Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

4.5 X 32MM BONE TORNIER

Facility

$525.00

Hospital Charge Code	270339517
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.5 X 32MM BONE TORNIER

Facility

$525.00

Hospital Charge Code	270339517
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

4.5 X36MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339518
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

4.5 X36MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339518
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

45X4.0 CONCELLOUS SCREW

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270656446
Hospital Revenue Code	278
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$68.25
Rate for Payer: Aetna Commercial	$51.87
Rate for Payer: Aetna Medicare Advantage	$40.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.81
Rate for Payer: Cigna Commercial	$68.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.88

45X4.0 CONCELLOUS SCREW

Facility

$136.50

Service Code	HCPCS C1713
Hospital Charge Code	270656446
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.03
Rate for Payer: Qualcare PPO/HMO/WC	$20.48

4.5 X 40MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339519
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.5 X 40MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339519
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

4.5 X 45MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339520
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

4.5 X 45MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339520
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.5 X 50MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339521
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

4.5 X 50MM BONE SCREW TORNIER

Facility

$525.00

Hospital Charge Code	270339521
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.75 KNOTLESSBC LOOP N TACK SY

Facility

$4,429.00

Hospital Charge Code	270703222
Hospital Revenue Code	278
Min. Negotiated Rate	$125.78
Max. Negotiated Rate	$2,214.50
Rate for Payer: Aetna Commercial	$1,683.02
Rate for Payer: Aetna Medicare Advantage	$1,328.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.39
Rate for Payer: Cigna Commercial	$2,214.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,071.82
Rate for Payer: Qualcare PPO/HMO/WC	$664.35
Rate for Payer: UnitedHealthcare Community & State	$139.96
Rate for Payer: Wellpoint Medicaid Managed Care	$125.78

4.75 KNOTLESSBC LOOP N TACK SY

Facility

$4,429.00

Hospital Charge Code	270703222
Hospital Revenue Code	278
Min. Negotiated Rate	$664.35
Max. Negotiated Rate	$1,071.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,071.82
Rate for Payer: Qualcare PPO/HMO/WC	$664.35

4.75MM KNOTLESSSWIVEL ANCHOR

Facility

$2,549.25

Service Code	HCPCS C1713
Hospital Charge Code	270704694
Hospital Revenue Code	278
Min. Negotiated Rate	$382.39
Max. Negotiated Rate	$616.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.92
Rate for Payer: Qualcare PPO/HMO/WC	$382.39

4.75MM KNOTLESSSWIVEL ANCHOR

Facility

$2,549.25

Service Code	HCPCS C1713
Hospital Charge Code	270704694
Hospital Revenue Code	278
Min. Negotiated Rate	$72.40
Max. Negotiated Rate	$1,274.62
Rate for Payer: Aetna Commercial	$968.72
Rate for Payer: Aetna Medicare Advantage	$764.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.06
Rate for Payer: Cigna Commercial	$1,274.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.92
Rate for Payer: Qualcare PPO/HMO/WC	$382.39
Rate for Payer: UnitedHealthcare Community & State	$80.56
Rate for Payer: Wellpoint Medicaid Managed Care	$72.40

480MM ROD

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270659158
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

480MM ROD

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270659158
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

4.8 DRILL BIT

Facility

$625.00

Hospital Charge Code	270339502
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

4.8 DRILL BIT

Facility

$625.00

Hospital Charge Code	270339502
Hospital Revenue Code	272
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

4.8MM CANC SCRW NONSTRL 32MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270685091
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

4.8MM CANC SCRW NONSTRL 32MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270685091
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

4 HOLE DISTAL LATERAL PLATE

Facility

$17,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270705007
Hospital Revenue Code	278
Min. Negotiated Rate	$2,601.75
Max. Negotiated Rate	$4,197.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,469.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,197.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,601.75

4 HOLE DISTAL LATERAL PLATE

Facility

$17,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270705007
Hospital Revenue Code	278
Min. Negotiated Rate	$492.60
Max. Negotiated Rate	$8,672.50
Rate for Payer: Aetna Commercial	$6,591.10
Rate for Payer: Aetna Medicare Advantage	$5,203.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,422.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,422.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,469.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,422.98
Rate for Payer: Cigna Commercial	$8,672.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,197.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,601.75
Rate for Payer: UnitedHealthcare Community & State	$548.10
Rate for Payer: Wellpoint Medicaid Managed Care	$492.60

Know your out-of-pocket cost for care.

All Charges