Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

45MM ROD

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270704010
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$227.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00

45MM ROD

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270704010
Hospital Revenue Code	278
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$470.00
Rate for Payer: Aetna Commercial	$357.20
Rate for Payer: Aetna Medicare Advantage	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.70
Rate for Payer: Cigna Commercial	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00
Rate for Payer: UnitedHealthcare Community & State	$29.70
Rate for Payer: Wellpoint Medicaid Managed Care	$26.70

45MM SKYLINE PLATE

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270683721
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$1,754.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

45MM SKYLINE PLATE

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270683721
Hospital Revenue Code	278
Min. Negotiated Rate	$205.90
Max. Negotiated Rate	$3,625.00
Rate for Payer: Aetna Commercial	$2,755.00
Rate for Payer: Aetna Medicare Advantage	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,848.75
Rate for Payer: Cigna Commercial	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50
Rate for Payer: UnitedHealthcare Community & State	$229.10
Rate for Payer: Wellpoint Medicaid Managed Care	$205.90

4.5MM SYNOVATOR PLATINUM SER

Facility

$250.00

Hospital Charge Code	270692789
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

4.5MM SYNOVATOR PLATINUM SER

Facility

$250.00

Hospital Charge Code	270692789
Hospital Revenue Code	272
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$50.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$50.00
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

4.5MM TAP GPS

Facility

$6,190.00

Hospital Charge Code	270697222
Hospital Revenue Code	272
Min. Negotiated Rate	$175.80
Max. Negotiated Rate	$3,095.00
Rate for Payer: Aetna Commercial	$2,352.20
Rate for Payer: Aetna Medicare Advantage	$1,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,578.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,578.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,578.45
Rate for Payer: Cigna Commercial	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,609.40
Rate for Payer: Oxford Commercial	$1,238.00
Rate for Payer: Qualcare PPO/HMO/WC	$928.50
Rate for Payer: UnitedHealthcare Commercial	$1,238.00
Rate for Payer: UnitedHealthcare Community & State	$195.60
Rate for Payer: Wellpoint Medicaid Managed Care	$175.80

4.5MM TAP GPS

Facility

$6,190.00

Hospital Charge Code	270697222
Hospital Revenue Code	272
Min. Negotiated Rate	$928.50
Max. Negotiated Rate	$928.50
Rate for Payer: Qualcare PPO/HMO/WC	$928.50

4.5 MM X 15MM SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270688782
Hospital Revenue Code	278
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$30.98
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

4.5 MM X 15MM SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270688782
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

4.5 MM X 15 SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270688781
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

4.5 MM X 15 SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270688781
Hospital Revenue Code	278
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$30.98
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

4.5 MM X 20MM SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270688783
Hospital Revenue Code	278
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$30.98
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

4.5 MM X 20MM SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270688783
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

4.5 TAP

Facility

$3,075.00

Hospital Charge Code	270704251
Hospital Revenue Code	279
Min. Negotiated Rate	$87.33
Max. Negotiated Rate	$1,537.50
Rate for Payer: Aetna Commercial	$1,168.50
Rate for Payer: Aetna Medicare Advantage	$922.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.12
Rate for Payer: Cigna Commercial	$1,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.50
Rate for Payer: Oxford Commercial	$615.00
Rate for Payer: Qualcare PPO/HMO/WC	$461.25
Rate for Payer: UnitedHealthcare Commercial	$615.00
Rate for Payer: UnitedHealthcare Community & State	$97.17
Rate for Payer: Wellpoint Medicaid Managed Care	$87.33

4.5 TAP

Facility

$3,075.00

Hospital Charge Code	270704251
Hospital Revenue Code	279
Min. Negotiated Rate	$461.25
Max. Negotiated Rate	$461.25
Rate for Payer: Qualcare PPO/HMO/WC	$461.25

4.5 TI MULTILOC SCREW

Facility

$2,569.95

Service Code	HCPCS C1713
Hospital Charge Code	270705550
Hospital Revenue Code	278
Min. Negotiated Rate	$385.49
Max. Negotiated Rate	$621.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$513.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.93
Rate for Payer: Qualcare PPO/HMO/WC	$385.49

4.5 TI MULTILOC SCREW

Facility

$2,569.95

Service Code	HCPCS C1713
Hospital Charge Code	270705549
Hospital Revenue Code	278
Min. Negotiated Rate	$385.49
Max. Negotiated Rate	$621.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$513.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.93
Rate for Payer: Qualcare PPO/HMO/WC	$385.49

4.5 TI MULTILOC SCREW

Facility

$2,569.95

Service Code	HCPCS C1713
Hospital Charge Code	270705549
Hospital Revenue Code	278
Min. Negotiated Rate	$72.99
Max. Negotiated Rate	$1,284.97
Rate for Payer: Aetna Commercial	$976.58
Rate for Payer: Aetna Medicare Advantage	$770.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$513.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.34
Rate for Payer: Cigna Commercial	$1,284.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.93
Rate for Payer: Qualcare PPO/HMO/WC	$385.49
Rate for Payer: UnitedHealthcare Community & State	$81.21
Rate for Payer: Wellpoint Medicaid Managed Care	$72.99

4.5 TI MULTILOC SCREW

Facility

$2,569.95

Service Code	HCPCS C1713
Hospital Charge Code	270705550
Hospital Revenue Code	278
Min. Negotiated Rate	$72.99
Max. Negotiated Rate	$1,284.97
Rate for Payer: Aetna Commercial	$976.58
Rate for Payer: Aetna Medicare Advantage	$770.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$513.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.34
Rate for Payer: Cigna Commercial	$1,284.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.93
Rate for Payer: Qualcare PPO/HMO/WC	$385.49
Rate for Payer: UnitedHealthcare Community & State	$81.21
Rate for Payer: Wellpoint Medicaid Managed Care	$72.99

4.5 TI MULTILOC SCREW

Facility

$2,569.95

Service Code	HCPCS C1713
Hospital Charge Code	270705548
Hospital Revenue Code	278
Min. Negotiated Rate	$385.49
Max. Negotiated Rate	$621.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$513.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.93
Rate for Payer: Qualcare PPO/HMO/WC	$385.49

4.5 TI MULTILOC SCREW

Facility

$2,569.95

Service Code	HCPCS C1713
Hospital Charge Code	270705548
Hospital Revenue Code	278
Min. Negotiated Rate	$72.99
Max. Negotiated Rate	$1,284.97
Rate for Payer: Aetna Commercial	$976.58
Rate for Payer: Aetna Medicare Advantage	$770.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$513.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.34
Rate for Payer: Cigna Commercial	$1,284.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$621.93
Rate for Payer: Qualcare PPO/HMO/WC	$385.49
Rate for Payer: UnitedHealthcare Community & State	$81.21
Rate for Payer: Wellpoint Medicaid Managed Care	$72.99

4.5X14MM SCREW

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704541
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

4.5X14MM SCREW

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704541
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

4.5x16MM SCREW PRECISION SPINE

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705172
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Know your out-of-pocket cost for care.

All Charges