Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ROD CARBON 300MM

Facility

$845.00

Service Code	HCPCS C1713
Hospital Charge Code	270699328
Hospital Revenue Code	278
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$422.50
Rate for Payer: Aetna Commercial	$321.10
Rate for Payer: Aetna Medicare Advantage	$253.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.47
Rate for Payer: Cigna Commercial	$422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.49
Rate for Payer: Qualcare PPO/HMO/WC	$126.75
Rate for Payer: UnitedHealthcare Community & State	$26.70
Rate for Payer: Wellpoint Medicaid Managed Care	$24.00

ROD CARBON 400MM

Facility

$845.00

Service Code	HCPCS C1713
Hospital Charge Code	270699329
Hospital Revenue Code	278
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$422.50
Rate for Payer: Aetna Commercial	$321.10
Rate for Payer: Aetna Medicare Advantage	$253.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.47
Rate for Payer: Cigna Commercial	$422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.49
Rate for Payer: Qualcare PPO/HMO/WC	$126.75
Rate for Payer: UnitedHealthcare Community & State	$26.70
Rate for Payer: Wellpoint Medicaid Managed Care	$24.00

ROD CARBON 400MM

Facility

$845.00

Service Code	HCPCS C1713
Hospital Charge Code	270699329
Hospital Revenue Code	278
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$204.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.49
Rate for Payer: Qualcare PPO/HMO/WC	$126.75

ROD CARBON 450MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700199
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 CARBON 450MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700199
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 CARBON 5X150MM

Facility

$820.00

Hospital Charge Code	270669005
Hospital Revenue Code	278
Min. Negotiated Rate	$23.29
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

ROD CARBON 5X150MM

Facility

$820.00

Hospital Charge Code	270669005
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$198.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

ROD CARBON 9.5 X 400MM 14185

Facility

$987.50

Service Code	HCPCS C1713
Hospital Charge Code	270637342
Hospital Revenue Code	278
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$493.75
Rate for Payer: Aetna Commercial	$375.25
Rate for Payer: Aetna Medicare Advantage	$296.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.81
Rate for Payer: Cigna Commercial	$493.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$148.12
Rate for Payer: UnitedHealthcare Community & State	$31.20
Rate for Payer: Wellpoint Medicaid Managed Care	$28.05

ROD CARBON 9.5 X 400MM 14185

Facility

$987.50

Service Code	HCPCS C1713
Hospital Charge Code	270637342
Hospital Revenue Code	278
Min. Negotiated Rate	$148.12
Max. Negotiated Rate	$238.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.97
Rate for Payer: Qualcare PPO/HMO/WC	$148.12

ROD CARBON FIBER 11.0mmX100mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270633452
Hospital Revenue Code	278
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$516.02
Rate for Payer: Aetna Commercial	$392.18
Rate for Payer: Aetna Medicare Advantage	$309.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.17
Rate for Payer: Cigna Commercial	$516.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81
Rate for Payer: UnitedHealthcare Community & State	$32.61
Rate for Payer: Wellpoint Medicaid Managed Care	$29.31

ROD CARBON FIBER 11.0mmX100mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270633452
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0MMX250MM

Facility

$1,142.60

Service Code	HCPCS C1713
Hospital Charge Code	270632992
Hospital Revenue Code	278
Min. Negotiated Rate	$32.45
Max. Negotiated Rate	$571.30
Rate for Payer: Aetna Commercial	$434.19
Rate for Payer: Aetna Medicare Advantage	$342.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.36
Rate for Payer: Cigna Commercial	$571.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.51
Rate for Payer: Qualcare PPO/HMO/WC	$171.39
Rate for Payer: UnitedHealthcare Community & State	$36.11
Rate for Payer: Wellpoint Medicaid Managed Care	$32.45

ROD CARBON FIBER 11.0MMX250MM

Facility

$1,142.60

Service Code	HCPCS C1713
Hospital Charge Code	270632992
Hospital Revenue Code	278
Min. Negotiated Rate	$171.39
Max. Negotiated Rate	$276.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.51
Rate for Payer: Qualcare PPO/HMO/WC	$171.39

ROD CARBON FIBER 11.0mmX 500mm

Facility

$1,217.45

Service Code	HCPCS C1713
Hospital Charge Code	270646020
Hospital Revenue Code	278
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$608.73
Rate for Payer: Aetna Commercial	$462.63
Rate for Payer: Aetna Medicare Advantage	$365.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.45
Rate for Payer: Cigna Commercial	$608.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.62
Rate for Payer: Qualcare PPO/HMO/WC	$182.62
Rate for Payer: UnitedHealthcare Community & State	$38.47
Rate for Payer: Wellpoint Medicaid Managed Care	$34.58

ROD CARBON FIBER 11.0mmX 500mm

Facility

$1,217.45

Service Code	HCPCS C1713
Hospital Charge Code	270646020
Hospital Revenue Code	278
Min. Negotiated Rate	$182.62
Max. Negotiated Rate	$294.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.62
Rate for Payer: Qualcare PPO/HMO/WC	$182.62

ROD CARBON FIBER 11.0mmX 550mm

Facility

$1,316.35

Service Code	HCPCS C1713
Hospital Charge Code	270639008
Hospital Revenue Code	278
Min. Negotiated Rate	$37.38
Max. Negotiated Rate	$658.17
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$394.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.67
Rate for Payer: Cigna Commercial	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$197.45
Rate for Payer: UnitedHealthcare Community & State	$41.60
Rate for Payer: Wellpoint Medicaid Managed Care	$37.38

ROD CARBON FIBER 11.0mmX 550mm

Facility

$1,316.35

Service Code	HCPCS C1713
Hospital Charge Code	270639008
Hospital Revenue Code	278
Min. Negotiated Rate	$197.45
Max. Negotiated Rate	$318.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$197.45

ROD CARBON FIBER 11.0mmX 600mm

Facility

$1,278.00

Service Code	HCPCS C1713
Hospital Charge Code	270639009
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$309.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.28
Rate for Payer: Qualcare PPO/HMO/WC	$191.70

ROD CARBON FIBER 11.0mmX 600mm

Facility

$1,278.00

Service Code	HCPCS C1713
Hospital Charge Code	270639009
Hospital Revenue Code	278
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$639.00
Rate for Payer: Aetna Commercial	$485.64
Rate for Payer: Aetna Medicare Advantage	$383.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.89
Rate for Payer: Cigna Commercial	$639.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.28
Rate for Payer: Qualcare PPO/HMO/WC	$191.70
Rate for Payer: UnitedHealthcare Community & State	$40.38
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

ROD CARBON FIBER 11.0mmX 650mm

Facility

$1,316.35

Service Code	HCPCS C1713
Hospital Charge Code	270639010
Hospital Revenue Code	278
Min. Negotiated Rate	$197.45
Max. Negotiated Rate	$318.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$197.45

ROD CARBON FIBER 11.0mmX 650mm

Facility

$1,316.35

Service Code	HCPCS C1713
Hospital Charge Code	270639010
Hospital Revenue Code	278
Min. Negotiated Rate	$37.38
Max. Negotiated Rate	$658.17
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$394.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.67
Rate for Payer: Cigna Commercial	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$197.45
Rate for Payer: UnitedHealthcare Community & State	$41.60
Rate for Payer: Wellpoint Medicaid Managed Care	$37.38

ROD CARBON FIBER 11.0x125mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270638107
Hospital Revenue Code	278
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$516.02
Rate for Payer: Aetna Commercial	$392.18
Rate for Payer: Aetna Medicare Advantage	$309.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.17
Rate for Payer: Cigna Commercial	$516.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81
Rate for Payer: UnitedHealthcare Community & State	$32.61
Rate for Payer: Wellpoint Medicaid Managed Care	$29.31

ROD CARBON FIBER 11.0x125mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270638107
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x150mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270639005
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x150mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270639005
Hospital Revenue Code	278
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$516.02
Rate for Payer: Aetna Commercial	$392.18
Rate for Payer: Aetna Medicare Advantage	$309.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.17
Rate for Payer: Cigna Commercial	$516.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81
Rate for Payer: UnitedHealthcare Community & State	$32.61
Rate for Payer: Wellpoint Medicaid Managed Care	$29.31

Know your out-of-pocket cost for care.

All Charges