Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SWIVELOCK MINI 3.5x8.5MM

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270677960
Hospital Revenue Code	278
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

SWIVELOCK MINI 3.5x8.5MM

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270677960
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

SWIVELOCK NANO DISP KIT

Facility

$1,475.00

Hospital Charge Code	270691848
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

SWIVELOCK NANO DISP KIT

Facility

$1,475.00

Hospital Charge Code	270691848
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SWIVELOCK PEEK 4.75MM

Facility

$425.00

Hospital Charge Code	270678031
Hospital Revenue Code	272
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

SWIVELOCK PEEK 4.75MM

Facility

$425.00

Hospital Charge Code	270678031
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

SWIVELOCK PEEK 4.75X19.1MM

Facility

$1,945.00

Service Code	HCPCS C1713
Hospital Charge Code	270674852
Hospital Revenue Code	278
Min. Negotiated Rate	$55.24
Max. Negotiated Rate	$972.50
Rate for Payer: Aetna Commercial	$739.10
Rate for Payer: Aetna Medicare Advantage	$583.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.98
Rate for Payer: Cigna Commercial	$972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.69
Rate for Payer: Qualcare PPO/HMO/WC	$291.75
Rate for Payer: UnitedHealthcare Community & State	$61.46
Rate for Payer: Wellpoint Medicaid Managed Care	$55.24

SWIVELOCK PEEK 4.75X19.1MM

Facility

$1,945.00

Service Code	HCPCS C1713
Hospital Charge Code	270674852
Hospital Revenue Code	278
Min. Negotiated Rate	$291.75
Max. Negotiated Rate	$470.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.69
Rate for Payer: Qualcare PPO/HMO/WC	$291.75

SWIVELOCK PEEK KNOTLESS 4.75MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270694729
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

SWIVELOCK PEEK KNOTLESS 4.75MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270694729
Hospital Revenue Code	278
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$68.73
Rate for Payer: Wellpoint Medicaid Managed Care	$61.77

SWIVELOCK PEEK SELF PUNCH

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270677381
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

SWIVELOCK PEEK SELF PUNCH

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270677381
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SWIVELOCK SP PEEK 4.75MM

Facility

$2,420.50

Service Code	HCPCS C1713
Hospital Charge Code	270704916
Hospital Revenue Code	278
Min. Negotiated Rate	$68.74
Max. Negotiated Rate	$1,210.25
Rate for Payer: Aetna Commercial	$919.79
Rate for Payer: Aetna Medicare Advantage	$726.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.23
Rate for Payer: Cigna Commercial	$1,210.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.76
Rate for Payer: Qualcare PPO/HMO/WC	$363.07
Rate for Payer: UnitedHealthcare Community & State	$76.49
Rate for Payer: Wellpoint Medicaid Managed Care	$68.74

SWIVELOCK SP PEEK 4.75MM

Facility

$2,420.50

Service Code	HCPCS C1713
Hospital Charge Code	270704916
Hospital Revenue Code	278
Min. Negotiated Rate	$363.07
Max. Negotiated Rate	$585.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.76
Rate for Payer: Qualcare PPO/HMO/WC	$363.07

SWIVELOCK TENODESIS 8x19.5MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270664574
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

SWIVELOCK TENODESIS 8x19.5MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270664574
Hospital Revenue Code	278
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$68.73
Rate for Payer: Wellpoint Medicaid Managed Care	$61.77

SWIVELOCK TENODESIS SUT ANCHOR

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270675047
Hospital Revenue Code	278
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$496.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

SWIVELOCK TENODESIS SUT ANCHOR

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270675047
Hospital Revenue Code	278
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$779.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Community & State	$64.78
Rate for Payer: Wellpoint Medicaid Managed Care	$58.22

SWIVLK BIO-COMP DBL 4.75x22MM

Facility

$2,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270679322
Hospital Revenue Code	278
Min. Negotiated Rate	$312.75
Max. Negotiated Rate	$504.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$504.57
Rate for Payer: Qualcare PPO/HMO/WC	$312.75

SWIVLK BIO-COMP DBL 4.75x22MM

Facility

$2,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270679322
Hospital Revenue Code	278
Min. Negotiated Rate	$59.21
Max. Negotiated Rate	$1,042.50
Rate for Payer: Aetna Commercial	$792.30
Rate for Payer: Aetna Medicare Advantage	$625.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$417.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$531.67
Rate for Payer: Cigna Commercial	$1,042.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$504.57
Rate for Payer: Qualcare PPO/HMO/WC	$312.75
Rate for Payer: UnitedHealthcare Community & State	$65.89
Rate for Payer: Wellpoint Medicaid Managed Care	$59.21

SWVLCK PEK SLF PNCH 5.5x24.5MM

Facility

$2,540.00

Hospital Charge Code	270679783
Hospital Revenue Code	272
Min. Negotiated Rate	$381.00
Max. Negotiated Rate	$381.00
Rate for Payer: Qualcare PPO/HMO/WC	$381.00

SWVLCK PEK SLF PNCH 5.5x24.5MM

Facility

$2,540.00

Hospital Charge Code	270679783
Hospital Revenue Code	272
Min. Negotiated Rate	$72.14
Max. Negotiated Rate	$1,270.00
Rate for Payer: Aetna Commercial	$965.20
Rate for Payer: Aetna Medicare Advantage	$762.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$647.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$647.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$647.70
Rate for Payer: Cigna Commercial	$1,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.40
Rate for Payer: Oxford Commercial	$508.00
Rate for Payer: Qualcare PPO/HMO/WC	$381.00
Rate for Payer: UnitedHealthcare Commercial	$508.00
Rate for Payer: UnitedHealthcare Community & State	$80.26
Rate for Payer: Wellpoint Medicaid Managed Care	$72.14

SWVLK TENO BIO-COMP 7x19.5MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270675046
Hospital Revenue Code	278
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$68.73
Rate for Payer: Wellpoint Medicaid Managed Care	$61.77

SWVLK TENO BIO-COMP 7x19.5MM

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270675046
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

SWWLK SP 5.5X 24.5MM

Facility

$420.00

Hospital Charge Code	270687031
Hospital Revenue Code	272
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

Know your out-of-pocket cost for care.

All Charges