Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BONE REVISION DOWLS 18

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680645
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

BONE SCAN, 3-PHASE

Facility

$12,000.00

Service Code	HCPCS 78315
Hospital Charge Code	4500542
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

BONE SCAN, 3-PHASE

Facility

$12,000.00

Service Code	HCPCS 78315
Hospital Charge Code	4500542
Hospital Revenue Code	341
Min. Negotiated Rate	$205.09
Max. Negotiated Rate	$4,820.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,722.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,722.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,722.84
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,120.00
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$379.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$340.80

BONE SCREW 16 THD 6.5x75MM

Facility

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	270675136
Hospital Revenue Code	278
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Community & State	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.83

BONE SCREW 16 THD 6.5x75MM

Facility

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	270675136
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

BONE SCREW 1.7X24MM

Facility

$650.00

Hospital Charge Code	270669235
Hospital Revenue Code	278
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

BONE SCREW 1.7X24MM

Facility

$650.00

Hospital Charge Code	270669235
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BONE SCREW 2 PACKING

Facility

$702.00

Hospital Charge Code	270690116
Hospital Revenue Code	270
Min. Negotiated Rate	$19.94
Max. Negotiated Rate	$351.00
Rate for Payer: Aetna Commercial	$266.76
Rate for Payer: Aetna Medicare Advantage	$210.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.01
Rate for Payer: Cigna Commercial	$351.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.52
Rate for Payer: Oxford Commercial	$140.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.30
Rate for Payer: UnitedHealthcare Commercial	$140.40
Rate for Payer: UnitedHealthcare Community & State	$22.18
Rate for Payer: Wellpoint Medicaid Managed Care	$19.94

BONE SCREW 2 PACKING

Facility

$702.00

Hospital Charge Code	270690116
Hospital Revenue Code	270
Min. Negotiated Rate	$105.30
Max. Negotiated Rate	$105.30
Rate for Payer: Qualcare PPO/HMO/WC	$105.30

BONE SCREW 32MM THD 6.5x95MM

Facility

$145.50

Hospital Charge Code	270675833
Hospital Revenue Code	278
Min. Negotiated Rate	$4.13
Max. Negotiated Rate	$72.75
Rate for Payer: Aetna Commercial	$55.29
Rate for Payer: Aetna Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.10
Rate for Payer: Cigna Commercial	$72.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: Qualcare PPO/HMO/WC	$21.82
Rate for Payer: UnitedHealthcare Community & State	$4.60
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

BONE SCREW 32MM THD 6.5x95MM

Facility

$145.50

Hospital Charge Code	270675833
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$35.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: Qualcare PPO/HMO/WC	$21.82

BONE SCREW 3.5x12MM

Facility

$354.90

Service Code	HCPCS C1713
Hospital Charge Code	270664088
Hospital Revenue Code	278
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$177.45
Rate for Payer: Aetna Commercial	$134.86
Rate for Payer: Aetna Medicare Advantage	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.50
Rate for Payer: Cigna Commercial	$177.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.23
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$10.08

BONE SCREW 3.5x12MM

Facility

$354.90

Service Code	HCPCS C1713
Hospital Charge Code	270664088
Hospital Revenue Code	278
Min. Negotiated Rate	$53.23
Max. Negotiated Rate	$85.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.23

BONE SCREW 5X25MM

Facility

$1,250.00

Hospital Charge Code	270702844
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

BONE SCREW 5X25MM

Facility

$1,250.00

Hospital Charge Code	270702844
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

BONE SCREW 6/5MM TAPER 110/50

Facility

$820.00

Service Code	HCPCS C1713
Hospital Charge Code	270673481
Hospital Revenue Code	278
Min. Negotiated Rate	$23.29
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

BONE SCREW 6/5MM TAPER 110/50

Facility

$820.00

Service Code	HCPCS C1713
Hospital Charge Code	270673481
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$198.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

BONE SCREW 6/5MM TAPER 120/40

Facility

$820.00

Service Code	HCPCS C1713
Hospital Charge Code	270673482
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$198.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

BONE SCREW 6/5MM TAPER 120/40

Facility

$820.00

Service Code	HCPCS C1713
Hospital Charge Code	270673482
Hospital Revenue Code	278
Min. Negotiated Rate	$23.29
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

BONE SCREW 6/5MM TAPER 130/30

Facility

$820.00

Service Code	HCPCS C1713
Hospital Charge Code	270673483
Hospital Revenue Code	278
Min. Negotiated Rate	$23.29
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$311.60
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$23.29

BONE SCREW 6/5MM TAPER 130/30

Facility

$820.00

Service Code	HCPCS C1713
Hospital Charge Code	270673483
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$198.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

BONE SCREW 6.5X 15

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270684251
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5X 15

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270684251
Hospital Revenue Code	278
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

BONE SCREW 6.5x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270672171
Hospital Revenue Code	278
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

BONE SCREW 6.5x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270672171
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

Know your out-of-pocket cost for care.

All Charges