Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TFNA NAIL 10MM/125D 340MM RT

Facility

$28,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270699642
Hospital Revenue Code	278
Min. Negotiated Rate	$4,305.00
Max. Negotiated Rate	$6,945.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,945.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,305.00

TFNA NAIL 10MM/125D 340MM RT

Facility

$28,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270699642
Hospital Revenue Code	278
Min. Negotiated Rate	$815.08
Max. Negotiated Rate	$14,350.00
Rate for Payer: Aetna Commercial	$10,906.00
Rate for Payer: Aetna Medicare Advantage	$8,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,318.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,740.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,318.50
Rate for Payer: Cigna Commercial	$14,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,945.40
Rate for Payer: Qualcare PPO/HMO/WC	$4,305.00
Rate for Payer: UnitedHealthcare Community & State	$906.92
Rate for Payer: Wellpoint Medicaid Managed Care	$815.08

TFNA NAIL 11MM/125D TI 170MM

Facility

$19,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270699732
Hospital Revenue Code	278
Min. Negotiated Rate	$544.57
Max. Negotiated Rate	$9,587.50
Rate for Payer: Aetna Commercial	$7,286.50
Rate for Payer: Aetna Medicare Advantage	$5,752.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,889.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,889.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,889.62
Rate for Payer: Cigna Commercial	$9,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,876.25
Rate for Payer: UnitedHealthcare Community & State	$605.93
Rate for Payer: Wellpoint Medicaid Managed Care	$544.57

TFNA NAIL 11MM/125D TI 170MM

Facility

$19,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270699732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,876.25
Max. Negotiated Rate	$4,640.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,640.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,876.25

TFNA SCREW 100MM STERILE

Facility

$3,230.45

Service Code	HCPCS C1713
Hospital Charge Code	270678460
Hospital Revenue Code	278
Min. Negotiated Rate	$91.74
Max. Negotiated Rate	$1,615.22
Rate for Payer: Aetna Commercial	$1,227.57
Rate for Payer: Aetna Medicare Advantage	$969.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.76
Rate for Payer: Cigna Commercial	$1,615.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.77
Rate for Payer: Qualcare PPO/HMO/WC	$484.57
Rate for Payer: UnitedHealthcare Community & State	$102.08
Rate for Payer: Wellpoint Medicaid Managed Care	$91.74

TFNA SCREW 100MM STERILE

Facility

$3,230.45

Service Code	HCPCS C1713
Hospital Charge Code	270678460
Hospital Revenue Code	278
Min. Negotiated Rate	$484.57
Max. Negotiated Rate	$781.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.77
Rate for Payer: Qualcare PPO/HMO/WC	$484.57

TFNA SCREW 90MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270696754
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.25
Max. Negotiated Rate	$2,070.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25

TFNA SCREW 90MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270696754
Hospital Revenue Code	278
Min. Negotiated Rate	$242.96
Max. Negotiated Rate	$4,277.50
Rate for Payer: Aetna Commercial	$3,250.90
Rate for Payer: Aetna Medicare Advantage	$2,566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,181.53
Rate for Payer: Cigna Commercial	$4,277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25
Rate for Payer: UnitedHealthcare Community & State	$270.34
Rate for Payer: Wellpoint Medicaid Managed Care	$242.96

TFNA SCREW 95MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676459
Hospital Revenue Code	278
Min. Negotiated Rate	$89.07
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$99.11
Rate for Payer: Wellpoint Medicaid Managed Care	$89.07

TFNA SCREW 95MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676459
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

TFNA SCREW FENESTRATED 80MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270699643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.25
Max. Negotiated Rate	$2,070.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25

TFNA SCREW FENESTRATED 80MM

Facility

$8,555.00

Service Code	HCPCS C1713
Hospital Charge Code	270699643
Hospital Revenue Code	278
Min. Negotiated Rate	$242.96
Max. Negotiated Rate	$4,277.50
Rate for Payer: Aetna Commercial	$3,250.90
Rate for Payer: Aetna Medicare Advantage	$2,566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,711.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,181.53
Rate for Payer: Cigna Commercial	$4,277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,070.31
Rate for Payer: Qualcare PPO/HMO/WC	$1,283.25
Rate for Payer: UnitedHealthcare Community & State	$270.34
Rate for Payer: Wellpoint Medicaid Managed Care	$242.96

TFNA TI 10MM/130D 340MM LT

Facility

$10,969.10

Service Code	HCPCS C1776
Hospital Charge Code	270693674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,645.37
Max. Negotiated Rate	$2,654.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,193.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,654.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,645.37

TFNA TI 10MM/130D 340MM LT

Facility

$10,969.10

Service Code	HCPCS C1776
Hospital Charge Code	270693674
Hospital Revenue Code	278
Min. Negotiated Rate	$311.52
Max. Negotiated Rate	$5,484.55
Rate for Payer: Aetna Commercial	$4,168.26
Rate for Payer: Aetna Medicare Advantage	$3,290.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,797.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,797.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,193.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,797.12
Rate for Payer: Cigna Commercial	$5,484.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,654.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,645.37
Rate for Payer: UnitedHealthcare Community & State	$346.62
Rate for Payer: Wellpoint Medicaid Managed Care	$311.52

TF ULTRA 2 UBRAID & NDLS 4.5mm

Facility

$1,520.00

Hospital Charge Code	270649965
Hospital Revenue Code	272
Min. Negotiated Rate	$43.17
Max. Negotiated Rate	$760.00
Rate for Payer: Aetna Commercial	$577.60
Rate for Payer: Aetna Medicare Advantage	$456.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.60
Rate for Payer: Cigna Commercial	$760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$395.20
Rate for Payer: Oxford Commercial	$304.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.00
Rate for Payer: UnitedHealthcare Commercial	$304.00
Rate for Payer: UnitedHealthcare Community & State	$48.03
Rate for Payer: Wellpoint Medicaid Managed Care	$43.17

TF ULTRA 2 UBRAID & NDLS 4.5mm

Facility

$1,520.00

Hospital Charge Code	270649965
Hospital Revenue Code	272
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$228.00
Rate for Payer: Qualcare PPO/HMO/WC	$228.00

THALLIUM BLOOD

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	39900456
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

THALLIUM BLOOD

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	39900456
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THALLIUM, SERUM

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472933
Hospital Revenue Code	301
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

THALLIUM, SERUM

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472933
Hospital Revenue Code	301
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.66
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

THALLIUM, URINE

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472932
Hospital Revenue Code	301
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

THALLIUM, URINE

Facility

$234.00

Service Code	HCPCS 83018
Hospital Charge Code	38472932
Hospital Revenue Code	301
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.66
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.84
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

THALLOUS CL PER MCI

Facility

$67.00

Hospital Charge Code	4509090
Hospital Revenue Code	343
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$25.46
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.90

THALLOUS CL PER MCI

Facility

$67.00

Hospital Charge Code	4509090
Hospital Revenue Code	343
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

T-HANDLE DRIVER

Facility

$7,220.00

Hospital Charge Code	270690628
Hospital Revenue Code	272
Min. Negotiated Rate	$205.05
Max. Negotiated Rate	$3,610.00
Rate for Payer: Aetna Commercial	$2,743.60
Rate for Payer: Aetna Medicare Advantage	$2,166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,841.10
Rate for Payer: Cigna Commercial	$3,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,877.20
Rate for Payer: Oxford Commercial	$1,444.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.00
Rate for Payer: UnitedHealthcare Commercial	$1,444.00
Rate for Payer: UnitedHealthcare Community & State	$228.15
Rate for Payer: Wellpoint Medicaid Managed Care	$205.05

Know your out-of-pocket cost for care.

All Charges