Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CANN SCREW 8.0MMX80MMX 14MM

Facility

$2,509.10

Service Code	HCPCS C1713
Hospital Charge Code	270704917
Hospital Revenue Code	278
Min. Negotiated Rate	$71.26
Max. Negotiated Rate	$1,254.55
Rate for Payer: Aetna Commercial	$953.46
Rate for Payer: Aetna Medicare Advantage	$752.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.82
Rate for Payer: Cigna Commercial	$1,254.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.20
Rate for Payer: Qualcare PPO/HMO/WC	$376.37
Rate for Payer: UnitedHealthcare Community & State	$79.29
Rate for Payer: Wellpoint Medicaid Managed Care	$71.26

CANN SCREW FULL THD 6.5X45MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680498
Hospital Revenue Code	278
Min. Negotiated Rate	$62.48
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$69.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.48

CANN SCREW FULL THD 6.5X45MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680498
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

CANN SCREW FULL THD 6.5X50MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680497
Hospital Revenue Code	278
Min. Negotiated Rate	$62.48
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$69.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.48

CANN SCREW FULL THD 6.5X50MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270680497
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

CANN SCREW FULL THD 6.5 X 85MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270688068
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$763.75
Rate for Payer: Aetna Commercial	$580.45
Rate for Payer: Aetna Medicare Advantage	$458.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.51
Rate for Payer: Cigna Commercial	$763.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: Qualcare PPO/HMO/WC	$229.12
Rate for Payer: UnitedHealthcare Community & State	$48.27
Rate for Payer: Wellpoint Medicaid Managed Care	$43.38

CANN SCREW FULL THD 6.5 X 85MM

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270688068
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$369.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: Qualcare PPO/HMO/WC	$229.12

CANN SCRW FULL THD 6.5MM X 80M

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270680496
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$369.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: Qualcare PPO/HMO/WC	$229.12

CANN SCRW FULL THD 6.5MM X 80M

Facility

$1,527.50

Service Code	HCPCS C1713
Hospital Charge Code	270680496
Hospital Revenue Code	278
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$763.75
Rate for Payer: Aetna Commercial	$580.45
Rate for Payer: Aetna Medicare Advantage	$458.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$389.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$389.51
Rate for Payer: Cigna Commercial	$763.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.65
Rate for Payer: Qualcare PPO/HMO/WC	$229.12
Rate for Payer: UnitedHealthcare Community & State	$48.27
Rate for Payer: Wellpoint Medicaid Managed Care	$43.38

CANN TFNA 11x360MM 130DEG RT

Facility

$9,942.75

Service Code	HCPCS C1713
Hospital Charge Code	270681181
Hospital Revenue Code	278
Min. Negotiated Rate	$1,491.41
Max. Negotiated Rate	$2,406.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41

CANN TFNA 11x360MM 130DEG RT

Facility

$9,942.75

Service Code	HCPCS C1713
Hospital Charge Code	270681181
Hospital Revenue Code	278
Min. Negotiated Rate	$282.37
Max. Negotiated Rate	$4,971.38
Rate for Payer: Aetna Commercial	$3,778.24
Rate for Payer: Aetna Medicare Advantage	$2,982.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,535.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,988.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,535.40
Rate for Payer: Cigna Commercial	$4,971.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,406.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,491.41
Rate for Payer: UnitedHealthcare Community & State	$314.19
Rate for Payer: Wellpoint Medicaid Managed Care	$282.37

CANN TRIPPLEDAM TWIST W/VALVE

Facility

$800.00

Hospital Charge Code	270682242
Hospital Revenue Code	272
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CANN TRIPPLEDAM TWIST W/VALVE

Facility

$800.00

Hospital Charge Code	270682242
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CANNULA 5.75mm X 7cm AR-6564

Facility

$125.00

Hospital Charge Code	270636059
Hospital Revenue Code	270
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) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$25.00
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

CANNULA 5.75mm X 7cm AR-6564

Facility

$125.00

Hospital Charge Code	270636059
Hospital Revenue Code	270
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CANNULA 5.8 MM TROCAR

Facility

$605.85

Hospital Charge Code	270688257
Hospital Revenue Code	272
Min. Negotiated Rate	$17.21
Max. Negotiated Rate	$302.93
Rate for Payer: Aetna Commercial	$230.22
Rate for Payer: Aetna Medicare Advantage	$181.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.49
Rate for Payer: Cigna Commercial	$302.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.52
Rate for Payer: Oxford Commercial	$121.17
Rate for Payer: Qualcare PPO/HMO/WC	$90.88
Rate for Payer: UnitedHealthcare Commercial	$121.17
Rate for Payer: UnitedHealthcare Community & State	$19.14
Rate for Payer: Wellpoint Medicaid Managed Care	$17.21

CANNULA 5.8 MM TROCAR

Facility

$605.85

Hospital Charge Code	270688257
Hospital Revenue Code	272
Min. Negotiated Rate	$90.88
Max. Negotiated Rate	$90.88
Rate for Payer: Qualcare PPO/HMO/WC	$90.88

CANNULA 6 X 55m 214660

Facility

$525.00

Hospital Charge Code	270635850
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

CANNULA 6 X 55m 214660

Facility

$525.00

Hospital Charge Code	270635850
Hospital Revenue Code	272
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.50
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$105.00
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

CANNULA 7.0 X 72 MM

Facility

$163.80

Hospital Charge Code	270682201
Hospital Revenue Code	272
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$81.90
Rate for Payer: Aetna Commercial	$62.24
Rate for Payer: Aetna Medicare Advantage	$49.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.77
Rate for Payer: Cigna Commercial	$81.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.59
Rate for Payer: Oxford Commercial	$32.76
Rate for Payer: Qualcare PPO/HMO/WC	$24.57
Rate for Payer: UnitedHealthcare Commercial	$32.76
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

CANNULA 7.0 X 72 MM

Facility

$163.80

Hospital Charge Code	270682201
Hospital Revenue Code	272
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$24.57
Rate for Payer: Qualcare PPO/HMO/WC	$24.57

CANNULA 8 5mm X 75mm 214680

Facility

$145.00

Hospital Charge Code	270637606
Hospital Revenue Code	272
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$55.10
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$29.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: Wellpoint Medicaid Managed Care	$4.12

CANNULA 8 5mm X 75mm 214680

Facility

$145.00

Hospital Charge Code	270637606
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

CANNULA 8MM LENGTH 7,8,9

Facility

$445.25

Hospital Charge Code	270673919
Hospital Revenue Code	272
Min. Negotiated Rate	$66.79
Max. Negotiated Rate	$66.79
Rate for Payer: Qualcare PPO/HMO/WC	$66.79

CANNULA 8MM LENGTH 7,8,9

Facility

$445.25

Hospital Charge Code	270673919
Hospital Revenue Code	272
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$222.62
Rate for Payer: Aetna Commercial	$169.19
Rate for Payer: Aetna Medicare Advantage	$133.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.54
Rate for Payer: Cigna Commercial	$222.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.77
Rate for Payer: Oxford Commercial	$89.05
Rate for Payer: Qualcare PPO/HMO/WC	$66.79
Rate for Payer: UnitedHealthcare Commercial	$89.05
Rate for Payer: UnitedHealthcare Community & State	$14.07
Rate for Payer: Wellpoint Medicaid Managed Care	$12.65

Know your out-of-pocket cost for care.

All Charges