Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CONNECTOR LOTUS TRANSV 30-36MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697976
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

CONNECTOR LOTUS TRANSV 30-36MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270697976
Hospital Revenue Code	278
Min. Negotiated Rate	$68.16
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$912.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Community & State	$75.84
Rate for Payer: Wellpoint Medicaid Managed Care	$68.16

CONNECTOR MATRIX #1

Facility

$5,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270691063
Hospital Revenue Code	278
Min. Negotiated Rate	$168.27
Max. Negotiated Rate	$2,962.50
Rate for Payer: Aetna Commercial	$2,251.50
Rate for Payer: Aetna Medicare Advantage	$1,777.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,510.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,510.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,510.88
Rate for Payer: Cigna Commercial	$2,962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,433.85
Rate for Payer: Qualcare PPO/HMO/WC	$888.75
Rate for Payer: UnitedHealthcare Community & State	$187.23
Rate for Payer: Wellpoint Medicaid Managed Care	$168.27

CONNECTOR MATRIX #1

Facility

$5,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270691063
Hospital Revenue Code	278
Min. Negotiated Rate	$888.75
Max. Negotiated Rate	$1,433.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,433.85
Rate for Payer: Qualcare PPO/HMO/WC	$888.75

CONNECTOR M SMARTSTITCH

Facility

$875.00

Hospital Charge Code	270668395
Hospital Revenue Code	272
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) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

CONNECTOR M SMARTSTITCH

Facility

$875.00

Hospital Charge Code	270668395
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

CONNECTOR NEURO RT ANG 45104

Facility

$321.60

Hospital Charge Code	270603331
Hospital Revenue Code	272
Min. Negotiated Rate	$9.13
Max. Negotiated Rate	$160.80
Rate for Payer: Aetna Commercial	$122.21
Rate for Payer: Aetna Medicare Advantage	$96.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.01
Rate for Payer: Cigna Commercial	$160.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.62
Rate for Payer: Oxford Commercial	$64.32
Rate for Payer: Qualcare PPO/HMO/WC	$48.24
Rate for Payer: UnitedHealthcare Commercial	$64.32
Rate for Payer: UnitedHealthcare Community & State	$10.16
Rate for Payer: Wellpoint Medicaid Managed Care	$9.13

CONNECTOR NEURO RT ANG 45104

Facility

$321.60

Hospital Charge Code	270603331
Hospital Revenue Code	272
Min. Negotiated Rate	$48.24
Max. Negotiated Rate	$48.24
Rate for Payer: Qualcare PPO/HMO/WC	$48.24

CONNECTOR OFFSET 11MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698270
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

CONNECTOR OFFSET 11MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698270
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CONNECTOR OFFSET 12MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698267
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

CONNECTOR OFFSET 12MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698267
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CONNECTOR PERFECT PASSER

Facility

$1,110.00

Hospital Charge Code	270672940
Hospital Revenue Code	272
Min. Negotiated Rate	$166.50
Max. Negotiated Rate	$166.50
Rate for Payer: Qualcare PPO/HMO/WC	$166.50

CONNECTOR PERFECT PASSER

Facility

$1,110.00

Hospital Charge Code	270672940
Hospital Revenue Code	272
Min. Negotiated Rate	$31.52
Max. Negotiated Rate	$555.00
Rate for Payer: Aetna Commercial	$421.80
Rate for Payer: Aetna Medicare Advantage	$333.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.05
Rate for Payer: Cigna Commercial	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.60
Rate for Payer: Oxford Commercial	$222.00
Rate for Payer: Qualcare PPO/HMO/WC	$166.50
Rate for Payer: UnitedHealthcare Commercial	$222.00
Rate for Payer: UnitedHealthcare Community & State	$35.08
Rate for Payer: Wellpoint Medicaid Managed Care	$31.52

CONNECTOR PREVENA

Facility

$17.50

Hospital Charge Code	270682887
Hospital Revenue Code	272
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.62

CONNECTOR PREVENA

Facility

$17.50

Hospital Charge Code	270682887
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$8.75
Rate for Payer: Aetna Commercial	$6.65
Rate for Payer: Aetna Medicare Advantage	$5.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.46
Rate for Payer: Cigna Commercial	$8.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.62
Rate for Payer: UnitedHealthcare Commercial	$3.50
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

CONNECTOR REG STER 360

Facility

$5.61

Hospital Charge Code	270300720
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

CONNECTOR REG STER 360

Facility

$5.61

Hospital Charge Code	270300720
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna Medicare Advantage	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.43
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.12
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

CONNECTOR ROD A5 F5 TI SFX

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270679013
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

CONNECTOR ROD A5 F5 TI SFX

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270679013
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

CONNECTOR SMALL SCREW STD

Facility

$2,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270688183
Hospital Revenue Code	278
Min. Negotiated Rate	$328.50
Max. Negotiated Rate	$529.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.98
Rate for Payer: Qualcare PPO/HMO/WC	$328.50

CONNECTOR SMALL SCREW STD

Facility

$2,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270688183
Hospital Revenue Code	278
Min. Negotiated Rate	$62.20
Max. Negotiated Rate	$1,095.00
Rate for Payer: Aetna Commercial	$832.20
Rate for Payer: Aetna Medicare Advantage	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$558.45
Rate for Payer: Cigna Commercial	$1,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.98
Rate for Payer: Qualcare PPO/HMO/WC	$328.50
Rate for Payer: UnitedHealthcare Community & State	$69.20
Rate for Payer: Wellpoint Medicaid Managed Care	$62.20

CONNECTOR STER SIMS TYPE

Facility

$15.00

Hospital Charge Code	270332247
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CONNECTOR STER SIMS TYPE

Facility

$15.00

Hospital Charge Code	270332247
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

CONNECTOR TRANSVERSE 25-31MM

Facility

$2,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270698271
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

Know your out-of-pocket cost for care.

All Charges