Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

6 HOLE HEAD 2 SHAFT 2 COL PLAT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270686606
Hospital Revenue Code	278
Min. Negotiated Rate	$198.33
Max. Negotiated Rate	$3,491.70
Rate for Payer: Aetna Commercial	$2,653.69
Rate for Payer: Aetna Medicare Advantage	$2,095.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.77
Rate for Payer: Cigna Commercial	$3,491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51
Rate for Payer: UnitedHealthcare Community & State	$220.68
Rate for Payer: Wellpoint Medicaid Managed Care	$198.33

6 HOLE PROXIMAL HUMERAL PLATE

Facility

$7,428.40

Service Code	HCPCS C1713
Hospital Charge Code	270686347
Hospital Revenue Code	278
Min. Negotiated Rate	$1,114.26
Max. Negotiated Rate	$1,797.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,797.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,114.26

6 HOLE PROXIMAL HUMERAL PLATE

Facility

$7,428.40

Service Code	HCPCS C1713
Hospital Charge Code	270686347
Hospital Revenue Code	278
Min. Negotiated Rate	$210.97
Max. Negotiated Rate	$3,714.20
Rate for Payer: Aetna Commercial	$2,822.79
Rate for Payer: Aetna Medicare Advantage	$2,228.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,894.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,894.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,485.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,894.24
Rate for Payer: Cigna Commercial	$3,714.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,797.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,114.26
Rate for Payer: UnitedHealthcare Community & State	$234.74
Rate for Payer: Wellpoint Medicaid Managed Care	$210.97

6 HOLE STRAIGHT PLATE

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270703884
Hospital Revenue Code	278
Min. Negotiated Rate	$82.93
Max. Negotiated Rate	$1,460.00
Rate for Payer: Aetna Commercial	$1,109.60
Rate for Payer: Aetna Medicare Advantage	$876.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.60
Rate for Payer: Cigna Commercial	$1,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: Qualcare PPO/HMO/WC	$438.00
Rate for Payer: UnitedHealthcare Community & State	$92.27
Rate for Payer: Wellpoint Medicaid Managed Care	$82.93

6 HOLE STRAIGHT PLATE

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270703884
Hospital Revenue Code	278
Min. Negotiated Rate	$438.00
Max. Negotiated Rate	$706.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: Qualcare PPO/HMO/WC	$438.00

#6 MATRIX CONNECTOR

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691893
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

#6 MATRIX CONNECTOR

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691893
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

6MM DRILL BIT

Facility

$1,500.00

Hospital Charge Code	270680775
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

6MM DRILL BIT

Facility

$1,500.00

Hospital Charge Code	270680775
Hospital Revenue Code	272
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) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

6MM SMALL SPIRA C

Facility

$8,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270703918
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

6MM SMALL SPIRA C

Facility

$8,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270703918
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 200 SHANTZ PIN

Facility

$887.95

Service Code	HCPCS C1713
Hospital Charge Code	270686263
Hospital Revenue Code	278
Min. Negotiated Rate	$133.19
Max. Negotiated Rate	$214.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.88
Rate for Payer: Qualcare PPO/HMO/WC	$133.19

6 X 200 SHANTZ PIN

Facility

$887.95

Service Code	HCPCS C1713
Hospital Charge Code	270686263
Hospital Revenue Code	278
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$443.98
Rate for Payer: Aetna Commercial	$337.42
Rate for Payer: Aetna Medicare Advantage	$266.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.43
Rate for Payer: Cigna Commercial	$443.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.88
Rate for Payer: Qualcare PPO/HMO/WC	$133.19
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

6X25MM SDF SCREW

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270704184
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

6X25MM SDF SCREW

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270704184
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

6 X 40 SCREW

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270680777
Hospital Revenue Code	278
Min. Negotiated Rate	$206.02
Max. Negotiated Rate	$3,627.15
Rate for Payer: Aetna Commercial	$2,756.63
Rate for Payer: Aetna Medicare Advantage	$2,176.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,849.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,849.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,849.85
Rate for Payer: Cigna Commercial	$3,627.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.14
Rate for Payer: UnitedHealthcare Community & State	$229.24
Rate for Payer: Wellpoint Medicaid Managed Care	$206.02

6 X 40 SCREW

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270680777
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.14
Max. Negotiated Rate	$1,755.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.14

6 X45 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673341
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

6 X45 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673341
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 50 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673342
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

6 X 50 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270673342
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 55 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679974
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

6 X 55 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679974
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 60 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679975
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

6 X 60 SCREW

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679975
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

Know your out-of-pocket cost for care.

All Charges