Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCRW COMP VAL KRELCK TI 3.5X10

Facility

$1,625.00

Hospital Charge Code	270703730
Hospital Revenue Code	278
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: Wellpoint Medicaid Managed Care	$46.15

SCRW COMP VAL KRELCK TI 3.5X12

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703732
Hospital Revenue Code	278
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: Wellpoint Medicaid Managed Care	$46.15

SCRW COMP VAL KRELCK TI 3.5X12

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703732
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCRW COMP VAL KRELCK TI 3.5X14

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703731
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCRW COMP VAL KRELCK TI 3.5X14

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270703731
Hospital Revenue Code	278
Min. Negotiated Rate	$46.15
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Community & State	$51.35
Rate for Payer: Wellpoint Medicaid Managed Care	$46.15

SCRW CORTICAL BONE 5.0MM X32MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270678401
Hospital Revenue Code	278
Min. Negotiated Rate	$20.51
Max. Negotiated Rate	$361.15
Rate for Payer: Aetna Commercial	$274.47
Rate for Payer: Aetna Medicare Advantage	$216.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.19
Rate for Payer: Cigna Commercial	$361.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$108.34
Rate for Payer: UnitedHealthcare Community & State	$22.82
Rate for Payer: Wellpoint Medicaid Managed Care	$20.51

SCRW CORTICAL BONE 5.0MM X32MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270678401
Hospital Revenue Code	278
Min. Negotiated Rate	$108.34
Max. Negotiated Rate	$174.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$108.34

SCRW CORT LOPRF SLFTPN3.5x26MM

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668001
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCRW CORT LOPRF SLFTPN3.5x26MM

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668001
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

SCRW CRT LO PRF SLFTPN3.5x18MM

Facility

$150.65

Service Code	HCPCS C1713
Hospital Charge Code	270680261
Hospital Revenue Code	278
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$75.33
Rate for Payer: Aetna Commercial	$57.25
Rate for Payer: Aetna Medicare Advantage	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.42
Rate for Payer: Cigna Commercial	$75.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60
Rate for Payer: UnitedHealthcare Community & State	$4.76
Rate for Payer: Wellpoint Medicaid Managed Care	$4.28

SCRW CRT LO PRF SLFTPN3.5x18MM

Facility

$150.65

Service Code	HCPCS C1713
Hospital Charge Code	270680261
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$36.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60

SCRW METPHYS SLFTP T8 2.7x10MM

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677642
Hospital Revenue Code	278
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$76.19
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: Qualcare PPO/HMO/WC	$30.07
Rate for Payer: UnitedHealthcare Community & State	$6.34
Rate for Payer: Wellpoint Medicaid Managed Care	$5.69

SCRW METPHYS SLFTP T8 2.7x10MM

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677642
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCRW METPHYS SLFTP T8 2.7x30MM

Facility

$194.65

Service Code	HCPCS C1713
Hospital Charge Code	270677645
Hospital Revenue Code	278
Min. Negotiated Rate	$29.20
Max. Negotiated Rate	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.11
Rate for Payer: Qualcare PPO/HMO/WC	$29.20

SCRW METPHYS SLFTP T8 2.7x30MM

Facility

$194.65

Service Code	HCPCS C1713
Hospital Charge Code	270677645
Hospital Revenue Code	278
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$97.33
Rate for Payer: Aetna Commercial	$73.97
Rate for Payer: Aetna Medicare Advantage	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.64
Rate for Payer: Cigna Commercial	$97.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.11
Rate for Payer: Qualcare PPO/HMO/WC	$29.20
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$5.53

SCRW N-LCK PIT R3CON 3.5X26MM

Facility

$612.00

Service Code	HCPCS C1713
Hospital Charge Code	270702048
Hospital Revenue Code	278
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$148.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.10
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

SCRW N-LCK PIT R3CON 3.5X26MM

Facility

$612.00

Service Code	HCPCS C1713
Hospital Charge Code	270702048
Hospital Revenue Code	278
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.10
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

SCRW RELN MAS 8.5X45MM 2CPLYAX

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686470
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SCRW RELN MAS 8.5X45MM 2CPLYAX

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686470
Hospital Revenue Code	278
Min. Negotiated Rate	$255.60
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$284.40
Rate for Payer: Wellpoint Medicaid Managed Care	$255.60

SCRW SLF TAP VAR ANGL 3.5X44MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270678175
Hospital Revenue Code	278
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$251.56
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Community & State	$20.92
Rate for Payer: Wellpoint Medicaid Managed Care	$18.80

SCRW SLF TAP VAR ANGL 3.5X44MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270678175
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCS GENERATOR-NEUROSTMTR E C S

Facility

$39,600.00

Hospital Charge Code	270335910
Hospital Revenue Code	278
Min. Negotiated Rate	$1,124.64
Max. Negotiated Rate	$19,800.00
Rate for Payer: Aetna Commercial	$15,048.00
Rate for Payer: Aetna Medicare Advantage	$11,880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,098.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,098.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,098.00
Rate for Payer: Cigna Commercial	$19,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,583.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,940.00
Rate for Payer: UnitedHealthcare Community & State	$1,251.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1,124.64

SCS GENERATOR-NEUROSTMTR E C S

Facility

$39,600.00

Hospital Charge Code	270335910
Hospital Revenue Code	278
Min. Negotiated Rate	$5,940.00
Max. Negotiated Rate	$9,583.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,583.20
Rate for Payer: Qualcare PPO/HMO/WC	$5,940.00

SCW CAN SHT THD 3 X 38MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701646
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCW CAN SHT THD 3 X 38MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701646
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

Know your out-of-pocket cost for care.

All Charges