Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SYNTHES 4.0 CALIBRATD DRILL BI

Facility

$381.00

Hospital Charge Code	270335923
Hospital Revenue Code	272
Min. Negotiated Rate	$10.82
Max. Negotiated Rate	$190.50
Rate for Payer: Aetna Commercial	$144.78
Rate for Payer: Aetna Medicare Advantage	$114.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.16
Rate for Payer: Cigna Commercial	$190.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.06
Rate for Payer: Oxford Commercial	$76.20
Rate for Payer: Qualcare PPO/HMO/WC	$57.15
Rate for Payer: UnitedHealthcare Commercial	$76.20
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: Wellpoint Medicaid Managed Care	$10.82

SYNTHES 4.0 CALIBRATD DRILL BI

Facility

$381.00

Hospital Charge Code	270335923
Hospital Revenue Code	272
Min. Negotiated Rate	$57.15
Max. Negotiated Rate	$57.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.15

SYNTHES 5.0 DRILL

Facility

$650.00

Hospital Charge Code	270335939
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SYNTHES 5.0 DRILL

Facility

$650.00

Hospital Charge Code	270335939
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

SYNTHES 5.0 SCREW 16 TO 45

Facility

$310.00

Hospital Charge Code	270335947
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SYNTHES 5.0 SCREW 16 TO 45

Facility

$310.00

Hospital Charge Code	270335947
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SYNTHES 5.0 SCREW 50, 60

Facility

$350.00

Hospital Charge Code	270335948
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

SYNTHES 5.0 SCREW 50, 60

Facility

$350.00

Hospital Charge Code	270335948
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

SYNTHES ANKLE SCREWS

Facility

$975.00

Hospital Charge Code	270335985
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SYNTHES ANKLE SCREWS

Facility

$975.00

Hospital Charge Code	270335985
Hospital Revenue Code	278
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$370.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Community & State	$30.81
Rate for Payer: Wellpoint Medicaid Managed Care	$27.69

SYNTHES LOCKING SCREW 5.0 X 34

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270656648
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

SYNTHES LOCKING SCREW 5.0 X 34

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270656648
Hospital Revenue Code	278
Min. Negotiated Rate	$94.43
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$105.07
Rate for Payer: Wellpoint Medicaid Managed Care	$94.43

SYNTHES LOCKING SCREW 5.0 X 42

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270677266
Hospital Revenue Code	278
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$30.07
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

SYNTHES LOCKING SCREW 5.0 X 42

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270677266
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SYNTHES LOCKING SCREW 5.0 X 46

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270645684
Hospital Revenue Code	278
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$30.07
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

SYNTHES LOCKING SCREW 5.0 X 46

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270645684
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SYNTHES MINI LOCK COLONEAL PLT

Facility

$997.50

Hospital Charge Code	270335984
Hospital Revenue Code	278
Min. Negotiated Rate	$149.62
Max. Negotiated Rate	$241.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.40
Rate for Payer: Qualcare PPO/HMO/WC	$149.62

SYNTHES MINI LOCK COLONEAL PLT

Facility

$997.50

Hospital Charge Code	270335984
Hospital Revenue Code	278
Min. Negotiated Rate	$28.33
Max. Negotiated Rate	$498.75
Rate for Payer: Aetna Commercial	$379.05
Rate for Payer: Aetna Medicare Advantage	$299.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$254.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$254.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$254.36
Rate for Payer: Cigna Commercial	$498.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.40
Rate for Payer: Qualcare PPO/HMO/WC	$149.62
Rate for Payer: UnitedHealthcare Community & State	$31.52
Rate for Payer: Wellpoint Medicaid Managed Care	$28.33

SYNTHES THREADED GUID WIRE 2.5

Facility

$82.00

Hospital Charge Code	270335924
Hospital Revenue Code	278
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$19.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

SYNTHES THREADED GUID WIRE 2.5

Facility

$82.00

Hospital Charge Code	270335924
Hospital Revenue Code	278
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$41.00
Rate for Payer: Aetna Commercial	$31.16
Rate for Payer: Aetna Medicare Advantage	$24.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.91
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Community & State	$2.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SYNTHES TI CANNULATED TIBIA NL

Facility

$2,136.00

Hospital Charge Code	270335922
Hospital Revenue Code	278
Min. Negotiated Rate	$60.66
Max. Negotiated Rate	$1,068.00
Rate for Payer: Aetna Commercial	$811.68
Rate for Payer: Aetna Medicare Advantage	$640.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$544.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$544.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$544.68
Rate for Payer: Cigna Commercial	$1,068.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.91
Rate for Payer: Qualcare PPO/HMO/WC	$320.40
Rate for Payer: UnitedHealthcare Community & State	$67.50
Rate for Payer: Wellpoint Medicaid Managed Care	$60.66

SYNTHES TI CANNULATED TIBIA NL

Facility

$2,136.00

Hospital Charge Code	270335922
Hospital Revenue Code	278
Min. Negotiated Rate	$320.40
Max. Negotiated Rate	$516.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$427.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.91
Rate for Payer: Qualcare PPO/HMO/WC	$320.40

SYNTHETIC BONE GRAFT 6CC

Facility

$10,750.00

Hospital Charge Code	270702209
Hospital Revenue Code	270
Min. Negotiated Rate	$305.30
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,795.00
Rate for Payer: Oxford Commercial	$2,150.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Commercial	$2,150.00
Rate for Payer: UnitedHealthcare Community & State	$339.70
Rate for Payer: Wellpoint Medicaid Managed Care	$305.30

SYNTHETIC BONE GRAFT 6CC

Facility

$10,750.00

Hospital Charge Code	270702209
Hospital Revenue Code	270
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$1,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SYPHILIS AB CASCADE REFL

Facility

$91.00

Service Code	HCPCS 86780
Hospital Charge Code	39900257
Hospital Revenue Code	302
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$36.01
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.03
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: Cigna Medicare Advantage	$13.24
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Medicare Advantage	$13.24
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

Know your out-of-pocket cost for care.

All Charges