Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TITAN 3D WEDGE COTTON 5MM

Facility

$10,412.50

Service Code	HCPCS C1713
Hospital Charge Code	270701425
Hospital Revenue Code	278
Min. Negotiated Rate	$1,561.88
Max. Negotiated Rate	$2,519.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,519.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,561.88

TITAN 3D WEDGE SYSTEM 8MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704487
Hospital Revenue Code	279
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,600.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

TITAN 3D WEDGE SYSTEM 8MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704487
Hospital Revenue Code	279
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

TITANIUM CORTEX SCREW

Facility

$1,093.00

Hospital Charge Code	270335048
Hospital Revenue Code	278
Min. Negotiated Rate	$31.04
Max. Negotiated Rate	$546.50
Rate for Payer: Aetna Commercial	$415.34
Rate for Payer: Aetna Medicare Advantage	$327.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.71
Rate for Payer: Cigna Commercial	$546.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.51
Rate for Payer: Qualcare PPO/HMO/WC	$163.95
Rate for Payer: UnitedHealthcare Community & State	$34.54
Rate for Payer: Wellpoint Medicaid Managed Care	$31.04

TITANIUM CORTEX SCREW

Facility

$1,093.00

Hospital Charge Code	270335048
Hospital Revenue Code	278
Min. Negotiated Rate	$163.95
Max. Negotiated Rate	$264.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.51
Rate for Payer: Qualcare PPO/HMO/WC	$163.95

TITANIUM HUMERAL NAIL 7MM

Facility

$7,605.00

Hospital Charge Code	270656701
Hospital Revenue Code	278
Min. Negotiated Rate	$215.98
Max. Negotiated Rate	$3,802.50
Rate for Payer: Aetna Commercial	$2,889.90
Rate for Payer: Aetna Medicare Advantage	$2,281.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,939.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,939.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,939.28
Rate for Payer: Cigna Commercial	$3,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,840.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,140.75
Rate for Payer: UnitedHealthcare Community & State	$240.32
Rate for Payer: Wellpoint Medicaid Managed Care	$215.98

TITANIUM HUMERAL NAIL 7MM

Facility

$7,605.00

Hospital Charge Code	270656701
Hospital Revenue Code	278
Min. Negotiated Rate	$1,140.75
Max. Negotiated Rate	$1,840.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,840.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,140.75

TITANIUM MINI DCP

Facility

$492.00

Hospital Charge Code	270335049
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

TITANIUM MINI DCP

Facility

$492.00

Hospital Charge Code	270335049
Hospital Revenue Code	278
Min. Negotiated Rate	$13.97
Max. Negotiated Rate	$246.00
Rate for Payer: Aetna Commercial	$186.96
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
Rate for Payer: UnitedHealthcare Community & State	$15.55
Rate for Payer: Wellpoint Medicaid Managed Care	$13.97

TITANIUM TIGHTROPE

Facility

$1,482.00

Hospital Charge Code	27038051
Hospital Revenue Code	278
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$741.00
Rate for Payer: Aetna Commercial	$563.16
Rate for Payer: Aetna Medicare Advantage	$444.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.91
Rate for Payer: Cigna Commercial	$741.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.64
Rate for Payer: Qualcare PPO/HMO/WC	$222.30
Rate for Payer: UnitedHealthcare Community & State	$46.83
Rate for Payer: Wellpoint Medicaid Managed Care	$42.09

TITANIUM TIGHTROPE

Facility

$1,482.00

Hospital Charge Code	27038051
Hospital Revenue Code	278
Min. Negotiated Rate	$222.30
Max. Negotiated Rate	$358.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.64
Rate for Payer: Qualcare PPO/HMO/WC	$222.30

TITANIUMTIP CYLDRICL TUBE SET

Facility

$122,375.00

Hospital Charge Code	270663200
Hospital Revenue Code	272
Min. Negotiated Rate	$18,356.25
Max. Negotiated Rate	$18,356.25
Rate for Payer: Qualcare PPO/HMO/WC	$18,356.25

TITANIUMTIP CYLDRICL TUBE SET

Facility

$122,375.00

Hospital Charge Code	270663200
Hospital Revenue Code	272
Min. Negotiated Rate	$3,475.45
Max. Negotiated Rate	$61,187.50
Rate for Payer: Aetna Commercial	$46,502.50
Rate for Payer: Aetna Medicare Advantage	$36,712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,205.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,205.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,205.62
Rate for Payer: Cigna Commercial	$61,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31,817.50
Rate for Payer: Oxford Commercial	$24,475.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,356.25
Rate for Payer: UnitedHealthcare Commercial	$24,475.00
Rate for Payer: UnitedHealthcare Community & State	$3,867.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3,475.45

TITER REFLEX RPR ANTIBODY

Facility

$42.06

Service Code	HCPCS 86592
Hospital Charge Code	397031151
Hospital Revenue Code	302
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

TITER REFLEX RPR ANTIBODY

Facility

$42.06

Service Code	HCPCS 86592
Hospital Charge Code	397031151
Hospital Revenue Code	302
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.49
Rate for Payer: Cigna Commercial	$21.03
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.94
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

TIZANIDINE 4 MG TAB

Facility

$11.79

Service Code	NDC 904641861
Hospital Charge Code	60629865
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.89
Rate for Payer: Aetna Commercial	$4.48
Rate for Payer: Aetna Medicare Advantage	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.01
Rate for Payer: Cigna Commercial	$5.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.07
Rate for Payer: Oxford Commercial	$2.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$2.36
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

TIZANIDINE 4 MG TAB

Facility

$11.79

Service Code	NDC 904641861
Hospital Charge Code	60629865
Hospital Revenue Code	250
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

TIZANIDINE (ZANAFLEX) 2MG CAP

Facility

$14.27

Service Code	NDC 378072219
Hospital Charge Code	60630191
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.13
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$2.85
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

TIZANIDINE (ZANAFLEX) 2MG CAP

Facility

$14.27

Service Code	NDC 378072219
Hospital Charge Code	60630191
Hospital Revenue Code	250
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

TLH W/T/O 250 G OR LESS

Facility

$43,334.60

Service Code	HCPCS 58571
Hospital Charge Code	16000763
Hospital Revenue Code	360
Min. Negotiated Rate	$1,230.70
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,267.00
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,369.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,230.70

TLH W/T/O 250 G OR LESS

Facility

$43,334.60

Service Code	HCPCS 58571
Hospital Charge Code	16000763
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

TLH W/T/O UTERUS OVER 250 G

Facility

$30,381.68

Service Code	HCPCS 58573
Hospital Charge Code	16000764
Hospital Revenue Code	360
Min. Negotiated Rate	$862.84
Max. Negotiated Rate	$45,809.96
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,809.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,809.96
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,899.24
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,557.25
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$960.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$862.84

TLH W/T/O UTERUS OVER 250 G

Facility

$30,381.68

Service Code	HCPCS 58573
Hospital Charge Code	16000764
Hospital Revenue Code	360
Min. Negotiated Rate	$4,557.25
Max. Negotiated Rate	$4,557.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,557.25

TLIF, 10X25, L

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704015
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

TLIF, 10X25, L

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704015
Hospital Revenue Code	278
Min. Negotiated Rate	$710.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$9,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00
Rate for Payer: UnitedHealthcare Community & State	$790.00
Rate for Payer: Wellpoint Medicaid Managed Care	$710.00

Know your out-of-pocket cost for care.

All Charges