Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STAPLE DYNANITE 9X10 W/INSTRU

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699541
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STAPLE DYNANITE NITI W/INSTRS

Facility

$7,475.00

Hospital Charge Code	270684944
Hospital Revenue Code	272
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,943.50
Rate for Payer: Oxford Commercial	$1,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$1,495.00
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

STAPLE DYNANITE NITI W/INSTRS

Facility

$7,475.00

Hospital Charge Code	270684944
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

STAPLE EASYFUSE 18X15MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270700661
Hospital Revenue Code	278
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25
Rate for Payer: UnitedHealthcare Community & State	$248.85
Rate for Payer: Wellpoint Medicaid Managed Care	$223.65

STAPLE EASYFUSE 18X15MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270700661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

STAPLE FUSEFORCE 15x15MM

Facility

$6,425.00

Hospital Charge Code	270678361
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

STAPLE FUSEFORCE 15x15MM

Facility

$6,425.00

Hospital Charge Code	270678361
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

STAPLE FUSEFORCE 18x16MM

Facility

$6,425.00

Hospital Charge Code	270669233
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

STAPLE FUSEFORCE 18x16MM

Facility

$6,425.00

Hospital Charge Code	270669233
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

STAPLE FUSEFORCE 18X16MM

Facility

$9,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270700603
Hospital Revenue Code	278
Min. Negotiated Rate	$1,367.25
Max. Negotiated Rate	$2,205.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,823.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,205.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,367.25

STAPLE FUSEFORCE 18X16MM

Facility

$9,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270700603
Hospital Revenue Code	278
Min. Negotiated Rate	$258.87
Max. Negotiated Rate	$4,557.50
Rate for Payer: Aetna Commercial	$3,463.70
Rate for Payer: Aetna Medicare Advantage	$2,734.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,324.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,324.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,823.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,324.32
Rate for Payer: Cigna Commercial	$4,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,205.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,367.25
Rate for Payer: UnitedHealthcare Community & State	$288.03
Rate for Payer: Wellpoint Medicaid Managed Care	$258.87

STAPLE FUSEFORCE 25x22MM

Facility

$6,425.00

Hospital Charge Code	270677126
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

STAPLE FUSEFORCE 25x22MM

Facility

$6,425.00

Hospital Charge Code	270677126
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

STAPLE FUSEFORCE 25x25MM

Facility

$6,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270704471
Hospital Revenue Code	278
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

STAPLE FUSEFORCE 25x25MM

Facility

$6,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270704471
Hospital Revenue Code	278
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$1,554.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

STAPLE FUSEFORCE NITINOL 10X10

Facility

$6,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270700829
Hospital Revenue Code	278
Min. Negotiated Rate	$186.16
Max. Negotiated Rate	$3,277.50
Rate for Payer: Aetna Commercial	$2,490.90
Rate for Payer: Aetna Medicare Advantage	$1,966.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,671.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,671.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,311.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,671.53
Rate for Payer: Cigna Commercial	$3,277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.31
Rate for Payer: Qualcare PPO/HMO/WC	$983.25
Rate for Payer: UnitedHealthcare Community & State	$207.14
Rate for Payer: Wellpoint Medicaid Managed Care	$186.16

STAPLE FUSEFORCE NITINOL 10X10

Facility

$6,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270700829
Hospital Revenue Code	278
Min. Negotiated Rate	$983.25
Max. Negotiated Rate	$1,586.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,311.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,586.31
Rate for Payer: Qualcare PPO/HMO/WC	$983.25

STAPLE GUN ENDO GIA 60 MULTIFI

Facility

$1,995.00

Hospital Charge Code	270335155
Hospital Revenue Code	272
Min. Negotiated Rate	$56.66
Max. Negotiated Rate	$997.50
Rate for Payer: Aetna Commercial	$758.10
Rate for Payer: Aetna Medicare Advantage	$598.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.73
Rate for Payer: Cigna Commercial	$997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$518.70
Rate for Payer: Oxford Commercial	$399.00
Rate for Payer: Qualcare PPO/HMO/WC	$299.25
Rate for Payer: UnitedHealthcare Commercial	$399.00
Rate for Payer: UnitedHealthcare Community & State	$63.04
Rate for Payer: Wellpoint Medicaid Managed Care	$56.66

STAPLE GUN ENDO GIA 60 MULTIFI

Facility

$1,995.00

Hospital Charge Code	270335155
Hospital Revenue Code	272
Min. Negotiated Rate	$299.25
Max. Negotiated Rate	$299.25
Rate for Payer: Qualcare PPO/HMO/WC	$299.25

STAPLE HAND FIX SYS 20x20MM

Facility

$6,425.00

Hospital Charge Code	270675807
Hospital Revenue Code	272
Min. Negotiated Rate	$182.47
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$2,441.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.50
Rate for Payer: Oxford Commercial	$1,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$963.75
Rate for Payer: UnitedHealthcare Commercial	$1,285.00
Rate for Payer: UnitedHealthcare Community & State	$203.03
Rate for Payer: Wellpoint Medicaid Managed Care	$182.47

STAPLE HAND FIX SYS 20x20MM

Facility

$6,425.00

Hospital Charge Code	270675807
Hospital Revenue Code	272
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$963.75
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

STAPLE JAWS STR 10X10MM

Facility

$6,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270700682
Hospital Revenue Code	278
Min. Negotiated Rate	$987.75
Max. Negotiated Rate	$1,593.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.57
Rate for Payer: Qualcare PPO/HMO/WC	$987.75

STAPLE JAWS STR 10X10MM

Facility

$6,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270700682
Hospital Revenue Code	278
Min. Negotiated Rate	$187.01
Max. Negotiated Rate	$3,292.50
Rate for Payer: Aetna Commercial	$2,502.30
Rate for Payer: Aetna Medicare Advantage	$1,975.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,679.17
Rate for Payer: Cigna Commercial	$3,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,593.57
Rate for Payer: Qualcare PPO/HMO/WC	$987.75
Rate for Payer: UnitedHealthcare Community & State	$208.09
Rate for Payer: Wellpoint Medicaid Managed Care	$187.01

STAPLE KIT ANGLED 8X8MM

Facility

$6,585.00

Hospital Charge Code	270701873
Hospital Revenue Code	273
Min. Negotiated Rate	$987.75
Max. Negotiated Rate	$987.75
Rate for Payer: Qualcare PPO/HMO/WC	$987.75

STAPLE KIT ANGLED 8X8MM

Facility

$6,585.00

Hospital Charge Code	270701873
Hospital Revenue Code	273
Min. Negotiated Rate	$187.01
Max. Negotiated Rate	$3,292.50
Rate for Payer: Aetna Commercial	$2,502.30
Rate for Payer: Aetna Medicare Advantage	$1,975.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,679.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,679.17
Rate for Payer: Cigna Commercial	$3,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,712.10
Rate for Payer: Qualcare PPO/HMO/WC	$987.75
Rate for Payer: UnitedHealthcare Community & State	$208.09
Rate for Payer: Wellpoint Medicaid Managed Care	$187.01

Know your out-of-pocket cost for care.

All Charges