Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

90 DEGRESS ABLATOR

Facility

$1,075.00

Hospital Charge Code	270703224
Hospital Revenue Code	270
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

90 MM ROD

Facility

$875.00

Service Code	HCPCS C1773
Hospital Charge Code	270703977
Hospital Revenue Code	278
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

90 MM ROD

Facility

$875.00

Service Code	HCPCS C1773
Hospital Charge Code	270703977
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

90MM ROD

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270705000
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

90MM ROD

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270705000
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

9.0 MM X 2.0 MM STEM

Facility

$11,585.00

Service Code	HCPCS C1776
Hospital Charge Code	270686224
Hospital Revenue Code	278
Min. Negotiated Rate	$329.01
Max. Negotiated Rate	$5,792.50
Rate for Payer: Aetna Commercial	$4,402.30
Rate for Payer: Aetna Medicare Advantage	$3,475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,954.18
Rate for Payer: Cigna Commercial	$5,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75
Rate for Payer: UnitedHealthcare Community & State	$366.09
Rate for Payer: Wellpoint Medicaid Managed Care	$329.01

9.0 MM X 2.0 MM STEM

Facility

$11,585.00

Service Code	HCPCS C1776
Hospital Charge Code	270686224
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$2,803.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

9.5X55MM SI SCREW - DUAL

Facility

$16,950.00

Hospital Charge Code	270703185
Hospital Revenue Code	278
Min. Negotiated Rate	$481.38
Max. Negotiated Rate	$8,475.00
Rate for Payer: Aetna Commercial	$6,441.00
Rate for Payer: Aetna Medicare Advantage	$5,085.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,322.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,322.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,322.25
Rate for Payer: Cigna Commercial	$8,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,101.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,542.50
Rate for Payer: UnitedHealthcare Community & State	$535.62
Rate for Payer: Wellpoint Medicaid Managed Care	$481.38

9.5X55MM SI SCREW - DUAL

Facility

$16,950.00

Hospital Charge Code	270703185
Hospital Revenue Code	278
Min. Negotiated Rate	$2,542.50
Max. Negotiated Rate	$4,101.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,101.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,542.50

9.5X65MM SI SCREW DUAL THREAD

Facility

$16,750.00

Hospital Charge Code	270703186
Hospital Revenue Code	278
Min. Negotiated Rate	$475.70
Max. Negotiated Rate	$8,375.00
Rate for Payer: Aetna Commercial	$6,365.00
Rate for Payer: Aetna Medicare Advantage	$5,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,271.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,271.25
Rate for Payer: Cigna Commercial	$8,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50
Rate for Payer: UnitedHealthcare Community & State	$529.30
Rate for Payer: Wellpoint Medicaid Managed Care	$475.70

9.5X65MM SI SCREW DUAL THREAD

Facility

$16,750.00

Hospital Charge Code	270703186
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.50
Max. Negotiated Rate	$4,053.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,053.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.50

9 HOLE NARROW PLATE

Facility

$17,705.00

Service Code	HCPCS C1713
Hospital Charge Code	270705135
Hospital Revenue Code	278
Min. Negotiated Rate	$502.82
Max. Negotiated Rate	$8,852.50
Rate for Payer: Aetna Commercial	$6,727.90
Rate for Payer: Aetna Medicare Advantage	$5,311.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,514.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,514.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,514.77
Rate for Payer: Cigna Commercial	$8,852.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.61
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.75
Rate for Payer: UnitedHealthcare Community & State	$559.48
Rate for Payer: Wellpoint Medicaid Managed Care	$502.82

9 HOLE NARROW PLATE

Facility

$17,705.00

Service Code	HCPCS C1713
Hospital Charge Code	270705135
Hospital Revenue Code	278
Min. Negotiated Rate	$2,655.75
Max. Negotiated Rate	$4,284.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,541.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,284.61
Rate for Payer: Qualcare PPO/HMO/WC	$2,655.75

9MM 6DEG ZAVATION CAGE

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	2707055356
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

9MM 6DEG ZAVATION CAGE

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	2707055356
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

9X38X28MM ALIF SPACER, 10DEG

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270703760
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

9X38X28MM ALIF SPACER, 10DEG

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270703760
Hospital Revenue Code	278
Min. Negotiated Rate	$940.75
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$12,587.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75
Rate for Payer: UnitedHealthcare Community & State	$1,046.75
Rate for Payer: Wellpoint Medicaid Managed Care	$940.75

A5 CONNECTOR

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270659852
Hospital Revenue Code	278
Min. Negotiated Rate	$181.05
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$201.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.05

A5 CONNECTOR

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270659852
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

A5 CROSSLINK

Facility

$11,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270665831
Hospital Revenue Code	278
Min. Negotiated Rate	$1,740.00
Max. Negotiated Rate	$2,807.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00

A5 CROSSLINK

Facility

$11,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270665831
Hospital Revenue Code	278
Min. Negotiated Rate	$329.44
Max. Negotiated Rate	$5,800.00
Rate for Payer: Aetna Commercial	$4,408.00
Rate for Payer: Aetna Medicare Advantage	$3,480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,958.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,958.00
Rate for Payer: Cigna Commercial	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,807.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,740.00
Rate for Payer: UnitedHealthcare Community & State	$366.56
Rate for Payer: Wellpoint Medicaid Managed Care	$329.44

A6 CONNECTOR

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270661529
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

A6 CONNECTOR

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270661529
Hospital Revenue Code	278
Min. Negotiated Rate	$181.05
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$201.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.05

ABACAVIR 300 MG TAB

Facility

$74.84

Service Code	NDC 49702022144
Hospital Charge Code	60629217
Hospital Revenue Code	250
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

ABACAVIR 300 MG TAB

Facility

$74.84

Service Code	NDC 49702022144
Hospital Charge Code	60629217
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.42
Rate for Payer: Aetna Commercial	$28.44
Rate for Payer: Aetna Medicare Advantage	$22.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.08
Rate for Payer: Cigna Commercial	$37.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.46
Rate for Payer: Oxford Commercial	$14.97
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$14.97
Rate for Payer: UnitedHealthcare Community & State	$2.36
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

Know your out-of-pocket cost for care.

All Charges