Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BOLT LOCKING 4.9x34mm ST

Facility

$976.45

Hospital Charge Code	270651640
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 4.9x34mm ST

Facility

$976.45

Hospital Charge Code	270651640
Hospital Revenue Code	272
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$146.47
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x36mm ST

Facility

$976.45

Hospital Charge Code	270651641
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x36mm ST

Facility

$976.45

Hospital Charge Code	270651641
Hospital Revenue Code	278
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) NJ Health	$195.29
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	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Community & State	$30.86
Rate for Payer: Wellpoint Medicaid Managed Care	$27.73

BOLT LOCKING 4.9x60mm ST

Facility

$976.45

Hospital Charge Code	270651643
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x60mm ST

Facility

$976.45

Hospital Charge Code	270651643
Hospital Revenue Code	278
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) NJ Health	$195.29
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	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Community & State	$30.86
Rate for Payer: Wellpoint Medicaid Managed Care	$27.73

BOLT SALVATION 5. X 120MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

BOLT SALVATION 5. X 120MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700897
Hospital Revenue Code	278
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) NJ Health	$2,000.00
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	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

BOLT SALVATION 6.5x100MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674307
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 SALVATION 6.5x100MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674307
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 SALVATION 6.5x130MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674306
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 SALVATION 6.5x130MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674306
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 SALVATION TOE JT 5X125MM

Facility

$9,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270698682
Hospital Revenue Code	278
Min. Negotiated Rate	$262.13
Max. Negotiated Rate	$4,615.00
Rate for Payer: Aetna Commercial	$3,507.40
Rate for Payer: Aetna Medicare Advantage	$2,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,353.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,353.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,846.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,353.65
Rate for Payer: Cigna Commercial	$4,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,384.50
Rate for Payer: UnitedHealthcare Community & State	$291.67
Rate for Payer: Wellpoint Medicaid Managed Care	$262.13

BOLT SALVATION TOE JT 5X125MM

Facility

$9,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270698682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,384.50
Max. Negotiated Rate	$2,233.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,846.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,384.50

BOLT SALVATION WIRE

Facility

$835.00

Hospital Charge Code	270684459
Hospital Revenue Code	272
Min. Negotiated Rate	$23.71
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$317.30
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.10
Rate for Payer: Oxford Commercial	$167.00
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Commercial	$167.00
Rate for Payer: UnitedHealthcare Community & State	$26.39
Rate for Payer: Wellpoint Medicaid Managed Care	$23.71

BOLT SALVATION WIRE

Facility

$835.00

Hospital Charge Code	270684459
Hospital Revenue Code	272
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$125.25
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

BOLT SCHANZ POST EXT FIX

Facility

$1,111.95

Hospital Charge Code	270693746
Hospital Revenue Code	272
Min. Negotiated Rate	$31.58
Max. Negotiated Rate	$555.98
Rate for Payer: Aetna Commercial	$422.54
Rate for Payer: Aetna Medicare Advantage	$333.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.55
Rate for Payer: Cigna Commercial	$555.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.11
Rate for Payer: Oxford Commercial	$222.39
Rate for Payer: Qualcare PPO/HMO/WC	$166.79
Rate for Payer: UnitedHealthcare Commercial	$222.39
Rate for Payer: UnitedHealthcare Community & State	$35.14
Rate for Payer: Wellpoint Medicaid Managed Care	$31.58

BOLT SCHANZ POST EXT FIX

Facility

$1,111.95

Hospital Charge Code	270693746
Hospital Revenue Code	272
Min. Negotiated Rate	$166.79
Max. Negotiated Rate	$166.79
Rate for Payer: Qualcare PPO/HMO/WC	$166.79

BOLT SCREW EXTRACTION 3.5/4MM

Facility

$414.05

Hospital Charge Code	270654493
Hospital Revenue Code	272
Min. Negotiated Rate	$11.76
Max. Negotiated Rate	$207.03
Rate for Payer: Aetna Commercial	$157.34
Rate for Payer: Aetna Medicare Advantage	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.58
Rate for Payer: Cigna Commercial	$207.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.65
Rate for Payer: Oxford Commercial	$82.81
Rate for Payer: Qualcare PPO/HMO/WC	$62.11
Rate for Payer: UnitedHealthcare Commercial	$82.81
Rate for Payer: UnitedHealthcare Community & State	$13.08
Rate for Payer: Wellpoint Medicaid Managed Care	$11.76

BOLT SCREW EXTRACTION 3.5/4MM

Facility

$414.05

Hospital Charge Code	270654493
Hospital Revenue Code	272
Min. Negotiated Rate	$62.11
Max. Negotiated Rate	$62.11
Rate for Payer: Qualcare PPO/HMO/WC	$62.11

BOLT SCREW SCHANZ POST

Facility

$1,005.75

Service Code	HCPCS C1713
Hospital Charge Code	270683954
Hospital Revenue Code	278
Min. Negotiated Rate	$150.86
Max. Negotiated Rate	$243.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.39
Rate for Payer: Qualcare PPO/HMO/WC	$150.86

BOLT SCREW SCHANZ POST

Facility

$1,005.75

Service Code	HCPCS C1713
Hospital Charge Code	270683954
Hospital Revenue Code	278
Min. Negotiated Rate	$28.56
Max. Negotiated Rate	$502.88
Rate for Payer: Aetna Commercial	$382.19
Rate for Payer: Aetna Medicare Advantage	$301.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.47
Rate for Payer: Cigna Commercial	$502.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.39
Rate for Payer: Qualcare PPO/HMO/WC	$150.86
Rate for Payer: UnitedHealthcare Community & State	$31.78
Rate for Payer: Wellpoint Medicaid Managed Care	$28.56

BOLT SHOULDER MAXFRAME 8 MM

Facility

$1,136.25

Hospital Charge Code	270683953
Hospital Revenue Code	272
Min. Negotiated Rate	$32.27
Max. Negotiated Rate	$568.12
Rate for Payer: Aetna Commercial	$431.77
Rate for Payer: Aetna Medicare Advantage	$340.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.74
Rate for Payer: Cigna Commercial	$568.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.43
Rate for Payer: Oxford Commercial	$227.25
Rate for Payer: Qualcare PPO/HMO/WC	$170.44
Rate for Payer: UnitedHealthcare Commercial	$227.25
Rate for Payer: UnitedHealthcare Community & State	$35.91
Rate for Payer: Wellpoint Medicaid Managed Care	$32.27

BOLT SHOULDER MAXFRAME 8 MM

Facility

$1,136.25

Hospital Charge Code	270683953
Hospital Revenue Code	272
Min. Negotiated Rate	$170.44
Max. Negotiated Rate	$170.44
Rate for Payer: Qualcare PPO/HMO/WC	$170.44

BOLT SHOULDER MAXFRAME FOR 8MM

Facility

$450.00

Hospital Charge Code	270681234
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

Know your out-of-pocket cost for care.

All Charges