Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

5.0 LOCKING SCREW 20

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677478
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

5.0 LOCKING SCREW 20

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270677478
Hospital Revenue Code	278
Min. Negotiated Rate	$21.39
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$286.14
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: Qualcare PPO/HMO/WC	$112.95
Rate for Payer: UnitedHealthcare Community & State	$23.79
Rate for Payer: Wellpoint Medicaid Managed Care	$21.39

5.0 LOCKING SCREW 8

Facility

$1,294.70

Service Code	HCPCS C1713
Hospital Charge Code	270679068
Hospital Revenue Code	278
Min. Negotiated Rate	$194.21
Max. Negotiated Rate	$313.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.32
Rate for Payer: Qualcare PPO/HMO/WC	$194.21

5.0 LOCKING SCREW 8

Facility

$1,294.70

Service Code	HCPCS C1713
Hospital Charge Code	270679068
Hospital Revenue Code	278
Min. Negotiated Rate	$36.77
Max. Negotiated Rate	$647.35
Rate for Payer: Aetna Commercial	$491.99
Rate for Payer: Aetna Medicare Advantage	$388.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.15
Rate for Payer: Cigna Commercial	$647.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.32
Rate for Payer: Qualcare PPO/HMO/WC	$194.21
Rate for Payer: UnitedHealthcare Community & State	$40.91
Rate for Payer: Wellpoint Medicaid Managed Care	$36.77

50MM 3 LEVEL CERVICAL PLATE

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704837
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

50MM 3 LEVEL CERVICAL PLATE

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704837
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

5.0MM CANN DRILL BIT LARGE QC/

Facility

$1,919.15

Hospital Charge Code	270605095
Hospital Revenue Code	272
Min. Negotiated Rate	$287.87
Max. Negotiated Rate	$287.87
Rate for Payer: Qualcare PPO/HMO/WC	$287.87

5.0MM CANN DRILL BIT LARGE QC/

Facility

$1,919.15

Hospital Charge Code	270605095
Hospital Revenue Code	272
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$959.58
Rate for Payer: Aetna Commercial	$729.28
Rate for Payer: Aetna Medicare Advantage	$575.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.38
Rate for Payer: Cigna Commercial	$959.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$498.98
Rate for Payer: Oxford Commercial	$383.83
Rate for Payer: Qualcare PPO/HMO/WC	$287.87
Rate for Payer: UnitedHealthcare Commercial	$383.83
Rate for Payer: UnitedHealthcare Community & State	$60.65
Rate for Payer: Wellpoint Medicaid Managed Care	$54.50

5.0MM THREADED DRILL SLEEVE

Facility

$900.00

Hospital Charge Code	270703298
Hospital Revenue Code	270
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

5.0MM THREADED DRILL SLEEVE

Facility

$900.00

Hospital Charge Code	270703298
Hospital Revenue Code	270
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

5.0MM TI LOCKIMNG SCR SLF TPNG

Facility

$1,077.00

Service Code	HCPCS C1713
Hospital Charge Code	270686945
Hospital Revenue Code	278
Min. Negotiated Rate	$30.59
Max. Negotiated Rate	$538.50
Rate for Payer: Aetna Commercial	$409.26
Rate for Payer: Aetna Medicare Advantage	$323.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.63
Rate for Payer: Cigna Commercial	$538.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.63
Rate for Payer: Qualcare PPO/HMO/WC	$161.55
Rate for Payer: UnitedHealthcare Community & State	$34.03
Rate for Payer: Wellpoint Medicaid Managed Care	$30.59

5.0MM TI LOCKIMNG SCR SLF TPNG

Facility

$1,077.00

Service Code	HCPCS C1713
Hospital Charge Code	270686945
Hospital Revenue Code	278
Min. Negotiated Rate	$161.55
Max. Negotiated Rate	$260.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.63
Rate for Payer: Qualcare PPO/HMO/WC	$161.55

50MM TI LOCKING SCR SLF-TPNG 4

Facility

$1,077.00

Service Code	HCPCS C1713
Hospital Charge Code	270687018
Hospital Revenue Code	278
Min. Negotiated Rate	$30.59
Max. Negotiated Rate	$538.50
Rate for Payer: Aetna Commercial	$409.26
Rate for Payer: Aetna Medicare Advantage	$323.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.63
Rate for Payer: Cigna Commercial	$538.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.63
Rate for Payer: Qualcare PPO/HMO/WC	$161.55
Rate for Payer: UnitedHealthcare Community & State	$34.03
Rate for Payer: Wellpoint Medicaid Managed Care	$30.59

50MM TI LOCKING SCR SLF-TPNG 4

Facility

$1,077.00

Service Code	HCPCS C1713
Hospital Charge Code	270687018
Hospital Revenue Code	278
Min. Negotiated Rate	$161.55
Max. Negotiated Rate	$260.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.63
Rate for Payer: Qualcare PPO/HMO/WC	$161.55

5.0MMTILOCKSCRSLFTP T25SD40MM

Facility

$868.95

Service Code	HCPCS C1713
Hospital Charge Code	270690900
Hospital Revenue Code	278
Min. Negotiated Rate	$130.34
Max. Negotiated Rate	$210.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.29
Rate for Payer: Qualcare PPO/HMO/WC	$130.34

5.0MMTILOCKSCRSLFTP T25SD40MM

Facility

$868.95

Service Code	HCPCS C1713
Hospital Charge Code	270690900
Hospital Revenue Code	278
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$434.48
Rate for Payer: Aetna Commercial	$330.20
Rate for Payer: Aetna Medicare Advantage	$260.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.58
Rate for Payer: Cigna Commercial	$434.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.29
Rate for Payer: Qualcare PPO/HMO/WC	$130.34
Rate for Payer: UnitedHealthcare Community & State	$27.46
Rate for Payer: Wellpoint Medicaid Managed Care	$24.68

5.0 SCREW 38

Facility

$1,314.45

Service Code	HCPCS C1713
Hospital Charge Code	270656660
Hospital Revenue Code	278
Min. Negotiated Rate	$197.17
Max. Negotiated Rate	$318.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: Qualcare PPO/HMO/WC	$197.17

5.0 SCREW 38

Facility

$1,314.45

Service Code	HCPCS C1713
Hospital Charge Code	270656660
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$657.23
Rate for Payer: Aetna Commercial	$499.49
Rate for Payer: Aetna Medicare Advantage	$394.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.18
Rate for Payer: Cigna Commercial	$657.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.10
Rate for Payer: Qualcare PPO/HMO/WC	$197.17
Rate for Payer: UnitedHealthcare Community & State	$41.54
Rate for Payer: Wellpoint Medicaid Managed Care	$37.33

51MM 3HOLE ANTERIOR RETACTOR

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704090
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

51MM 3HOLE ANTERIOR RETACTOR

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704090
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$4,275.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50
Rate for Payer: UnitedHealthcare Community & State	$355.50
Rate for Payer: Wellpoint Medicaid Managed Care	$319.50

5.25MMX6MM BOLT

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270687817
Hospital Revenue Code	278
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$611.80
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50
Rate for Payer: UnitedHealthcare Community & State	$50.88
Rate for Payer: Wellpoint Medicaid Managed Care	$45.72

5.25MMX6MM BOLT

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270687817
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

5.5MM BONE TAP

Facility

$2,767.50

Hospital Charge Code	270704177
Hospital Revenue Code	279
Min. Negotiated Rate	$78.60
Max. Negotiated Rate	$1,383.75
Rate for Payer: Aetna Commercial	$1,051.65
Rate for Payer: Aetna Medicare Advantage	$830.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$705.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$705.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$705.71
Rate for Payer: Cigna Commercial	$1,383.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.55
Rate for Payer: Oxford Commercial	$553.50
Rate for Payer: Qualcare PPO/HMO/WC	$415.12
Rate for Payer: UnitedHealthcare Commercial	$553.50
Rate for Payer: UnitedHealthcare Community & State	$87.45
Rate for Payer: Wellpoint Medicaid Managed Care	$78.60

5.5MM BONE TAP

Facility

$2,767.50

Hospital Charge Code	270704177
Hospital Revenue Code	279
Min. Negotiated Rate	$415.12
Max. Negotiated Rate	$415.12
Rate for Payer: Qualcare PPO/HMO/WC	$415.12

Know your out-of-pocket cost for care.

All Charges