Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

1.5.CC AUGMENT

Facility

$9,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686218
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$2,407.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

1.5.CC AUGMENT

Facility

$9,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270686218
Hospital Revenue Code	278
Min. Negotiated Rate	$282.58
Max. Negotiated Rate	$4,975.00
Rate for Payer: Aetna Commercial	$3,781.00
Rate for Payer: Aetna Medicare Advantage	$2,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,537.25
Rate for Payer: Cigna Commercial	$4,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50
Rate for Payer: UnitedHealthcare Community & State	$314.42
Rate for Payer: Wellpoint Medicaid Managed Care	$282.58

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,098.75
Max. Negotiated Rate	$1,772.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684331
Hospital Revenue Code	278
Min. Negotiated Rate	$208.03
Max. Negotiated Rate	$3,662.50
Rate for Payer: Aetna Commercial	$2,783.50
Rate for Payer: Aetna Medicare Advantage	$2,197.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,867.88
Rate for Payer: Cigna Commercial	$3,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75
Rate for Payer: UnitedHealthcare Community & State	$231.47
Rate for Payer: Wellpoint Medicaid Managed Care	$208.03

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684334
Hospital Revenue Code	278
Min. Negotiated Rate	$208.03
Max. Negotiated Rate	$3,662.50
Rate for Payer: Aetna Commercial	$2,783.50
Rate for Payer: Aetna Medicare Advantage	$2,197.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,867.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,867.88
Rate for Payer: Cigna Commercial	$3,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75
Rate for Payer: UnitedHealthcare Community & State	$231.47
Rate for Payer: Wellpoint Medicaid Managed Care	$208.03

15 CM X 20 CM OVAL

Facility

$7,325.00

Service Code	HCPCS C1781
Hospital Charge Code	270684331
Hospital Revenue Code	278
Min. Negotiated Rate	$1,098.75
Max. Negotiated Rate	$1,772.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.75

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270677816
Hospital Revenue Code	272
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.16
Rate for Payer: Oxford Commercial	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Commercial	$73.20
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.39

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270686111
Hospital Revenue Code	272
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.16
Rate for Payer: Oxford Commercial	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Commercial	$73.20
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.39

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270677816
Hospital Revenue Code	272
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

1.5 DRILL BIT

Facility

$366.00

Hospital Charge Code	270686111
Hospital Revenue Code	272
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

15 LITRE 1 MIN FLOW METER

Facility

$208.00

Hospital Charge Code	270663148
Hospital Revenue Code	270
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

15 LITRE 1 MIN FLOW METER

Facility

$208.00

Hospital Charge Code	270663148
Hospital Revenue Code	270
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$79.04
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.08
Rate for Payer: Oxford Commercial	$41.60
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$41.60
Rate for Payer: UnitedHealthcare Community & State	$6.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.91

1.5 LOCKING SCREW 10MM

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681691
Hospital Revenue Code	278
Min. Negotiated Rate	$364.73
Max. Negotiated Rate	$588.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$486.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.44
Rate for Payer: Qualcare PPO/HMO/WC	$364.73

1.5 LOCKING SCREW 10MM

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681691
Hospital Revenue Code	278
Min. Negotiated Rate	$69.06
Max. Negotiated Rate	$1,215.78
Rate for Payer: Aetna Commercial	$923.99
Rate for Payer: Aetna Medicare Advantage	$729.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$486.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.05
Rate for Payer: Cigna Commercial	$1,215.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.44
Rate for Payer: Qualcare PPO/HMO/WC	$364.73
Rate for Payer: UnitedHealthcare Community & State	$76.84
Rate for Payer: Wellpoint Medicaid Managed Care	$69.06

1.5 MM CORTEX 14MM

Facility

$179.00

Hospital Charge Code	270662659
Hospital Revenue Code	278
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$89.50
Rate for Payer: Aetna Commercial	$68.02
Rate for Payer: Aetna Medicare Advantage	$53.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$89.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.32
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
Rate for Payer: UnitedHealthcare Community & State	$5.66
Rate for Payer: Wellpoint Medicaid Managed Care	$5.08

1.5 MM CORTEX 14MM

Facility

$179.00

Hospital Charge Code	270662659
Hospital Revenue Code	278
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$43.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.32
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

1.5MM DRILL BIT/MINI QC/65MM

Facility

$324.65

Hospital Charge Code	270634487
Hospital Revenue Code	272
Min. Negotiated Rate	$48.70
Max. Negotiated Rate	$48.70
Rate for Payer: Qualcare PPO/HMO/WC	$48.70

1.5MM DRILL BIT/MINI QC/65MM

Facility

$324.65

Hospital Charge Code	270634487
Hospital Revenue Code	272
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$162.32
Rate for Payer: Aetna Commercial	$123.37
Rate for Payer: Aetna Medicare Advantage	$97.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.79
Rate for Payer: Cigna Commercial	$162.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.41
Rate for Payer: Oxford Commercial	$64.93
Rate for Payer: Qualcare PPO/HMO/WC	$48.70
Rate for Payer: UnitedHealthcare Commercial	$64.93
Rate for Payer: UnitedHealthcare Community & State	$10.26
Rate for Payer: Wellpoint Medicaid Managed Care	$9.22

1.5MM TI CORTX SCRW SLFTAP 9MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686788
Hospital Revenue Code	278
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$76.38
Rate for Payer: Aetna Commercial	$58.05
Rate for Payer: Aetna Medicare Advantage	$45.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.95
Rate for Payer: Cigna Commercial	$76.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.91
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.34

1.5MM TI CORTX SCRW SLFTAP 9MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686788
Hospital Revenue Code	278
Min. Negotiated Rate	$22.91
Max. Negotiated Rate	$36.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.91

1.5MM TI CRTX SCRW SLFTAP 13MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686789
Hospital Revenue Code	278
Min. Negotiated Rate	$22.91
Max. Negotiated Rate	$36.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.91

1.5MM TI CRTX SCRW SLFTAP 13MM

Facility

$152.75

Service Code	HCPCS C1713
Hospital Charge Code	270686789
Hospital Revenue Code	278
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$76.38
Rate for Payer: Aetna Commercial	$58.05
Rate for Payer: Aetna Medicare Advantage	$45.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.95
Rate for Payer: Cigna Commercial	$76.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.91
Rate for Payer: UnitedHealthcare Community & State	$4.83
Rate for Payer: Wellpoint Medicaid Managed Care	$4.34

1.5 PLATE

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681683
Hospital Revenue Code	278
Min. Negotiated Rate	$69.06
Max. Negotiated Rate	$1,215.78
Rate for Payer: Aetna Commercial	$923.99
Rate for Payer: Aetna Medicare Advantage	$729.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$486.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.05
Rate for Payer: Cigna Commercial	$1,215.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.44
Rate for Payer: Qualcare PPO/HMO/WC	$364.73
Rate for Payer: UnitedHealthcare Community & State	$76.84
Rate for Payer: Wellpoint Medicaid Managed Care	$69.06

1.5 PLATE

Facility

$2,431.55

Service Code	HCPCS C1713
Hospital Charge Code	270681683
Hospital Revenue Code	278
Min. Negotiated Rate	$364.73
Max. Negotiated Rate	$588.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$486.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$588.44
Rate for Payer: Qualcare PPO/HMO/WC	$364.73

Know your out-of-pocket cost for care.

All Charges