Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

1.3MM TI CORTX SCRW SLFTAP 6MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686786
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

1.3MM TI CORTX SCRW SLFTAP 6MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686786
Hospital Revenue Code	278
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.58

1.3MM TI CORTX SCRW SLFTAP 7MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686787
Hospital Revenue Code	278
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$168.70
Rate for Payer: Aetna Commercial	$128.21
Rate for Payer: Aetna Medicare Advantage	$101.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.04
Rate for Payer: Cigna Commercial	$168.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: Qualcare PPO/HMO/WC	$50.61
Rate for Payer: UnitedHealthcare Community & State	$10.66
Rate for Payer: Wellpoint Medicaid Managed Care	$9.58

1.3MM TI CORTX SCRW SLFTAP 7MM

Facility

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	270686787
Hospital Revenue Code	278
Min. Negotiated Rate	$50.61
Max. Negotiated Rate	$81.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.65
Rate for Payer: Qualcare PPO/HMO/WC	$50.61

13MM X 8 DEGREE PLATE

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704185
Hospital Revenue Code	278
Min. Negotiated Rate	$340.80
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$379.20
Rate for Payer: Wellpoint Medicaid Managed Care	$340.80

13MM X 8 DEGREE PLATE

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704185
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

140/80 HA PINS

Facility

$720.00

Hospital Charge Code	270339495
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

140/80 HA PINS

Facility

$720.00

Hospital Charge Code	270339495
Hospital Revenue Code	272
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$273.60
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.20
Rate for Payer: Oxford Commercial	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$144.00
Rate for Payer: UnitedHealthcare Community & State	$22.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.45

14.3.3 ETA PROTEIN (SERUM)

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	3032492
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

14.3.3 ETA PROTEIN (SERUM)

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	3032492
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.65
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

14-3-3 PROTEIN,CSF

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900338
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

14-3-3 PROTEIN,CSF

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900338
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.65
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

14 FR X 15 CM SLX SCHON CATHET

Facility

$425.00

Service Code	HCPCS C1752
Hospital Charge Code	270661315
Hospital Revenue Code	278
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

14 FR X 15 CM SLX SCHON CATHET

Facility

$425.00

Service Code	HCPCS C1752
Hospital Charge Code	270661315
Hospital Revenue Code	278
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$85.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

14 FR X 20 CM SLX SCHON CATH

Facility

$510.00

Service Code	HCPCS C1752
Hospital Charge Code	270661314
Hospital Revenue Code	278
Min. Negotiated Rate	$14.48
Max. Negotiated Rate	$255.00
Rate for Payer: Aetna Commercial	$193.80
Rate for Payer: Aetna Medicare Advantage	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.05
Rate for Payer: Cigna Commercial	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.42
Rate for Payer: Qualcare PPO/HMO/WC	$76.50
Rate for Payer: UnitedHealthcare Community & State	$16.12
Rate for Payer: Wellpoint Medicaid Managed Care	$14.48

14 FR X 20 CM SLX SCHON CATH

Facility

$510.00

Service Code	HCPCS C1752
Hospital Charge Code	270661314
Hospital Revenue Code	278
Min. Negotiated Rate	$76.50
Max. Negotiated Rate	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.42
Rate for Payer: Qualcare PPO/HMO/WC	$76.50

1-4MM, 30CC

Facility

$13,050.00

Service Code	HCPCS C1765
Hospital Charge Code	270704996
Hospital Revenue Code	278
Min. Negotiated Rate	$1,957.50
Max. Negotiated Rate	$3,158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,158.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,957.50

1-4MM, 30CC

Facility

$13,050.00

Service Code	HCPCS C1765
Hospital Charge Code	270704996
Hospital Revenue Code	278
Min. Negotiated Rate	$370.62
Max. Negotiated Rate	$6,525.00
Rate for Payer: Aetna Commercial	$4,959.00
Rate for Payer: Aetna Medicare Advantage	$3,915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,327.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,327.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,327.75
Rate for Payer: Cigna Commercial	$6,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,158.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,957.50
Rate for Payer: UnitedHealthcare Community & State	$412.38
Rate for Payer: Wellpoint Medicaid Managed Care	$370.62

14MM SELF DRILL RESCUE SCREW

Facility

$382.50

Service Code	HCPCS C1713
Hospital Charge Code	270705021
Hospital Revenue Code	278
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$92.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

14MM SELF DRILL RESCUE SCREW

Facility

$382.50

Service Code	HCPCS C1713
Hospital Charge Code	270705021
Hospital Revenue Code	278
Min. Negotiated Rate	$10.86
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$145.35
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.56
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Community & State	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.86

14X12X6 CAGE 6D TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703449
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

14X12X6 CAGE 6D TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703449
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

14X12X7MM,6DEGREE TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703450
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

14X12X7MM,6DEGREE TIGERSHARK

Facility

$5,500.00

Hospital Charge Code	270703450
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

150MM CARBON ROD

Facility

$775.00

Hospital Charge Code	270339505
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

Know your out-of-pocket cost for care.

All Charges