Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCW CAN SHT THD 4 X 46MM

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701644
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

SCW CAN SHT THD 4 X 46MM

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701644
Hospital Revenue Code	278
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$34.33
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

SCW CAN THD HD 2.7 X 16MM

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701643
Hospital Revenue Code	278
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$412.77
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94
Rate for Payer: UnitedHealthcare Community & State	$34.33
Rate for Payer: Wellpoint Medicaid Managed Care	$30.85

SCW CAN THD HD 2.7 X 16MM

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701643
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

SCW LKNG R3CON 2.7 X 34MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270702045
Hospital Revenue Code	278
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$28.68
Rate for Payer: Wellpoint Medicaid Managed Care	$25.77

SCW LKNG R3CON 2.7 X 34MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270702045
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCW LKNG R3CON 3.5 X 26MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270702047
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCW LKNG R3CON 3.5 X 26MM

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270702047
Hospital Revenue Code	278
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$28.68
Rate for Payer: Wellpoint Medicaid Managed Care	$25.77

SCW LKNG R3CON 3.5X36MM

Facility

$660.00

Service Code	HCPCS C1716
Hospital Charge Code	270701596
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCW LKNG R3CON 3.5X36MM

Facility

$660.00

Service Code	HCPCS C1716
Hospital Charge Code	270701596
Hospital Revenue Code	278
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$2,166.34
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.34
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$18.74

SCW NCB UNICORTICAL 5.0 L = 26

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270704922
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

SCW NCB UNICORTICAL 5.0 L = 26

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270704922
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 N-LKNG PIT 3.5 X 30MM R3CO

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701495
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCW N-LKNG PIT 3.5 X 30MM R3CO

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701495
Hospital Revenue Code	278
Min. Negotiated Rate	$18.74
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$250.80
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: Wellpoint Medicaid Managed Care	$18.74

SCW N-LKNG PIT 3.5 X 40MM R3CO

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701496
Hospital Revenue Code	278
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$453.75
Rate for Payer: Aetna Commercial	$344.85
Rate for Payer: Aetna Medicare Advantage	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.41
Rate for Payer: Cigna Commercial	$453.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: Qualcare PPO/HMO/WC	$136.12
Rate for Payer: UnitedHealthcare Community & State	$28.68
Rate for Payer: Wellpoint Medicaid Managed Care	$25.77

SCW N-LKNG PIT 3.5 X 40MM R3CO

Facility

$907.50

Service Code	HCPCS C1713
Hospital Charge Code	270701496
Hospital Revenue Code	278
Min. Negotiated Rate	$136.12
Max. Negotiated Rate	$219.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.62
Rate for Payer: Qualcare PPO/HMO/WC	$136.12

SCW R3CON N-LKNGPIT 3.5 X 22MM

Facility

$612.00

Hospital Charge Code	270701955
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

SCW R3CON N-LKNGPIT 3.5 X 22MM

Facility

$612.00

Hospital Charge Code	270701955
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

SCW SLD SHT BLNT TIP 5.5X46MM

Facility

$3,231.25

Hospital Charge Code	270701726
Hospital Revenue Code	278
Min. Negotiated Rate	$484.69
Max. Negotiated Rate	$781.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: Qualcare PPO/HMO/WC	$484.69

SCW SLD SHT BLNT TIP 5.5X46MM

Facility

$3,231.25

Hospital Charge Code	270701726
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$1,615.62
Rate for Payer: Aetna Commercial	$1,227.88
Rate for Payer: Aetna Medicare Advantage	$969.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.97
Rate for Payer: Cigna Commercial	$1,615.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: Qualcare PPO/HMO/WC	$484.69
Rate for Payer: UnitedHealthcare Community & State	$102.11
Rate for Payer: Wellpoint Medicaid Managed Care	$91.77

SDS BEDSIDE PROCEDURE

Facility

$2,230.00

Hospital Charge Code	1001190
Hospital Revenue Code	361
Min. Negotiated Rate	$63.33
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$847.40
Rate for Payer: Aetna Medicare Advantage	$669.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.65
Rate for Payer: Cigna Commercial	$1,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.80
Rate for Payer: Qualcare PPO/HMO/WC	$334.50
Rate for Payer: UnitedHealthcare Community & State	$70.47
Rate for Payer: Wellpoint Medicaid Managed Care	$63.33

SDS BEDSIDE PROCEDURE

Facility

$2,230.00

Hospital Charge Code	1001190
Hospital Revenue Code	361
Min. Negotiated Rate	$334.50
Max. Negotiated Rate	$334.50
Rate for Payer: Qualcare PPO/HMO/WC	$334.50

SD SCREW 12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703901
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SD SCREW 12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703901
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SD SCREW 3.5X16MM

Facility

$1,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270704127
Hospital Revenue Code	278
Min. Negotiated Rate	$48.28
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Community & State	$53.72
Rate for Payer: Wellpoint Medicaid Managed Care	$48.28

Know your out-of-pocket cost for care.

All Charges