Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

4 HOLE UDR PLATE NARROW (L)

Facility

$9,075.00

Hospital Charge Code	270703216
Hospital Revenue Code	278
Min. Negotiated Rate	$257.73
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$286.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.73

4 HOLE UDR PLATE NARROW (L)

Facility

$9,075.00

Hospital Charge Code	270703216
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

4 L SUPERIOR CLAVICLE PLATE LE

Facility

$4,528.45

Service Code	HCPCS C1713
Hospital Charge Code	270690413
Hospital Revenue Code	278
Min. Negotiated Rate	$128.61
Max. Negotiated Rate	$2,264.22
Rate for Payer: Aetna Commercial	$1,720.81
Rate for Payer: Aetna Medicare Advantage	$1,358.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,154.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,154.75
Rate for Payer: Cigna Commercial	$2,264.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,095.88
Rate for Payer: Qualcare PPO/HMO/WC	$679.27
Rate for Payer: UnitedHealthcare Community & State	$143.10
Rate for Payer: Wellpoint Medicaid Managed Care	$128.61

4 L SUPERIOR CLAVICLE PLATE LE

Facility

$4,528.45

Service Code	HCPCS C1713
Hospital Charge Code	270690413
Hospital Revenue Code	278
Min. Negotiated Rate	$679.27
Max. Negotiated Rate	$1,095.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$905.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,095.88
Rate for Payer: Qualcare PPO/HMO/WC	$679.27

#4 MATRIX CONNECTOR

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691892
Hospital Revenue Code	278
Min. Negotiated Rate	$888.94
Max. Negotiated Rate	$1,434.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.15
Rate for Payer: Qualcare PPO/HMO/WC	$888.94

#4 MATRIX CONNECTOR

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691892
Hospital Revenue Code	278
Min. Negotiated Rate	$168.31
Max. Negotiated Rate	$2,963.12
Rate for Payer: Aetna Commercial	$2,251.97
Rate for Payer: Aetna Medicare Advantage	$1,777.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,511.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,511.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,511.19
Rate for Payer: Cigna Commercial	$2,963.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.15
Rate for Payer: Qualcare PPO/HMO/WC	$888.94
Rate for Payer: UnitedHealthcare Community & State	$187.27
Rate for Payer: Wellpoint Medicaid Managed Care	$168.31

4 Max Kit

Facility

$8,150.00

Hospital Charge Code	270682966S
Hospital Revenue Code	272
Min. Negotiated Rate	$1,222.50
Max. Negotiated Rate	$1,222.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.50

4 Max Kit

Facility

$8,150.00

Hospital Charge Code	270682966S
Hospital Revenue Code	272
Min. Negotiated Rate	$231.46
Max. Negotiated Rate	$4,075.00
Rate for Payer: Aetna Commercial	$3,097.00
Rate for Payer: Aetna Medicare Advantage	$2,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,078.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,078.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,078.25
Rate for Payer: Cigna Commercial	$4,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,119.00
Rate for Payer: Oxford Commercial	$1,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.50
Rate for Payer: UnitedHealthcare Commercial	$1,630.00
Rate for Payer: UnitedHealthcare Community & State	$257.54
Rate for Payer: Wellpoint Medicaid Managed Care	$231.46

4 MAX KIT

Facility

$8,150.00

Hospital Charge Code	270682966N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,222.50
Max. Negotiated Rate	$1,222.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.50

4 MAX KIT

Facility

$8,150.00

Hospital Charge Code	270682966N
Hospital Revenue Code	272
Min. Negotiated Rate	$231.46
Max. Negotiated Rate	$4,075.00
Rate for Payer: Aetna Commercial	$3,097.00
Rate for Payer: Aetna Medicare Advantage	$2,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,078.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,078.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,078.25
Rate for Payer: Cigna Commercial	$4,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,119.00
Rate for Payer: Oxford Commercial	$1,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.50
Rate for Payer: UnitedHealthcare Commercial	$1,630.00
Rate for Payer: UnitedHealthcare Community & State	$257.54
Rate for Payer: Wellpoint Medicaid Managed Care	$231.46

4 MM CANC SCREW FT 20MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270632513
Hospital Revenue Code	278
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$94.05
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Community & State	$7.82
Rate for Payer: Wellpoint Medicaid Managed Care	$7.03

4 MM CANC SCREW FT 20MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270632513
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

4MM DOUBLECUT

Facility

$200.00

Hospital Charge Code	270702944
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

4MM DOUBLECUT

Facility

$200.00

Hospital Charge Code	270702944
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.68

4MM RIGHT OPEN WEDGE PLATE

Facility

$3,540.00

Service Code	HCPCS C1713
Hospital Charge Code	270656469
Hospital Revenue Code	278
Min. Negotiated Rate	$531.00
Max. Negotiated Rate	$856.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.68
Rate for Payer: Qualcare PPO/HMO/WC	$531.00

4MM RIGHT OPEN WEDGE PLATE

Facility

$3,540.00

Service Code	HCPCS C1713
Hospital Charge Code	270656469
Hospital Revenue Code	278
Min. Negotiated Rate	$100.54
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,345.20
Rate for Payer: Aetna Medicare Advantage	$1,062.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.70
Rate for Payer: Cigna Commercial	$1,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.68
Rate for Payer: Qualcare PPO/HMO/WC	$531.00
Rate for Payer: UnitedHealthcare Community & State	$111.86
Rate for Payer: Wellpoint Medicaid Managed Care	$100.54

4TENDRILLEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233
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

4TENDRILLEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233
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

4TENDRILLLEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233C
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

4TENDRILLLEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233C
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

4X42MM PARTIALLY THREADED SCRE

Facility

$849.80

Service Code	HCPCS C1713
Hospital Charge Code	270702479
Hospital Revenue Code	278
Min. Negotiated Rate	$127.47
Max. Negotiated Rate	$205.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.65
Rate for Payer: Qualcare PPO/HMO/WC	$127.47

4X42MM PARTIALLY THREADED SCRE

Facility

$849.80

Service Code	HCPCS C1713
Hospital Charge Code	270702479
Hospital Revenue Code	278
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$424.90
Rate for Payer: Aetna Commercial	$322.92
Rate for Payer: Aetna Medicare Advantage	$254.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.70
Rate for Payer: Cigna Commercial	$424.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.65
Rate for Payer: Qualcare PPO/HMO/WC	$127.47
Rate for Payer: UnitedHealthcare Community & State	$26.85
Rate for Payer: Wellpoint Medicaid Managed Care	$24.13

5.0 3FLTD DRIL BT QC 356/126MM

Facility

$1,370.05

Hospital Charge Code	270687938
Hospital Revenue Code	272
Min. Negotiated Rate	$205.51
Max. Negotiated Rate	$205.51
Rate for Payer: Qualcare PPO/HMO/WC	$205.51

5.0 3FLTD DRIL BT QC 356/126MM

Facility

$1,370.05

Hospital Charge Code	270687938
Hospital Revenue Code	272
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$685.02
Rate for Payer: Aetna Commercial	$520.62
Rate for Payer: Aetna Medicare Advantage	$411.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.36
Rate for Payer: Cigna Commercial	$685.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.21
Rate for Payer: Oxford Commercial	$274.01
Rate for Payer: Qualcare PPO/HMO/WC	$205.51
Rate for Payer: UnitedHealthcare Commercial	$274.01
Rate for Payer: UnitedHealthcare Community & State	$43.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38.91

5.0 CANNULATED LOCKING SCREW 2

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270679067
Hospital Revenue Code	278
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$399.23
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59
Rate for Payer: UnitedHealthcare Community & State	$33.20
Rate for Payer: Wellpoint Medicaid Managed Care	$29.84

Know your out-of-pocket cost for care.

All Charges