Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

Y-PLATE 2.0MM 3 HOLE/8HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654830
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

Y-PLATE 2.4MM 3HOLE/8HOLE

Facility

$1,164.95

Service Code	HCPCS C1713
Hospital Charge Code	270654863
Hospital Revenue Code	278
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$582.48
Rate for Payer: Aetna Commercial	$442.68
Rate for Payer: Aetna Medicare Advantage	$349.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.06
Rate for Payer: Cigna Commercial	$582.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.92
Rate for Payer: Qualcare PPO/HMO/WC	$174.74
Rate for Payer: UnitedHealthcare Community & State	$36.81
Rate for Payer: Wellpoint Medicaid Managed Care	$33.08

Y-PLATE 2.4MM 3HOLE/8HOLE

Facility

$1,164.95

Service Code	HCPCS C1713
Hospital Charge Code	270654863
Hospital Revenue Code	278
Min. Negotiated Rate	$174.74
Max. Negotiated Rate	$281.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.92
Rate for Payer: Qualcare PPO/HMO/WC	$174.74

Y-PLATE LCP 3/HEAD 7H 2.4x60MM

Facility

$2,970.00

Hospital Charge Code	270659767
Hospital Revenue Code	278
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$718.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$594.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$718.74
Rate for Payer: Qualcare PPO/HMO/WC	$445.50

Y-PLATE LCP 3/HEAD 7H 2.4x60MM

Facility

$2,970.00

Hospital Charge Code	270659767
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,485.00
Rate for Payer: Aetna Commercial	$1,128.60
Rate for Payer: Aetna Medicare Advantage	$891.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$757.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$757.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$757.35
Rate for Payer: Cigna Commercial	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$718.74
Rate for Payer: Qualcare PPO/HMO/WC	$445.50
Rate for Payer: UnitedHealthcare Community & State	$93.85
Rate for Payer: Wellpoint Medicaid Managed Care	$84.35

Y PLATE MAX EXTREME LOCK

Facility

$4,740.00

Hospital Charge Code	270339472
Hospital Revenue Code	278
Min. Negotiated Rate	$134.62
Max. Negotiated Rate	$2,370.00
Rate for Payer: Aetna Commercial	$1,801.20
Rate for Payer: Aetna Medicare Advantage	$1,422.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$948.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,208.70
Rate for Payer: Cigna Commercial	$2,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,147.08
Rate for Payer: Qualcare PPO/HMO/WC	$711.00
Rate for Payer: UnitedHealthcare Community & State	$149.78
Rate for Payer: Wellpoint Medicaid Managed Care	$134.62

Y PLATE MAX EXTREME LOCK

Facility

$4,740.00

Hospital Charge Code	270339472
Hospital Revenue Code	278
Min. Negotiated Rate	$711.00
Max. Negotiated Rate	$1,147.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$948.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,147.08
Rate for Payer: Qualcare PPO/HMO/WC	$711.00

Y PLATE MINI MAX LOCK EXTREME

Facility

$3,960.00

Hospital Charge Code	270339474
Hospital Revenue Code	278
Min. Negotiated Rate	$112.46
Max. Negotiated Rate	$1,980.00
Rate for Payer: Aetna Commercial	$1,504.80
Rate for Payer: Aetna Medicare Advantage	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,009.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,009.80
Rate for Payer: Cigna Commercial	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: Qualcare PPO/HMO/WC	$594.00
Rate for Payer: UnitedHealthcare Community & State	$125.14
Rate for Payer: Wellpoint Medicaid Managed Care	$112.46

Y PLATE MINI MAX LOCK EXTREME

Facility

$3,960.00

Hospital Charge Code	270339474
Hospital Revenue Code	278
Min. Negotiated Rate	$594.00
Max. Negotiated Rate	$958.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$792.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$958.32
Rate for Payer: Qualcare PPO/HMO/WC	$594.00

ZA10 PTA FEMORAL-POPLITEAL AR

Facility

$5,000.00

Service Code	HCPCS 37224
Hospital Charge Code	1600000375
Hospital Revenue Code	360
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

ZA10 PTA FEMORAL-POPLITEAL AR

Facility

$5,000.00

Service Code	HCPCS 37224
Hospital Charge Code	1600000375
Hospital Revenue Code	360
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$14,869.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
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	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

ZANOSAR PER 1GM INJ

Facility

$1,999.01

Hospital Charge Code	606394262
Hospital Revenue Code	636
Min. Negotiated Rate	$56.77
Max. Negotiated Rate	$999.50
Rate for Payer: Aetna Commercial	$759.62
Rate for Payer: Aetna Medicare Advantage	$599.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$509.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$509.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$509.75
Rate for Payer: Cigna Commercial	$999.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.76
Rate for Payer: Qualcare PPO/HMO/WC	$299.85
Rate for Payer: UnitedHealthcare Community & State	$63.17
Rate for Payer: Wellpoint Medicaid Managed Care	$56.77

ZANOSAR PER 1GM INJ

Facility

$1,999.01

Hospital Charge Code	606394262
Hospital Revenue Code	636
Min. Negotiated Rate	$299.85
Max. Negotiated Rate	$483.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.76
Rate for Payer: Qualcare PPO/HMO/WC	$299.85

ZARONTIN (ETHOSUXIMIDE)

Facility

$421.00

Service Code	HCPCS 80168
Hospital Charge Code	38472705
Hospital Revenue Code	301
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$210.50
Rate for Payer: Aetna Commercial	$44.44
Rate for Payer: Aetna Medicare Advantage	$52.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.27
Rate for Payer: Cigna Commercial	$210.50
Rate for Payer: Cigna Medicare Advantage	$16.34
Rate for Payer: Clover Medicare Advantage	$15.52
Rate for Payer: EmblemHealth Commercial	$49.02
Rate for Payer: Humana Medicare Advantage	$16.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.46
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.34
Rate for Payer: Wellcare Medicare Advantage	$16.34
Rate for Payer: Wellpoint Medicaid Managed Care	$11.96

ZARONTIN (ETHOSUXIMIDE)

Facility

$421.00

Service Code	HCPCS 80168
Hospital Charge Code	38472705
Hospital Revenue Code	301
Min. Negotiated Rate	$63.15
Max. Negotiated Rate	$63.15
Rate for Payer: Qualcare PPO/HMO/WC	$63.15

ZCAGE VARISYN ALIF 24X30MM 15D

Facility

$32,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270703638
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

ZCAGE VARISYN ALIF 24X30MM 15D

Facility

$32,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270703638
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

ZCAGE VARISYN ALIF 24X30MM 8D

Facility

$32,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270703635
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

ZCAGE VARISYN ALIF 24X30MM 8D

Facility

$32,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270703635
Hospital Revenue Code	278
Min. Negotiated Rate	$923.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$12,350.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00
Rate for Payer: UnitedHealthcare Community & State	$1,027.00
Rate for Payer: Wellpoint Medicaid Managed Care	$923.00

ZEBETA 10MG TAB

Facility

$8.17

Service Code	NDC 185077430
Hospital Charge Code	60635124
Hospital Revenue Code	250
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

ZEBETA 10MG TAB

Facility

$8.17

Service Code	NDC 185077430
Hospital Charge Code	60635124
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$3.10
Rate for Payer: Aetna Medicare Advantage	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.12
Rate for Payer: Oxford Commercial	$1.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$1.63
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

ZERIT/15MG/CAP

Facility

$54.87

Service Code	NDC 3196401
Hospital Charge Code	60634955
Hospital Revenue Code	250
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$8.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.23

ZERIT/15MG/CAP

Facility

$54.87

Service Code	NDC 3196401
Hospital Charge Code	60634955
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.43
Rate for Payer: Aetna Commercial	$20.85
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.99
Rate for Payer: Cigna Commercial	$27.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.27
Rate for Payer: Oxford Commercial	$10.97
Rate for Payer: Qualcare PPO/HMO/WC	$8.23
Rate for Payer: UnitedHealthcare Commercial	$10.97
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

ZERO-P VA CAGE 6MM LORDOTIC

Facility

$16,267.25

Service Code	HCPCS C1889
Hospital Charge Code	270670528
Hospital Revenue Code	278
Min. Negotiated Rate	$461.99
Max. Negotiated Rate	$8,133.62
Rate for Payer: Aetna Commercial	$6,181.56
Rate for Payer: Aetna Medicare Advantage	$4,880.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,148.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,148.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,253.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,148.15
Rate for Payer: Cigna Commercial	$8,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,936.67
Rate for Payer: Qualcare PPO/HMO/WC	$2,440.09
Rate for Payer: UnitedHealthcare Community & State	$514.05
Rate for Payer: Wellpoint Medicaid Managed Care	$461.99

ZERO-P VA CAGE 6MM LORDOTIC

Facility

$16,267.25

Service Code	HCPCS C1889
Hospital Charge Code	270670528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,440.09
Max. Negotiated Rate	$3,936.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,253.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,936.67
Rate for Payer: Qualcare PPO/HMO/WC	$2,440.09

Know your out-of-pocket cost for care.

All Charges