Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

5.5MM PERCUTANEOUS ROD/PREBENT

Facility

$1,250.00

Hospital Charge Code	270701733
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

5.5MM PERCUTANEOUS ROD/PREBENT

Facility

$1,250.00

Hospital Charge Code	270701733
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

5.5MM SET SCREW

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704176
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

5.5MM SET SCREW

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704176
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

5.5X10MM IONFACET SCREW

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704206
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

5.5X10MM IONFACET SCREW

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704206
Hospital Revenue Code	278
Min. Negotiated Rate	$411.80
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$458.20
Rate for Payer: Wellpoint Medicaid Managed Care	$411.80

5.5X200MM TI ROD

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704057
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

5.5X200MM TI ROD

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704057
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

5.5X40MM LUMBAR ROD

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270704244
Hospital Revenue Code	278
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) NJ Health	$180.00
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	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

5.5X40MM LUMBAR ROD

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270704244
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

5.5X40MM SCREW

Facility

$5,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704009
Hospital Revenue Code	278
Min. Negotiated Rate	$154.78
Max. Negotiated Rate	$2,725.00
Rate for Payer: Aetna Commercial	$2,071.00
Rate for Payer: Aetna Medicare Advantage	$1,635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,090.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,389.75
Rate for Payer: Cigna Commercial	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.90
Rate for Payer: Qualcare PPO/HMO/WC	$817.50
Rate for Payer: UnitedHealthcare Community & State	$172.22
Rate for Payer: Wellpoint Medicaid Managed Care	$154.78

5.5X40MM SCREW

Facility

$5,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704009
Hospital Revenue Code	278
Min. Negotiated Rate	$817.50
Max. Negotiated Rate	$1,318.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.90
Rate for Payer: Qualcare PPO/HMO/WC	$817.50

5.5 X 45 SCREW

Facility

$3,344.00

Hospital Charge Code	270339023
Hospital Revenue Code	278
Min. Negotiated Rate	$94.97
Max. Negotiated Rate	$1,672.00
Rate for Payer: Aetna Commercial	$1,270.72
Rate for Payer: Aetna Medicare Advantage	$1,003.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$852.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$852.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$852.72
Rate for Payer: Cigna Commercial	$1,672.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$809.25
Rate for Payer: Qualcare PPO/HMO/WC	$501.60
Rate for Payer: UnitedHealthcare Community & State	$105.67
Rate for Payer: Wellpoint Medicaid Managed Care	$94.97

5.5 X 45 SCREW

Facility

$3,344.00

Hospital Charge Code	270339023
Hospital Revenue Code	278
Min. Negotiated Rate	$501.60
Max. Negotiated Rate	$809.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$809.25
Rate for Payer: Qualcare PPO/HMO/WC	$501.60

5.5 X 50 CURVED ROD

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270665091
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

5.5 X 50 CURVED ROD

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270665091
Hospital Revenue Code	278
Min. Negotiated Rate	$82.36
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$91.64
Rate for Payer: Wellpoint Medicaid Managed Care	$82.36

5.5 X 50 CURVE ROD

Facility

$2,900.00

Hospital Charge Code	270662647
Hospital Revenue Code	278
Min. Negotiated Rate	$82.36
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$91.64
Rate for Payer: Wellpoint Medicaid Managed Care	$82.36

5.5 X 50 CURVE ROD

Facility

$2,900.00

Hospital Charge Code	270662647
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

5.5X50 POLY SCREW

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270662646
Hospital Revenue Code	278
Min. Negotiated Rate	$252.76
Max. Negotiated Rate	$4,450.00
Rate for Payer: Aetna Commercial	$3,382.00
Rate for Payer: Aetna Medicare Advantage	$2,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,269.50
Rate for Payer: Cigna Commercial	$4,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00
Rate for Payer: UnitedHealthcare Community & State	$281.24
Rate for Payer: Wellpoint Medicaid Managed Care	$252.76

5.5X50 POLY SCREW

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270662646
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.00
Max. Negotiated Rate	$2,153.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00

5.5 X 60 CURVE ROD

Facility

$2,900.00

Hospital Charge Code	270662648
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

5.5 X 60 CURVE ROD

Facility

$2,900.00

Hospital Charge Code	270662648
Hospital Revenue Code	278
Min. Negotiated Rate	$82.36
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$91.64
Rate for Payer: Wellpoint Medicaid Managed Care	$82.36

5 BEVEL NEUROTRACE

Facility

$51.65

Hospital Charge Code	270628623
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$25.82
Rate for Payer: Aetna Commercial	$19.63
Rate for Payer: Aetna Medicare Advantage	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.17
Rate for Payer: Cigna Commercial	$25.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.43
Rate for Payer: Oxford Commercial	$10.33
Rate for Payer: Qualcare PPO/HMO/WC	$7.75
Rate for Payer: UnitedHealthcare Commercial	$10.33
Rate for Payer: UnitedHealthcare Community & State	$1.63
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

5 BEVEL NEUROTRACE

Facility

$51.65

Hospital Charge Code	270628623
Hospital Revenue Code	272
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$7.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.75

5CC BONE FIBER

Facility

$3,395.00

Service Code	HCPCS C1765
Hospital Charge Code	270703923
Hospital Revenue Code	278
Min. Negotiated Rate	$509.25
Max. Negotiated Rate	$821.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$679.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$821.59
Rate for Payer: Qualcare PPO/HMO/WC	$509.25

Know your out-of-pocket cost for care.

All Charges