Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

34MM AMBASSADOR 2-LVL PLATE

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704977
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

34MM AMBASSADOR 2-LVL PLATE

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704977
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

-3.5 36MM FEMORAL HEAD

Facility

$725.00

Hospital Charge Code	270656874
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

-3.5 36MM FEMORAL HEAD

Facility

$725.00

Hospital Charge Code	270656874
Hospital Revenue Code	278
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) NJ Health	$145.00
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	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

3.5 BONE SCREW 18 MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270665464
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

3.5 BONE SCREW 18 MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270665464
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

3.5 CONT DUAL COMP PLT 8

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704659
Hospital Revenue Code	278
Min. Negotiated Rate	$123.54
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$137.46
Rate for Payer: Wellpoint Medicaid Managed Care	$123.54

3.5 CONT DUAL COMP PLT 8

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704659
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

3.5 CONT DUAL COMP PLT 9

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704664
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

3.5 CONT DUAL COMP PLT 9

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270704664
Hospital Revenue Code	278
Min. Negotiated Rate	$123.54
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$137.46
Rate for Payer: Wellpoint Medicaid Managed Care	$123.54

3.5 CORTEX SCREW 42MM

Facility

$93.10

Service Code	HCPCS C1713
Hospital Charge Code	270675512
Hospital Revenue Code	278
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$46.55
Rate for Payer: Aetna Commercial	$35.38
Rate for Payer: Aetna Medicare Advantage	$27.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.74
Rate for Payer: Cigna Commercial	$46.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.53
Rate for Payer: Qualcare PPO/HMO/WC	$13.96
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

3.5 CORTEX SCREW 42MM

Facility

$93.10

Service Code	HCPCS C1713
Hospital Charge Code	270675512
Hospital Revenue Code	278
Min. Negotiated Rate	$13.96
Max. Negotiated Rate	$22.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.53
Rate for Payer: Qualcare PPO/HMO/WC	$13.96

3.5/CORTEX TI SCREW 3.5/L12

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703650
Hospital Revenue Code	278
Min. Negotiated Rate	$40.15
Max. Negotiated Rate	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.15

3.5/CORTEX TI SCREW 3.5/L12

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703650
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$133.82
Rate for Payer: Aetna Commercial	$101.71
Rate for Payer: Aetna Medicare Advantage	$80.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.25
Rate for Payer: Cigna Commercial	$133.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.15
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.60

3.5 CORTEX TI SCREW L10MM

Facility

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	270704203
Hospital Revenue Code	278
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Community & State	$8.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.53

3.5 CORTEX TI SCREW L10MM

Facility

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	270704203
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

3.5CORTICAL

Facility

$122.15

Service Code	HCPCS C1713
Hospital Charge Code	270656876
Hospital Revenue Code	278
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$61.08
Rate for Payer: Aetna Commercial	$46.42
Rate for Payer: Aetna Medicare Advantage	$36.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.15
Rate for Payer: Cigna Commercial	$61.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.56
Rate for Payer: Qualcare PPO/HMO/WC	$18.32
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

3.5CORTICAL

Facility

$122.15

Service Code	HCPCS C1713
Hospital Charge Code	270656876
Hospital Revenue Code	278
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$29.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.56
Rate for Payer: Qualcare PPO/HMO/WC	$18.32

3.5 CORTICAL 14MM

Facility

$176.95

Service Code	HCPCS C1713
Hospital Charge Code	270656879
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$42.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: Qualcare PPO/HMO/WC	$26.54

3.5 CORTICAL 14MM

Facility

$176.95

Service Code	HCPCS C1713
Hospital Charge Code	270656879
Hospital Revenue Code	278
Min. Negotiated Rate	$5.03
Max. Negotiated Rate	$88.47
Rate for Payer: Aetna Commercial	$67.24
Rate for Payer: Aetna Medicare Advantage	$53.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.12
Rate for Payer: Cigna Commercial	$88.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: Qualcare PPO/HMO/WC	$26.54
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: Wellpoint Medicaid Managed Care	$5.03

3.5 CORTICAL 26MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270665461
Hospital Revenue Code	278
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$7.11
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

3.5 CORTICAL 26MM

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	270665461
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$54.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

3.5 COUNTER SINK 8MM

Facility

$1,210.00

Hospital Charge Code	270665454
Hospital Revenue Code	278
Min. Negotiated Rate	$34.36
Max. Negotiated Rate	$605.00
Rate for Payer: Aetna Commercial	$459.80
Rate for Payer: Aetna Medicare Advantage	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.55
Rate for Payer: Cigna Commercial	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.82
Rate for Payer: Qualcare PPO/HMO/WC	$181.50
Rate for Payer: UnitedHealthcare Community & State	$38.24
Rate for Payer: Wellpoint Medicaid Managed Care	$34.36

3.5 COUNTER SINK 8MM

Facility

$1,210.00

Hospital Charge Code	270665454
Hospital Revenue Code	278
Min. Negotiated Rate	$181.50
Max. Negotiated Rate	$292.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.82
Rate for Payer: Qualcare PPO/HMO/WC	$181.50

3.5 DRILL

Facility

$1,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270702953
Hospital Revenue Code	278
Min. Negotiated Rate	$227.25
Max. Negotiated Rate	$366.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.63
Rate for Payer: Qualcare PPO/HMO/WC	$227.25

Know your out-of-pocket cost for care.

All Charges