Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

3.0X16MM VAL SCREW,TI

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686390
Hospital Revenue Code	278
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

3.0X18 PARTIALLY THREADED SCRE

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270656447
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

3.0X18 PARTIALLY THREADED SCRE

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270656447
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

3 1/2 PROTECTORS INSTRUTMENT

Facility

$81.80

Hospital Charge Code	270665051
Hospital Revenue Code	270
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

3 1/2 PROTECTORS INSTRUTMENT

Facility

$81.80

Hospital Charge Code	270665051
Hospital Revenue Code	270
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$40.90
Rate for Payer: Aetna Commercial	$31.08
Rate for Payer: Aetna Medicare Advantage	$24.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$40.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.27
Rate for Payer: Oxford Commercial	$16.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$16.36
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.32

3.2 3-FLTD DRILL/MOD QC/145

Facility

$3,100.00

Hospital Charge Code	270705554
Hospital Revenue Code	279
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

3.2 3-FLTD DRILL/MOD QC/145

Facility

$3,100.00

Hospital Charge Code	270705554
Hospital Revenue Code	279
Min. Negotiated Rate	$88.04
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$1,178.00
Rate for Payer: Aetna Medicare Advantage	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.50
Rate for Payer: Cigna Commercial	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.00
Rate for Payer: Oxford Commercial	$620.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.00
Rate for Payer: UnitedHealthcare Commercial	$620.00
Rate for Payer: UnitedHealthcare Community & State	$97.96
Rate for Payer: Wellpoint Medicaid Managed Care	$88.04

32MM 2HOLE CERVICAL PLATE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704172
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

32MM 2HOLE CERVICAL PLATE

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704172
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

3.2MM CALIBRATED DRILL BIT

Facility

$700.00

Hospital Charge Code	270680674
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

3.2MM CALIBRATED DRILL BIT

Facility

$770.00

Hospital Charge Code	270686578
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

3.2MM CALIBRATED DRILL BIT

Facility

$700.00

Hospital Charge Code	270680674
Hospital Revenue Code	272
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) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

3.2MM CALIBRATED DRILL BIT

Facility

$770.00

Hospital Charge Code	270686578
Hospital Revenue Code	272
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.20
Rate for Payer: Oxford Commercial	$154.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Commercial	$154.00
Rate for Payer: UnitedHealthcare Community & State	$24.33
Rate for Payer: Wellpoint Medicaid Managed Care	$21.87

32MM COCR HEAD M

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270684270
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

32MM COCR HEAD M

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270684270
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

3.2MM MEASURING DRILL SLEEVE

Facility

$990.00

Hospital Charge Code	270680675
Hospital Revenue Code	272
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$495.00
Rate for Payer: Aetna Commercial	$376.20
Rate for Payer: Aetna Medicare Advantage	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.45
Rate for Payer: Cigna Commercial	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.40
Rate for Payer: Oxford Commercial	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.50
Rate for Payer: UnitedHealthcare Commercial	$198.00
Rate for Payer: UnitedHealthcare Community & State	$31.28
Rate for Payer: Wellpoint Medicaid Managed Care	$28.12

3.2MM MEASURING DRILL SLEEVE

Facility

$990.00

Hospital Charge Code	270680675
Hospital Revenue Code	272
Min. Negotiated Rate	$148.50
Max. Negotiated Rate	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$148.50

3.2MM THREAD PIN, 508MM

Facility

$900.00

Hospital Charge Code	270663166
Hospital Revenue Code	270
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) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

3.2MM THREAD PIN, 508MM

Facility

$900.00

Hospital Charge Code	270663166
Hospital Revenue Code	270
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270681042
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1769
Hospital Charge Code	270681043
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1769
Hospital Charge Code	270681043
Hospital Revenue Code	272
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.00
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$230.00
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

3.2MM X 560MM COCR THD TIP

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270681042
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

3.3 MM FREE HAND TARG DRILL

Facility

$725.00

Hospital Charge Code	270688153
Hospital Revenue Code	272
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

3.3 MM FREE HAND TARG DRILL

Facility

$725.00

Hospital Charge Code	270688153
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

Know your out-of-pocket cost for care.

All Charges