Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

3.5X40 PT SCREW

Facility

$885.00

Service Code	HCPCS C1713
Hospital Charge Code	270703144
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

3.5X40 PT SCREW

Facility

$885.00

Service Code	HCPCS C1713
Hospital Charge Code	270703144
Hospital Revenue Code	278
Min. Negotiated Rate	$25.13
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$27.97
Rate for Payer: Wellpoint Medicaid Managed Care	$25.13

3.5X56 SCREW

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270675181
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

3.5X56 SCREW

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270675181
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

36MM-3.5 HEAD

Facility

$3,311.05

Service Code	HCPCS C1713
Hospital Charge Code	270656893
Hospital Revenue Code	278
Min. Negotiated Rate	$94.03
Max. Negotiated Rate	$1,655.53
Rate for Payer: Aetna Commercial	$1,258.20
Rate for Payer: Aetna Medicare Advantage	$993.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.32
Rate for Payer: Cigna Commercial	$1,655.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: Qualcare PPO/HMO/WC	$496.66
Rate for Payer: UnitedHealthcare Community & State	$104.63
Rate for Payer: Wellpoint Medicaid Managed Care	$94.03

36MM-3.5 HEAD

Facility

$3,311.05

Service Code	HCPCS C1713
Hospital Charge Code	270656893
Hospital Revenue Code	278
Min. Negotiated Rate	$496.66
Max. Negotiated Rate	$801.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$662.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$801.27
Rate for Payer: Qualcare PPO/HMO/WC	$496.66

36MM COCR MOD HD + 9MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270672278
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

36MM COCR MOD HD + 9MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270672278
Hospital Revenue Code	278
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) NJ Health	$500.00
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	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

36MM MODULAR HEAD +6MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270666902
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

36MM MODULAR HEAD +6MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270666902
Hospital Revenue Code	278
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) NJ Health	$500.00
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	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

375-950-000 ROUND BUR

Facility

$323.73

Service Code	HCPCS C1713
Hospital Charge Code	270656364
Hospital Revenue Code	278
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$161.87
Rate for Payer: Aetna Commercial	$123.02
Rate for Payer: Aetna Medicare Advantage	$97.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.55
Rate for Payer: Cigna Commercial	$161.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.34
Rate for Payer: Qualcare PPO/HMO/WC	$48.56
Rate for Payer: UnitedHealthcare Community & State	$10.23
Rate for Payer: Wellpoint Medicaid Managed Care	$9.19

375-950-000 ROUND BUR

Facility

$323.73

Service Code	HCPCS C1713
Hospital Charge Code	270656364
Hospital Revenue Code	278
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$78.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.34
Rate for Payer: Qualcare PPO/HMO/WC	$48.56

38#2 PE SUT W 1/2 CIR TPR ND

Facility

$300.00

Hospital Charge Code	270688976
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

38#2 PE SUT W 1/2 CIR TPR ND

Facility

$300.00

Hospital Charge Code	270688976
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

38MM BRIGADE PLATE, LORDOTIC

Facility

$14,406.00

Service Code	HCPCS C1713
Hospital Charge Code	270703757
Hospital Revenue Code	278
Min. Negotiated Rate	$2,160.90
Max. Negotiated Rate	$3,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,881.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,486.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.90

38MM BRIGADE PLATE, LORDOTIC

Facility

$14,406.00

Service Code	HCPCS C1713
Hospital Charge Code	270703757
Hospital Revenue Code	278
Min. Negotiated Rate	$409.13
Max. Negotiated Rate	$7,203.00
Rate for Payer: Aetna Commercial	$5,474.28
Rate for Payer: Aetna Medicare Advantage	$4,321.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,673.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,673.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,881.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,673.53
Rate for Payer: Cigna Commercial	$7,203.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,486.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.90
Rate for Payer: UnitedHealthcare Community & State	$455.23
Rate for Payer: Wellpoint Medicaid Managed Care	$409.13

3.8MM DRILL BIT

Facility

$1,025.00

Hospital Charge Code	270685090
Hospital Revenue Code	272
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$153.75
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

3.8MM DRILL BIT

Facility

$1,025.00

Hospital Charge Code	270685090
Hospital Revenue Code	272
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$205.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Commercial	$205.00
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

3.8X14MM SCREW

Facility

$4,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270704994
Hospital Revenue Code	278
Min. Negotiated Rate	$121.41
Max. Negotiated Rate	$2,137.50
Rate for Payer: Aetna Commercial	$1,624.50
Rate for Payer: Aetna Medicare Advantage	$1,282.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,090.12
Rate for Payer: Cigna Commercial	$2,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25
Rate for Payer: UnitedHealthcare Community & State	$135.09
Rate for Payer: Wellpoint Medicaid Managed Care	$121.41

3.8X14MM SCREW

Facility

$4,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270704994
Hospital Revenue Code	278
Min. Negotiated Rate	$641.25
Max. Negotiated Rate	$1,034.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25

3.9MM MIS ACHILLES SPDBRG

Facility

$16,454.25

Service Code	HCPCS C1713
Hospital Charge Code	270704142
Hospital Revenue Code	278
Min. Negotiated Rate	$467.30
Max. Negotiated Rate	$8,227.12
Rate for Payer: Aetna Commercial	$6,252.61
Rate for Payer: Aetna Medicare Advantage	$4,936.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,195.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,195.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,290.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,195.83
Rate for Payer: Cigna Commercial	$8,227.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,981.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,468.14
Rate for Payer: UnitedHealthcare Community & State	$519.95
Rate for Payer: Wellpoint Medicaid Managed Care	$467.30

3.9MM MIS ACHILLES SPDBRG

Facility

$16,454.25

Service Code	HCPCS C1713
Hospital Charge Code	270704142
Hospital Revenue Code	278
Min. Negotiated Rate	$2,468.14
Max. Negotiated Rate	$3,981.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,290.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,981.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,468.14

3D MAX MESH MEDIUM LEFT

Facility

$1,162.00

Service Code	HCPCS C1781
Hospital Charge Code	270686357
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$581.00
Rate for Payer: Aetna Commercial	$441.56
Rate for Payer: Aetna Medicare Advantage	$348.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.31
Rate for Payer: Cigna Commercial	$581.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.20
Rate for Payer: Qualcare PPO/HMO/WC	$174.30
Rate for Payer: UnitedHealthcare Community & State	$36.72
Rate for Payer: Wellpoint Medicaid Managed Care	$33.00

3D MAX MESH MEDIUM LEFT

Facility

$1,162.00

Service Code	HCPCS C1781
Hospital Charge Code	270686357
Hospital Revenue Code	278
Min. Negotiated Rate	$174.30
Max. Negotiated Rate	$281.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.20
Rate for Payer: Qualcare PPO/HMO/WC	$174.30

3D MAX Right Medium (Mesh)

Facility

$1,162.50

Service Code	HCPCS C1781
Hospital Charge Code	270686358
Hospital Revenue Code	278
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$581.25
Rate for Payer: Aetna Commercial	$441.75
Rate for Payer: Aetna Medicare Advantage	$348.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$296.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$296.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$296.44
Rate for Payer: Cigna Commercial	$581.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.32
Rate for Payer: Qualcare PPO/HMO/WC	$174.38
Rate for Payer: UnitedHealthcare Community & State	$36.73
Rate for Payer: Wellpoint Medicaid Managed Care	$33.02

Know your out-of-pocket cost for care.

All Charges