Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ROD CONNECTING 11X200MM

Facility

$2,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270669477
Hospital Revenue Code	278
Min. Negotiated Rate	$71.85
Max. Negotiated Rate	$1,265.00
Rate for Payer: Aetna Commercial	$961.40
Rate for Payer: Aetna Medicare Advantage	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$645.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$645.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$506.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$645.15
Rate for Payer: Cigna Commercial	$1,265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$612.26
Rate for Payer: Qualcare PPO/HMO/WC	$379.50
Rate for Payer: UnitedHealthcare Community & State	$79.95
Rate for Payer: Wellpoint Medicaid Managed Care	$71.85

ROD CONNECTING 11X350MM

Facility

$2,595.00

Service Code	HCPCS C1713
Hospital Charge Code	270669476
Hospital Revenue Code	278
Min. Negotiated Rate	$389.25
Max. Negotiated Rate	$627.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.99
Rate for Payer: Qualcare PPO/HMO/WC	$389.25

ROD CONNECTING 11X350MM

Facility

$2,595.00

Service Code	HCPCS C1713
Hospital Charge Code	270669476
Hospital Revenue Code	278
Min. Negotiated Rate	$73.70
Max. Negotiated Rate	$1,297.50
Rate for Payer: Aetna Commercial	$986.10
Rate for Payer: Aetna Medicare Advantage	$778.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.73
Rate for Payer: Cigna Commercial	$1,297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.99
Rate for Payer: Qualcare PPO/HMO/WC	$389.25
Rate for Payer: UnitedHealthcare Community & State	$82.00
Rate for Payer: Wellpoint Medicaid Managed Care	$73.70

ROD CONNECTOR 3.5MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270704794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

ROD CONNECTOR 3.5MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270704794
Hospital Revenue Code	278
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$248.85
Rate for Payer: Wellpoint Medicaid Managed Care	$223.65

ROD CONNECT SM EXT FIX 4x60mm

Facility

$176.15

Service Code	HCPCS C1713
Hospital Charge Code	270639003
Hospital Revenue Code	278
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$88.08
Rate for Payer: Aetna Commercial	$66.94
Rate for Payer: Aetna Medicare Advantage	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.92
Rate for Payer: Cigna Commercial	$88.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.63
Rate for Payer: Qualcare PPO/HMO/WC	$26.42
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

ROD CONNECT SM EXT FIX 4x60mm

Facility

$176.15

Service Code	HCPCS C1713
Hospital Charge Code	270639003
Hospital Revenue Code	278
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$42.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.63
Rate for Payer: Qualcare PPO/HMO/WC	$26.42

ROD CONNECT SM EXT FIX 4x80mm

Facility

$176.15

Service Code	HCPCS C1713
Hospital Charge Code	270639004
Hospital Revenue Code	278
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$88.08
Rate for Payer: Aetna Commercial	$66.94
Rate for Payer: Aetna Medicare Advantage	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.92
Rate for Payer: Cigna Commercial	$88.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.63
Rate for Payer: Qualcare PPO/HMO/WC	$26.42
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

ROD CONNECT SM EXT FIX 4x80mm

Facility

$176.15

Service Code	HCPCS C1713
Hospital Charge Code	270639004
Hospital Revenue Code	278
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$42.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.63
Rate for Payer: Qualcare PPO/HMO/WC	$26.42

ROD CONTOURED 5.5MM 100MM

Facility

$1,450.00

Hospital Charge Code	270670380
Hospital Revenue Code	278
Min. Negotiated Rate	$41.18
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$45.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.18

ROD CONTOURED 5.5MM 100MM

Facility

$1,450.00

Hospital Charge Code	270670380
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

ROD CONTOURED 5.5MM 110MM

Facility

$1,915.00

Hospital Charge Code	270670404
Hospital Revenue Code	278
Min. Negotiated Rate	$54.39
Max. Negotiated Rate	$957.50
Rate for Payer: Aetna Commercial	$727.70
Rate for Payer: Aetna Medicare Advantage	$574.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.32
Rate for Payer: Cigna Commercial	$957.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.43
Rate for Payer: Qualcare PPO/HMO/WC	$287.25
Rate for Payer: UnitedHealthcare Community & State	$60.51
Rate for Payer: Wellpoint Medicaid Managed Care	$54.39

ROD CONTOURED 5.5MM 110MM

Facility

$1,915.00

Hospital Charge Code	270670404
Hospital Revenue Code	278
Min. Negotiated Rate	$287.25
Max. Negotiated Rate	$463.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.43
Rate for Payer: Qualcare PPO/HMO/WC	$287.25

ROD CONTOURED 5.5MM 125MM

Facility

$1,915.00

Hospital Charge Code	270670405
Hospital Revenue Code	278
Min. Negotiated Rate	$54.39
Max. Negotiated Rate	$957.50
Rate for Payer: Aetna Commercial	$727.70
Rate for Payer: Aetna Medicare Advantage	$574.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.32
Rate for Payer: Cigna Commercial	$957.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.43
Rate for Payer: Qualcare PPO/HMO/WC	$287.25
Rate for Payer: UnitedHealthcare Community & State	$60.51
Rate for Payer: Wellpoint Medicaid Managed Care	$54.39

ROD CONTOURED 5.5MM 125MM

Facility

$1,915.00

Hospital Charge Code	270670405
Hospital Revenue Code	278
Min. Negotiated Rate	$287.25
Max. Negotiated Rate	$463.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.43
Rate for Payer: Qualcare PPO/HMO/WC	$287.25

ROD CONTOURED 5.5MM 150MM

Facility

$1,915.00

Hospital Charge Code	270670406
Hospital Revenue Code	278
Min. Negotiated Rate	$54.39
Max. Negotiated Rate	$957.50
Rate for Payer: Aetna Commercial	$727.70
Rate for Payer: Aetna Medicare Advantage	$574.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.32
Rate for Payer: Cigna Commercial	$957.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.43
Rate for Payer: Qualcare PPO/HMO/WC	$287.25
Rate for Payer: UnitedHealthcare Community & State	$60.51
Rate for Payer: Wellpoint Medicaid Managed Care	$54.39

ROD CONTOURED 5.5MM 150MM

Facility

$1,915.00

Hospital Charge Code	270670406
Hospital Revenue Code	278
Min. Negotiated Rate	$287.25
Max. Negotiated Rate	$463.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.43
Rate for Payer: Qualcare PPO/HMO/WC	$287.25

ROD CONTOURED 5.5MM 30MM

Facility

$1,430.00

Hospital Charge Code	270670363
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 30MM

Facility

$1,430.00

Hospital Charge Code	270670363
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 35MM

Facility

$1,430.00

Hospital Charge Code	270670364
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 35MM

Facility

$1,430.00

Hospital Charge Code	270670364
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 40MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670365
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

ROD CONTOURED 5.5MM 40MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670365
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 45MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670367
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$346.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50

ROD CONTOURED 5.5MM 45MM

Facility

$1,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270670367
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$715.00
Rate for Payer: Aetna Commercial	$543.40
Rate for Payer: Aetna Medicare Advantage	$429.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.65
Rate for Payer: Cigna Commercial	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.06
Rate for Payer: Qualcare PPO/HMO/WC	$214.50
Rate for Payer: UnitedHealthcare Community & State	$45.19
Rate for Payer: Wellpoint Medicaid Managed Care	$40.61

Know your out-of-pocket cost for care.

All Charges