Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BOLT 8.5 X30MM

Facility

$5,210.00

Hospital Charge Code	270703005
Hospital Revenue Code	278
Min. Negotiated Rate	$147.96
Max. Negotiated Rate	$2,605.00
Rate for Payer: Aetna Commercial	$1,979.80
Rate for Payer: Aetna Medicare Advantage	$1,563.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,328.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,328.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,328.55
Rate for Payer: Cigna Commercial	$2,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,260.82
Rate for Payer: Qualcare PPO/HMO/WC	$781.50
Rate for Payer: UnitedHealthcare Community & State	$164.64
Rate for Payer: Wellpoint Medicaid Managed Care	$147.96

BOLT CONNECTING

Facility

$53.30

Hospital Charge Code	270681236
Hospital Revenue Code	272
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$26.65
Rate for Payer: Aetna Commercial	$20.25
Rate for Payer: Aetna Medicare Advantage	$15.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.59
Rate for Payer: Cigna Commercial	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.86
Rate for Payer: Oxford Commercial	$10.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.00
Rate for Payer: UnitedHealthcare Commercial	$10.66
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

BOLT CONNECTING

Facility

$53.30

Hospital Charge Code	270681236
Hospital Revenue Code	272
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.00

BOLT FEM NECK 90MM STERILE

Facility

$1,597.55

Service Code	HCPCS C1713
Hospital Charge Code	270686943
Hospital Revenue Code	278
Min. Negotiated Rate	$239.63
Max. Negotiated Rate	$386.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.63

BOLT FEM NECK 90MM STERILE

Facility

$1,597.55

Service Code	HCPCS C1713
Hospital Charge Code	270686943
Hospital Revenue Code	278
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$798.77
Rate for Payer: Aetna Commercial	$607.07
Rate for Payer: Aetna Medicare Advantage	$479.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407.38
Rate for Payer: Cigna Commercial	$798.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.63
Rate for Payer: UnitedHealthcare Community & State	$50.48
Rate for Payer: Wellpoint Medicaid Managed Care	$45.37

BOLT FEMORAL NECK SYSTEM 95MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697922
Hospital Revenue Code	278
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$104.28
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

BOLT FEMORAL NECK SYSTEM 95MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697922
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

BOLT FOOT PLATE

Facility

$1,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270697188
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

BOLT FOOT PLATE

Facility

$1,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270697188
Hospital Revenue Code	278
Min. Negotiated Rate	$46.86
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$52.14
Rate for Payer: Wellpoint Medicaid Managed Care	$46.86

BOLT FOR FEMORAL NECK SYS 75MM

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687503
Hospital Revenue Code	278
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$441.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

BOLT FOR FEMORAL NECK SYS 75MM

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687503
Hospital Revenue Code	278
Min. Negotiated Rate	$51.83
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Community & State	$57.67
Rate for Payer: Wellpoint Medicaid Managed Care	$51.83

BOLT FOR FEMORAL NECK SYS 90MM

Facility

$1,551.00

Service Code	HCPCS C1713
Hospital Charge Code	270687815
Hospital Revenue Code	278
Min. Negotiated Rate	$232.65
Max. Negotiated Rate	$375.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.34
Rate for Payer: Qualcare PPO/HMO/WC	$232.65

BOLT FOR FEMORAL NECK SYS 90MM

Facility

$1,551.00

Service Code	HCPCS C1713
Hospital Charge Code	270687815
Hospital Revenue Code	278
Min. Negotiated Rate	$44.05
Max. Negotiated Rate	$775.50
Rate for Payer: Aetna Commercial	$589.38
Rate for Payer: Aetna Medicare Advantage	$465.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.50
Rate for Payer: Cigna Commercial	$775.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.34
Rate for Payer: Qualcare PPO/HMO/WC	$232.65
Rate for Payer: UnitedHealthcare Community & State	$49.01
Rate for Payer: Wellpoint Medicaid Managed Care	$44.05

BOLT FOR FEMORAL NECK SYSTEM 8

Facility

$1,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270687016
Hospital Revenue Code	278
Min. Negotiated Rate	$56.23
Max. Negotiated Rate	$990.00
Rate for Payer: Aetna Commercial	$752.40
Rate for Payer: Aetna Medicare Advantage	$594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$504.90
Rate for Payer: Cigna Commercial	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$479.16
Rate for Payer: Qualcare PPO/HMO/WC	$297.00
Rate for Payer: UnitedHealthcare Community & State	$62.57
Rate for Payer: Wellpoint Medicaid Managed Care	$56.23

BOLT FOR FEMORAL NECK SYSTEM 8

Facility

$1,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270687016
Hospital Revenue Code	278
Min. Negotiated Rate	$297.00
Max. Negotiated Rate	$479.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$479.16
Rate for Payer: Qualcare PPO/HMO/WC	$297.00

BOLT FOR FEMORAL NK 110MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270699631
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

BOLT FOR FEMORAL NK 110MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270699631
Hospital Revenue Code	278
Min. Negotiated Rate	$93.72
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$1,254.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00
Rate for Payer: UnitedHealthcare Community & State	$104.28
Rate for Payer: Wellpoint Medicaid Managed Care	$93.72

BOLT IM NAIL CONNECTING

Facility

$903.85

Service Code	HCPCS C1713
Hospital Charge Code	270700140
Hospital Revenue Code	278
Min. Negotiated Rate	$25.67
Max. Negotiated Rate	$451.93
Rate for Payer: Aetna Commercial	$343.46
Rate for Payer: Aetna Medicare Advantage	$271.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.48
Rate for Payer: Cigna Commercial	$451.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.73
Rate for Payer: Qualcare PPO/HMO/WC	$135.58
Rate for Payer: UnitedHealthcare Community & State	$28.56
Rate for Payer: Wellpoint Medicaid Managed Care	$25.67

BOLT IM NAIL CONNECTING

Facility

$903.85

Service Code	HCPCS C1713
Hospital Charge Code	270700140
Hospital Revenue Code	278
Min. Negotiated Rate	$135.58
Max. Negotiated Rate	$218.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.73
Rate for Payer: Qualcare PPO/HMO/WC	$135.58

BOLT JIG FLEXIBLE 8MM

Facility

$8,610.00

Hospital Charge Code	270702100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,291.50
Max. Negotiated Rate	$2,083.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50

BOLT JIG FLEXIBLE 8MM

Facility

$8,610.00

Hospital Charge Code	270702100
Hospital Revenue Code	278
Min. Negotiated Rate	$244.52
Max. Negotiated Rate	$4,305.00
Rate for Payer: Aetna Commercial	$3,271.80
Rate for Payer: Aetna Medicare Advantage	$2,583.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,195.55
Rate for Payer: Cigna Commercial	$4,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50
Rate for Payer: UnitedHealthcare Community & State	$272.08
Rate for Payer: Wellpoint Medicaid Managed Care	$244.52

BOLT LOCKING 41MM

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270677752
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

BOLT LOCKING 41MM

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270677752
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

BOLT LOCKING 4.9x32mm ST

Facility

$976.45

Hospital Charge Code	270651639
Hospital Revenue Code	272
Min. Negotiated Rate	$27.73
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$371.05
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.88
Rate for Payer: Oxford Commercial	$195.29
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Commercial	$195.29
Rate for Payer: UnitedHealthcare Community & State	$30.86
Rate for Payer: Wellpoint Medicaid Managed Care	$27.73

BOLT LOCKING 4.9x32mm ST

Facility

$976.45

Hospital Charge Code	270651639
Hospital Revenue Code	272
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$146.47
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

Know your out-of-pocket cost for care.

All Charges