Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SPEED IMPLANT 9x10x10MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674296
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

SPEED IMPLANT TITAN 15x15x15MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEED IMPLANT TITAN 15x15x15MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679102
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

SPEED IMPLANT TITAN 18x18x18MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEED IMPLANT TITAN 18x18x18MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679103
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

SPEEDLOCK KNOTLESS FIXATION

Facility

$5,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270668394
Hospital Revenue Code	278
Min. Negotiated Rate	$153.64
Max. Negotiated Rate	$2,705.00
Rate for Payer: Aetna Commercial	$2,055.80
Rate for Payer: Aetna Medicare Advantage	$1,623.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,379.55
Rate for Payer: Cigna Commercial	$2,705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: Qualcare PPO/HMO/WC	$811.50
Rate for Payer: UnitedHealthcare Community & State	$170.96
Rate for Payer: Wellpoint Medicaid Managed Care	$153.64

SPEEDLOCK KNOTLESS FIXATION

Facility

$5,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270668394
Hospital Revenue Code	278
Min. Negotiated Rate	$811.50
Max. Negotiated Rate	$1,309.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: Qualcare PPO/HMO/WC	$811.50

SPEED MTP 3.5 HEADLESS SCREW

Facility

$3,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704033
Hospital Revenue Code	278
Min. Negotiated Rate	$93.29
Max. Negotiated Rate	$1,642.50
Rate for Payer: Aetna Commercial	$1,248.30
Rate for Payer: Aetna Medicare Advantage	$985.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$837.67
Rate for Payer: Cigna Commercial	$1,642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: Qualcare PPO/HMO/WC	$492.75
Rate for Payer: UnitedHealthcare Community & State	$103.81
Rate for Payer: Wellpoint Medicaid Managed Care	$93.29

SPEED MTP 3.5 HEADLESS SCREW

Facility

$3,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704033
Hospital Revenue Code	278
Min. Negotiated Rate	$492.75
Max. Negotiated Rate	$794.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: Qualcare PPO/HMO/WC	$492.75

SPEED MTP FAST PITCH SCREW

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704032
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

SPEED MTP FAST PITCH SCREW

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704032
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SPEED MTP IMPLANT

Facility

$18,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704031
Hospital Revenue Code	278
Min. Negotiated Rate	$2,811.75
Max. Negotiated Rate	$4,536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,749.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,536.29
Rate for Payer: Qualcare PPO/HMO/WC	$2,811.75

SPEED MTP IMPLANT

Facility

$18,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704031
Hospital Revenue Code	278
Min. Negotiated Rate	$532.36
Max. Negotiated Rate	$9,372.50
Rate for Payer: Aetna Commercial	$7,123.10
Rate for Payer: Aetna Medicare Advantage	$5,623.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,779.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,779.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,779.98
Rate for Payer: Cigna Commercial	$9,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,536.29
Rate for Payer: Qualcare PPO/HMO/WC	$2,811.75
Rate for Payer: UnitedHealthcare Community & State	$592.34
Rate for Payer: Wellpoint Medicaid Managed Care	$532.36

SPEEDPLATE LAPIPLASTY 18X17MM

Facility

$16,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270700192
Hospital Revenue Code	278
Min. Negotiated Rate	$2,530.50
Max. Negotiated Rate	$4,082.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,082.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,530.50

SPEEDPLATE LAPIPLASTY 18X17MM

Facility

$16,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270700192
Hospital Revenue Code	278
Min. Negotiated Rate	$479.11
Max. Negotiated Rate	$8,435.00
Rate for Payer: Aetna Commercial	$6,410.60
Rate for Payer: Aetna Medicare Advantage	$5,061.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,301.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,301.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,301.85
Rate for Payer: Cigna Commercial	$8,435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,082.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,530.50
Rate for Payer: UnitedHealthcare Community & State	$533.09
Rate for Payer: Wellpoint Medicaid Managed Care	$479.11

SPEED RELEASE DISP SN20

Facility

$2,500.00

Hospital Charge Code	270696796
Hospital Revenue Code	272
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

SPEED RELEASE DISP SN20

Facility

$2,500.00

Hospital Charge Code	270696796
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SPEEDSTITCH BLACK CO-BRAID

Facility

$1,416.67

Hospital Charge Code	270674888
Hospital Revenue Code	272
Min. Negotiated Rate	$40.23
Max. Negotiated Rate	$708.34
Rate for Payer: Aetna Commercial	$538.33
Rate for Payer: Aetna Medicare Advantage	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.25
Rate for Payer: Cigna Commercial	$708.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.33
Rate for Payer: Oxford Commercial	$283.33
Rate for Payer: Qualcare PPO/HMO/WC	$212.50
Rate for Payer: UnitedHealthcare Commercial	$283.33
Rate for Payer: UnitedHealthcare Community & State	$44.77
Rate for Payer: Wellpoint Medicaid Managed Care	$40.23

SPEEDSTITCH BLACK CO-BRAID

Facility

$1,416.67

Hospital Charge Code	270674888
Hospital Revenue Code	272
Min. Negotiated Rate	$212.50
Max. Negotiated Rate	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$212.50

SPEEDSTITCH CO-BRAID CUT CART

Facility

$1,375.00

Hospital Charge Code	270669994
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SPEEDSTITCH CO-BRAID CUT CART

Facility

$1,375.00

Hospital Charge Code	270669994
Hospital Revenue Code	272
Min. Negotiated Rate	$39.05
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$275.00
Rate for Payer: UnitedHealthcare Community & State	$43.45
Rate for Payer: Wellpoint Medicaid Managed Care	$39.05

SPEED TITAN IMPLANT 25x20x20MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680263
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

SPEED TITAN IMPLANT 25x20x20MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPERM ANTIBODIES

Facility

$75.00

Service Code	HCPCS 89325
Hospital Charge Code	38477075
Hospital Revenue Code	300
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SPERM ANTIBODIES

Facility

$75.00

Service Code	HCPCS 89325
Hospital Charge Code	38477075
Hospital Revenue Code	300
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$29.02
Rate for Payer: Aetna Medicare Advantage	$34.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.71
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: Cigna Medicare Advantage	$10.67
Rate for Payer: Clover Medicare Advantage	$10.14
Rate for Payer: EmblemHealth Commercial	$32.01
Rate for Payer: Humana Medicare Advantage	$10.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.67
Rate for Payer: Wellcare Medicare Advantage	$10.67
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

Know your out-of-pocket cost for care.

All Charges