Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ROD SYST SMALL BONE 3x110MM

Facility

$7,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270677145
Hospital Revenue Code	278
Min. Negotiated Rate	$213.43
Max. Negotiated Rate	$3,757.50
Rate for Payer: Aetna Commercial	$2,855.70
Rate for Payer: Aetna Medicare Advantage	$2,254.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,916.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,916.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,503.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,916.33
Rate for Payer: Cigna Commercial	$3,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,818.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,127.25
Rate for Payer: UnitedHealthcare Community & State	$237.47
Rate for Payer: Wellpoint Medicaid Managed Care	$213.43

ROD SYST SMALL BONE 3x110MM

Facility

$7,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270677145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,127.25
Max. Negotiated Rate	$1,818.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,503.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,818.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,127.25

ROD SYST SMALL BONE 3x145MM

Facility

$7,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270681077
Hospital Revenue Code	278
Min. Negotiated Rate	$1,127.25
Max. Negotiated Rate	$1,818.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,503.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,818.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,127.25

ROD SYST SMALL BONE 3x145MM

Facility

$7,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270681077
Hospital Revenue Code	278
Min. Negotiated Rate	$213.43
Max. Negotiated Rate	$3,757.50
Rate for Payer: Aetna Commercial	$2,855.70
Rate for Payer: Aetna Medicare Advantage	$2,254.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,916.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,916.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,503.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,916.33
Rate for Payer: Cigna Commercial	$3,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,818.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,127.25
Rate for Payer: UnitedHealthcare Community & State	$237.47
Rate for Payer: Wellpoint Medicaid Managed Care	$213.43

RODS Z

Facility

$6,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270674126
Hospital Revenue Code	278
Min. Negotiated Rate	$178.92
Max. Negotiated Rate	$3,150.00
Rate for Payer: Aetna Commercial	$2,394.00
Rate for Payer: Aetna Medicare Advantage	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,606.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,606.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,606.50
Rate for Payer: Cigna Commercial	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,524.60
Rate for Payer: Qualcare PPO/HMO/WC	$945.00
Rate for Payer: UnitedHealthcare Community & State	$199.08
Rate for Payer: Wellpoint Medicaid Managed Care	$178.92

RODS Z

Facility

$6,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270674126
Hospital Revenue Code	278
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$1,524.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,524.60
Rate for Payer: Qualcare PPO/HMO/WC	$945.00

ROD TBOLT PREBENT 5.5X45MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696834
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

ROD TBOLT PREBENT 5.5X45MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696834
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

ROD THRD 100MM LNG/SLOTTED

Facility

$299.75

Service Code	HCPCS C1713
Hospital Charge Code	270678086
Hospital Revenue Code	278
Min. Negotiated Rate	$8.51
Max. Negotiated Rate	$149.88
Rate for Payer: Aetna Commercial	$113.91
Rate for Payer: Aetna Medicare Advantage	$89.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.44
Rate for Payer: Cigna Commercial	$149.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.54
Rate for Payer: Qualcare PPO/HMO/WC	$44.96
Rate for Payer: UnitedHealthcare Community & State	$9.47
Rate for Payer: Wellpoint Medicaid Managed Care	$8.51

ROD THRD 100MM LNG/SLOTTED

Facility

$299.75

Service Code	HCPCS C1713
Hospital Charge Code	270678086
Hospital Revenue Code	278
Min. Negotiated Rate	$44.96
Max. Negotiated Rate	$72.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.54
Rate for Payer: Qualcare PPO/HMO/WC	$44.96

ROD THRD 300MM LNG/SLOTTED

Facility

$377.00

Hospital Charge Code	270678153
Hospital Revenue Code	278
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$188.50
Rate for Payer: Aetna Commercial	$143.26
Rate for Payer: Aetna Medicare Advantage	$113.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.14
Rate for Payer: Cigna Commercial	$188.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.55
Rate for Payer: UnitedHealthcare Community & State	$11.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.71

ROD THRD 300MM LNG/SLOTTED

Facility

$377.00

Hospital Charge Code	270678153
Hospital Revenue Code	278
Min. Negotiated Rate	$56.55
Max. Negotiated Rate	$91.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.55

ROD THREADED 250MM LONG

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681235
Hospital Revenue Code	278
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.58

ROD THREADED 250MM LONG

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270681235
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

ROD THREADED 6x300MM

Facility

$460.00

Hospital Charge Code	270674292
Hospital Revenue Code	272
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

ROD THREADED 6x300MM

Facility

$460.00

Hospital Charge Code	270674292
Hospital Revenue Code	272
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$174.80
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.60
Rate for Payer: Oxford Commercial	$92.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Commercial	$92.00
Rate for Payer: UnitedHealthcare Community & State	$14.54
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

ROD THREADED EXT FIX 150MM

Facility

$319.10

Hospital Charge Code	270693743
Hospital Revenue Code	272
Min. Negotiated Rate	$9.06
Max. Negotiated Rate	$159.55
Rate for Payer: Aetna Commercial	$121.26
Rate for Payer: Aetna Medicare Advantage	$95.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.37
Rate for Payer: Cigna Commercial	$159.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.97
Rate for Payer: Oxford Commercial	$63.82
Rate for Payer: Qualcare PPO/HMO/WC	$47.87
Rate for Payer: UnitedHealthcare Commercial	$63.82
Rate for Payer: UnitedHealthcare Community & State	$10.08
Rate for Payer: Wellpoint Medicaid Managed Care	$9.06

ROD THREADED EXT FIX 150MM

Facility

$319.10

Hospital Charge Code	270693743
Hospital Revenue Code	272
Min. Negotiated Rate	$47.87
Max. Negotiated Rate	$47.87
Rate for Payer: Qualcare PPO/HMO/WC	$47.87

ROD THREADED EXT FIX 200MM

Facility

$349.05

Hospital Charge Code	270693742
Hospital Revenue Code	272
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$52.36
Rate for Payer: Qualcare PPO/HMO/WC	$52.36

ROD THREADED EXT FIX 200MM

Facility

$349.05

Hospital Charge Code	270693742
Hospital Revenue Code	272
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$174.53
Rate for Payer: Aetna Commercial	$132.64
Rate for Payer: Aetna Medicare Advantage	$104.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.01
Rate for Payer: Cigna Commercial	$174.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Oxford Commercial	$69.81
Rate for Payer: Qualcare PPO/HMO/WC	$52.36
Rate for Payer: UnitedHealthcare Commercial	$69.81
Rate for Payer: UnitedHealthcare Community & State	$11.03
Rate for Payer: Wellpoint Medicaid Managed Care	$9.91

ROD THREADED LRF 200MM

Facility

$408.70

Service Code	HCPCS C1713
Hospital Charge Code	270699593
Hospital Revenue Code	278
Min. Negotiated Rate	$61.30
Max. Negotiated Rate	$98.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.91
Rate for Payer: Qualcare PPO/HMO/WC	$61.30

ROD THREADED LRF 200MM

Facility

$408.70

Service Code	HCPCS C1713
Hospital Charge Code	270699593
Hospital Revenue Code	278
Min. Negotiated Rate	$11.61
Max. Negotiated Rate	$204.35
Rate for Payer: Aetna Commercial	$155.31
Rate for Payer: Aetna Medicare Advantage	$122.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.22
Rate for Payer: Cigna Commercial	$204.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.91
Rate for Payer: Qualcare PPO/HMO/WC	$61.30
Rate for Payer: UnitedHealthcare Community & State	$12.91
Rate for Payer: Wellpoint Medicaid Managed Care	$11.61

ROD TI 5.5X40MM

Facility

$2,390.00

Service Code	HCPCS C1713
Hospital Charge Code	270699218
Hospital Revenue Code	278
Min. Negotiated Rate	$358.50
Max. Negotiated Rate	$578.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.38
Rate for Payer: Qualcare PPO/HMO/WC	$358.50

ROD TI 5.5X40MM

Facility

$2,390.00

Service Code	HCPCS C1713
Hospital Charge Code	270699218
Hospital Revenue Code	278
Min. Negotiated Rate	$67.88
Max. Negotiated Rate	$1,195.00
Rate for Payer: Aetna Commercial	$908.20
Rate for Payer: Aetna Medicare Advantage	$717.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.45
Rate for Payer: Cigna Commercial	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.38
Rate for Payer: Qualcare PPO/HMO/WC	$358.50
Rate for Payer: UnitedHealthcare Community & State	$75.52
Rate for Payer: Wellpoint Medicaid Managed Care	$67.88

ROD TI 5.5 X 45MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691780
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

Know your out-of-pocket cost for care.

All Charges