Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ROD EXTND TAB 50MM OVRWTCH MIS

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692587
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

ROD EXTND TAB 50MM OVRWTCH MIS

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692587
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

ROD FIXED 60 MM PALISADE

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692238
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

ROD FIXED 60 MM PALISADE

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692238
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

ROD HUNTER 5MMX24.5CM

Facility

$7,150.00

Service Code	HCPCS C1889
Hospital Charge Code	270692638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,072.50
Max. Negotiated Rate	$1,730.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,730.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,072.50

ROD HUNTER 5MMX24.5CM

Facility

$7,150.00

Service Code	HCPCS C1889
Hospital Charge Code	270692638
Hospital Revenue Code	278
Min. Negotiated Rate	$203.06
Max. Negotiated Rate	$3,575.00
Rate for Payer: Aetna Commercial	$2,717.00
Rate for Payer: Aetna Medicare Advantage	$2,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,823.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,823.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,823.25
Rate for Payer: Cigna Commercial	$3,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,730.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,072.50
Rate for Payer: UnitedHealthcare Community & State	$225.94
Rate for Payer: Wellpoint Medicaid Managed Care	$203.06

ROD HUNTER TENDON 4MMX24.5CM

Facility

$12,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270694118
Hospital Revenue Code	278
Min. Negotiated Rate	$350.31
Max. Negotiated Rate	$6,167.50
Rate for Payer: Aetna Commercial	$4,687.30
Rate for Payer: Aetna Medicare Advantage	$3,700.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,145.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,145.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,467.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,145.43
Rate for Payer: Cigna Commercial	$6,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,985.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,850.25
Rate for Payer: UnitedHealthcare Community & State	$389.79
Rate for Payer: Wellpoint Medicaid Managed Care	$350.31

ROD HUNTER TENDON 4MMX24.5CM

Facility

$12,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270694118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,850.25
Max. Negotiated Rate	$2,985.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,467.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,985.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,850.25

ROD IMPLANT

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	270675856
Hospital Revenue Code	278
Min. Negotiated Rate	$129.94
Max. Negotiated Rate	$209.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.63
Rate for Payer: Qualcare PPO/HMO/WC	$129.94

ROD IMPLANT

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	270675856
Hospital Revenue Code	278
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$433.12
Rate for Payer: Aetna Commercial	$329.18
Rate for Payer: Aetna Medicare Advantage	$259.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.89
Rate for Payer: Cigna Commercial	$433.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.63
Rate for Payer: Qualcare PPO/HMO/WC	$129.94
Rate for Payer: UnitedHealthcare Community & State	$27.37
Rate for Payer: Wellpoint Medicaid Managed Care	$24.60

ROD INVICTUS TI LORDOTIC

Facility

$1,125.00

Hospital Charge Code	270703009
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

ROD INVICTUS TI LORDOTIC

Facility

$1,125.00

Hospital Charge Code	270703009
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

ROD LEGACY 5.5x70mm

Facility

$2,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270685221
Hospital Revenue Code	278
Min. Negotiated Rate	$368.25
Max. Negotiated Rate	$594.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: Qualcare PPO/HMO/WC	$368.25

ROD LEGACY 5.5x70mm

Facility

$2,455.00

Service Code	HCPCS C1713
Hospital Charge Code	270685221
Hospital Revenue Code	278
Min. Negotiated Rate	$69.72
Max. Negotiated Rate	$1,227.50
Rate for Payer: Aetna Commercial	$932.90
Rate for Payer: Aetna Medicare Advantage	$736.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.02
Rate for Payer: Cigna Commercial	$1,227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.11
Rate for Payer: Qualcare PPO/HMO/WC	$368.25
Rate for Payer: UnitedHealthcare Community & State	$77.58
Rate for Payer: Wellpoint Medicaid Managed Care	$69.72

ROD LINESIDER TI CURV 5.5X65MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694920
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

ROD LINESIDER TI CURV 5.5X65MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694920
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ROD LORDOSED 3.5X100MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270694467
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 LORDOSED 3.5X100MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270694467
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 LORDOSED 3.5X120MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270697978
Hospital Revenue Code	278
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

ROD LORDOSED 3.5X120MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270697978
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LORDOSED 3.5X60MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698163
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LORDOSED 3.5X60MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698163
Hospital Revenue Code	278
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

ROD LORDOSED 3.5X80MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270695316
Hospital Revenue Code	278
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

ROD LORDOSED 3.5X80MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270695316
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LORDOSED 5.5 X 100MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686925
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges