Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TIGHTROPE KNOTLESS TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684365
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHT ROPE MINI 4.5X14MM

Facility

$3,400.00

Hospital Charge Code	270670500
Hospital Revenue Code	278
Min. Negotiated Rate	$96.56
Max. Negotiated Rate	$1,700.00
Rate for Payer: Aetna Commercial	$1,292.00
Rate for Payer: Aetna Medicare Advantage	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$867.00
Rate for Payer: Cigna Commercial	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.80
Rate for Payer: Qualcare PPO/HMO/WC	$510.00
Rate for Payer: UnitedHealthcare Community & State	$107.44
Rate for Payer: Wellpoint Medicaid Managed Care	$96.56

TIGHT ROPE MINI 4.5X14MM

Facility

$3,400.00

Hospital Charge Code	270670500
Hospital Revenue Code	278
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$822.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.80
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

TIGHTROPE MINI REPAIR KIT

Facility

$3,750.00

Hospital Charge Code	270670041
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

TIGHTROPE MINI REPAIR KIT

Facility

$3,750.00

Hospital Charge Code	270670041
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

TIGHTROPE MINI SYST CMC

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693763
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

TIGHTROPE MINI SYST CMC

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693763
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

TIGHTROPE MINI W/INSERT

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270676820
Hospital Revenue Code	278
Min. Negotiated Rate	$85.91
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$1,149.50
Rate for Payer: Aetna Medicare Advantage	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.38
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75
Rate for Payer: UnitedHealthcare Community & State	$95.59
Rate for Payer: Wellpoint Medicaid Managed Care	$85.91

TIGHTROPE MINI W/INSERT

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270676820
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

TIGHTROPE RT W/10MM FLIPCUTTER

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270675758
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

TIGHTROPE RT W/10MM FLIPCUTTER

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270675758
Hospital Revenue Code	278
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Community & State	$106.65
Rate for Payer: Wellpoint Medicaid Managed Care	$95.85

TIGHTROPE SS XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682060
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHTROPE SS XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682060
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

TIGHT ROPE SYNDEMOSIS REPAIR

Facility

$425.00

Hospital Charge Code	270652942
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

TIGHT ROPE SYNDEMOSIS REPAIR

Facility

$425.00

Hospital Charge Code	270652942
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

TIGHTROPE SYSTEM

Facility

$9,759.25

Hospital Charge Code	270702326
Hospital Revenue Code	278
Min. Negotiated Rate	$277.16
Max. Negotiated Rate	$4,879.62
Rate for Payer: Aetna Commercial	$3,708.51
Rate for Payer: Aetna Medicare Advantage	$2,927.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,488.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,488.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,951.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,488.61
Rate for Payer: Cigna Commercial	$4,879.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,361.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,463.89
Rate for Payer: UnitedHealthcare Community & State	$308.39
Rate for Payer: Wellpoint Medicaid Managed Care	$277.16

TIGHTROPE SYSTEM

Facility

$9,759.25

Hospital Charge Code	270702326
Hospital Revenue Code	278
Min. Negotiated Rate	$1,463.89
Max. Negotiated Rate	$2,361.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,951.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,361.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,463.89

TIGHT ROPE TITANIUM

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270654984
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

TIGHT ROPE TITANIUM

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270654984
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 TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682061
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

TIGHTROPE TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270682061
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHTROPE WITH FIBER TAG

Facility

$1,675.00

Hospital Charge Code	270690999
Hospital Revenue Code	272
Min. Negotiated Rate	$47.57
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.50
Rate for Payer: Oxford Commercial	$335.00
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Commercial	$335.00
Rate for Payer: UnitedHealthcare Community & State	$52.93
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

TIGHTROPE WITH FIBER TAG

Facility

$1,675.00

Hospital Charge Code	270690999
Hospital Revenue Code	272
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$251.25
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

TIGHTROPE XP STAINLESS

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270655935
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

TIGHTROPE XP STAINLESS

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270655935
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

Know your out-of-pocket cost for care.

All Charges