1713
Hospital Charge Code	270635609
Hospital Revenue Code	272
Min. Negotiated Rate	$54.85
Max. Negotiated Rate	$965.62
Rate for Payer: Aetna Commercial	$733.88
Rate for Payer: Aetna Medicare Advantage	$579.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.47
Rate for Payer: Cigna Commercial	$965.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.12
Rate for Payer: Oxford Commercial	$386.25
Rate for Payer: Qualcare PPO/HMO/WC	$289.69
Rate for Payer: UnitedHealthcare Commercial	$386.25
Rate for Payer: UnitedHealthcare Community & State	$61.03
Rate for Payer: Wellpoint Medicaid Managed Care	$54.85

ROD AVATAR 5.5X115MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699332
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

ROD AVATAR 5.5X115MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699332
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

ROD AVATAR LORDOT BUL 5.5X50MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697677
Hospital Revenue Code	278
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) NJ Health	$200.00
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	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

ROD AVATAR LORDOT BUL 5.5X50MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697677
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ROD BENT TILOCK 45MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699241
Hospital Revenue Code	278
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$1,196.25
Rate for Payer: Aetna Commercial	$909.15
Rate for Payer: Aetna Medicare Advantage	$717.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.09
Rate for Payer: Cigna Commercial	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: Qualcare PPO/HMO/WC	$358.88
Rate for Payer: UnitedHealthcare Community & State	$75.60
Rate for Payer: Wellpoint Medicaid Managed Care	$67.95

ROD BENT TILOCK 45MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699241
Hospital Revenue Code	278
Min. Negotiated Rate	$358.88
Max. Negotiated Rate	$578.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: Qualcare PPO/HMO/WC	$358.88

ROD BENT TILOCK 50MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699240
Hospital Revenue Code	278
Min. Negotiated Rate	$358.88
Max. Negotiated Rate	$578.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: Qualcare PPO/HMO/WC	$358.88

ROD BENT TILOCK 50MM

Facility

$2,392.50

Service Code	HCPCS C1713
Hospital Charge Code	270699240
Hospital Revenue Code	278
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$1,196.25
Rate for Payer: Aetna Commercial	$909.15
Rate for Payer: Aetna Medicare Advantage	$717.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$610.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$610.09
Rate for Payer: Cigna Commercial	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.99
Rate for Payer: Qualcare PPO/HMO/WC	$358.88
Rate for Payer: UnitedHealthcare Community & State	$75.60
Rate for Payer: Wellpoint Medicaid Managed Care	$67.95

ROD BRDGNG/EXT FIXTR 190/239MM

Facility

$1,909.60

Hospital Charge Code	270678524
Hospital Revenue Code	272
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$954.80
Rate for Payer: Aetna Commercial	$725.65
Rate for Payer: Aetna Medicare Advantage	$572.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.95
Rate for Payer: Cigna Commercial	$954.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.50
Rate for Payer: Oxford Commercial	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$286.44
Rate for Payer: UnitedHealthcare Commercial	$381.92
Rate for Payer: UnitedHealthcare Community & State	$60.34
Rate for Payer: Wellpoint Medicaid Managed Care	$54.23

ROD BRDGNG/EXT FIXTR 190/239MM

Facility

$1,909.60

Hospital Charge Code	270678524
Hospital Revenue Code	272
Min. Negotiated Rate	$286.44
Max. Negotiated Rate	$286.44
Rate for Payer: Qualcare PPO/HMO/WC	$286.44

ROD BRIDGING 11.0 222MM SHORT

Facility

$1,909.60

Hospital Charge Code	270667998
Hospital Revenue Code	272
Min. Negotiated Rate	$286.44
Max. Negotiated Rate	$286.44
Rate for Payer: Qualcare PPO/HMO/WC	$286.44

ROD BRIDGING 11.0 222MM SHORT

Facility

$1,909.60

Hospital Charge Code	270667998
Hospital Revenue Code	272
Min. Negotiated Rate	$54.23
Max. Negotiated Rate	$954.80
Rate for Payer: Aetna Commercial	$725.65
Rate for Payer: Aetna Medicare Advantage	$572.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.95
Rate for Payer: Cigna Commercial	$954.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.50
Rate for Payer: Oxford Commercial	$381.92
Rate for Payer: Qualcare PPO/HMO/WC	$286.44
Rate for Payer: UnitedHealthcare Commercial	$381.92
Rate for Payer: UnitedHealthcare Community & State	$60.34
Rate for Payer: Wellpoint Medicaid Managed Care	$54.23

Know your out-of-pocket cost for care.

All Charges