Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TIGHT ROPE

Facility

$1,976.00

Hospital Charge Code	270332166
Hospital Revenue Code	278
Min. Negotiated Rate	$296.40
Max. Negotiated Rate	$478.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.19
Rate for Payer: Qualcare PPO/HMO/WC	$296.40

TIGHT ROPE

Facility

$1,976.00

Hospital Charge Code	270332166
Hospital Revenue Code	278
Min. Negotiated Rate	$56.12
Max. Negotiated Rate	$988.00
Rate for Payer: Aetna Commercial	$750.88
Rate for Payer: Aetna Medicare Advantage	$592.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.88
Rate for Payer: Cigna Commercial	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.19
Rate for Payer: Qualcare PPO/HMO/WC	$296.40
Rate for Payer: UnitedHealthcare Community & State	$62.44
Rate for Payer: Wellpoint Medicaid Managed Care	$56.12

TIGHTROPE 1.1 MM IMPLANT

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684814
Hospital Revenue Code	278
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$109.81
Rate for Payer: Wellpoint Medicaid Managed Care	$98.69

TIGHTROPE 1.1 MM IMPLANT

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684814
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

TIGHT ROPE ABS,14MM BUTTON

Facility

$1,070.00

Service Code	HCPCS C1713
Hospital Charge Code	270664774
Hospital Revenue Code	278
Min. Negotiated Rate	$30.39
Max. Negotiated Rate	$535.00
Rate for Payer: Aetna Commercial	$406.60
Rate for Payer: Aetna Medicare Advantage	$321.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.85
Rate for Payer: Cigna Commercial	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: Qualcare PPO/HMO/WC	$160.50
Rate for Payer: UnitedHealthcare Community & State	$33.81
Rate for Payer: Wellpoint Medicaid Managed Care	$30.39

TIGHT ROPE ABS,14MM BUTTON

Facility

$1,070.00

Service Code	HCPCS C1713
Hospital Charge Code	270664774
Hospital Revenue Code	278
Min. Negotiated Rate	$160.50
Max. Negotiated Rate	$258.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.94
Rate for Payer: Qualcare PPO/HMO/WC	$160.50

TIGHT ROPE ABS 14 MM CONVA

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690220
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

TIGHT ROPE ABS 14 MM CONVA

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690220
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TIGHTROPE ABS BUT RD CONC 17MM

Facility

$1,422.90

Hospital Charge Code	270702507
Hospital Revenue Code	278
Min. Negotiated Rate	$213.44
Max. Negotiated Rate	$344.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.34
Rate for Payer: Qualcare PPO/HMO/WC	$213.44

TIGHTROPE ABS BUT RD CONC 17MM

Facility

$1,422.90

Hospital Charge Code	270702507
Hospital Revenue Code	278
Min. Negotiated Rate	$40.41
Max. Negotiated Rate	$711.45
Rate for Payer: Aetna Commercial	$540.70
Rate for Payer: Aetna Medicare Advantage	$426.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.84
Rate for Payer: Cigna Commercial	$711.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.34
Rate for Payer: Qualcare PPO/HMO/WC	$213.44
Rate for Payer: UnitedHealthcare Community & State	$44.96
Rate for Payer: Wellpoint Medicaid Managed Care	$40.41

TIGHT ROPE ABS BUTTON 8X12MM

Facility

$715.00

Service Code	HCPCS C1713
Hospital Charge Code	270669603
Hospital Revenue Code	278
Min. Negotiated Rate	$20.31
Max. Negotiated Rate	$357.50
Rate for Payer: Aetna Commercial	$271.70
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: Qualcare PPO/HMO/WC	$107.25
Rate for Payer: UnitedHealthcare Community & State	$22.59
Rate for Payer: Wellpoint Medicaid Managed Care	$20.31

TIGHT ROPE ABS BUTTON 8X12MM

Facility

$715.00

Service Code	HCPCS C1713
Hospital Charge Code	270669603
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$173.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

TIGHTROPE ABS IMPLANT OPEN

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	270666957
Hospital Revenue Code	278
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Community & State	$30.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.55

TIGHTROPE ABS IMPLANT OPEN

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	270666957
Hospital Revenue Code	278
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TIGHTROPE ABS ROUND 20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690896
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TIGHTROPE ABS ROUND 20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690896
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

TIGHT ROPE ACL FIBERTAG

Facility

$4,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695231
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

TIGHT ROPE ACL FIBERTAG

Facility

$4,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695231
Hospital Revenue Code	278
Min. Negotiated Rate	$138.45
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,852.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25
Rate for Payer: UnitedHealthcare Community & State	$154.05
Rate for Payer: Wellpoint Medicaid Managed Care	$138.45

TIGHT ROPE BUTTON EXTENDER

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270669639
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

TIGHT ROPE BUTTON EXTENDER

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270669639
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

TIGHTROPE BUTTRESS PLATE

Facility

$5,125.00

Hospital Charge Code	270670742
Hospital Revenue Code	278
Min. Negotiated Rate	$768.75
Max. Negotiated Rate	$1,240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,240.25
Rate for Payer: Qualcare PPO/HMO/WC	$768.75

TIGHTROPE BUTTRESS PLATE

Facility

$5,125.00

Hospital Charge Code	270670742
Hospital Revenue Code	278
Min. Negotiated Rate	$145.55
Max. Negotiated Rate	$2,562.50
Rate for Payer: Aetna Commercial	$1,947.50
Rate for Payer: Aetna Medicare Advantage	$1,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.88
Rate for Payer: Cigna Commercial	$2,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,240.25
Rate for Payer: Qualcare PPO/HMO/WC	$768.75
Rate for Payer: UnitedHealthcare Community & State	$161.95
Rate for Payer: Wellpoint Medicaid Managed Care	$145.55

TIGHTROPE KNOTLESS SS

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270683274
Hospital Revenue Code	278
Min. Negotiated Rate	$124.96
Max. Negotiated Rate	$2,200.00
Rate for Payer: Aetna Commercial	$1,672.00
Rate for Payer: Aetna Medicare Advantage	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.00
Rate for Payer: Cigna Commercial	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$660.00
Rate for Payer: UnitedHealthcare Community & State	$139.04
Rate for Payer: Wellpoint Medicaid Managed Care	$124.96

TIGHTROPE KNOTLESS SS

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270683274
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$1,064.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

TIGHTROPE KNOTLESS TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684365
Hospital Revenue Code	278
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) NJ Health	$1,495.00
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	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

Know your out-of-pocket cost for care.

All Charges