Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COVER FOAM 12

Facility

$25.00

Hospital Charge Code	270672154
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$9.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

COVER FOAM 12

Facility

$25.00

Hospital Charge Code	270672154
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

COVER FOAM 14

Facility

$28.75

Hospital Charge Code	270672156
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$14.38
Rate for Payer: Aetna Commercial	$10.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.33
Rate for Payer: Cigna Commercial	$14.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.47
Rate for Payer: Oxford Commercial	$5.75
Rate for Payer: Qualcare PPO/HMO/WC	$4.31
Rate for Payer: UnitedHealthcare Commercial	$5.75
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

COVER FOAM 14

Facility

$28.75

Hospital Charge Code	270672156
Hospital Revenue Code	272
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$4.31
Rate for Payer: Qualcare PPO/HMO/WC	$4.31

COVER FOAM 8

Facility

$21.25

Hospital Charge Code	270672153
Hospital Revenue Code	272
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.19

COVER FOAM 8

Facility

$21.25

Hospital Charge Code	270672153
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$10.62
Rate for Payer: Aetna Commercial	$8.07
Rate for Payer: Aetna Medicare Advantage	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.42
Rate for Payer: Cigna Commercial	$10.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.53
Rate for Payer: Oxford Commercial	$4.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.19
Rate for Payer: UnitedHealthcare Commercial	$4.25
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

COVER KAPS STERILE 18 DEPTH

Facility

$250.75

Hospital Charge Code	270662662
Hospital Revenue Code	270
Min. Negotiated Rate	$37.61
Max. Negotiated Rate	$37.61
Rate for Payer: Qualcare PPO/HMO/WC	$37.61

COVER KAPS STERILE 18 DEPTH

Facility

$250.75

Hospital Charge Code	270662662
Hospital Revenue Code	270
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$125.38
Rate for Payer: Aetna Commercial	$95.28
Rate for Payer: Aetna Medicare Advantage	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.94
Rate for Payer: Cigna Commercial	$125.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.19
Rate for Payer: Oxford Commercial	$50.15
Rate for Payer: Qualcare PPO/HMO/WC	$37.61
Rate for Payer: UnitedHealthcare Commercial	$50.15
Rate for Payer: UnitedHealthcare Community & State	$7.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

COVER LATERAL PLATE LOCKING 14

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693156
Hospital Revenue Code	278
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

COVER LATERAL PLATE LOCKING 14

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693156
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

COVER LIGHT HANDLE STRL

Facility

$874.15

Hospital Charge Code	270665025
Hospital Revenue Code	270
Min. Negotiated Rate	$24.83
Max. Negotiated Rate	$437.07
Rate for Payer: Aetna Commercial	$332.18
Rate for Payer: Aetna Medicare Advantage	$262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.91
Rate for Payer: Cigna Commercial	$437.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.28
Rate for Payer: Oxford Commercial	$174.83
Rate for Payer: Qualcare PPO/HMO/WC	$131.12
Rate for Payer: UnitedHealthcare Commercial	$174.83
Rate for Payer: UnitedHealthcare Community & State	$27.62
Rate for Payer: Wellpoint Medicaid Managed Care	$24.83

COVER LIGHT HANDLE STRL

Facility

$874.15

Hospital Charge Code	270665025
Hospital Revenue Code	270
Min. Negotiated Rate	$131.12
Max. Negotiated Rate	$131.12
Rate for Payer: Qualcare PPO/HMO/WC	$131.12

COVER LOCKING BACK UP 5-12 MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694460
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

COVER LOCKING BACK UP 5-12 MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694460
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

COVERLOC LATERAL TALUS TORNIER

Facility

$800.00

Hospital Charge Code	270339516
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

COVERLOC LATERAL TALUS TORNIER

Facility

$800.00

Hospital Charge Code	270339516
Hospital Revenue Code	278
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) NJ Health	$160.00
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	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

COVERLOC - TIBIA TORNIER

Facility

$800.00

Hospital Charge Code	270339515
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

COVERLOC - TIBIA TORNIER

Facility

$800.00

Hospital Charge Code	270339515
Hospital Revenue Code	278
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) NJ Health	$160.00
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	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

COVER NAVIG PROBE 5X9 3787

Facility

$47.27

Hospital Charge Code	270614504
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

COVER NAVIG PROBE 5X9 3787

Facility

$47.27

Hospital Charge Code	270614504
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$23.64
Rate for Payer: Aetna Commercial	$17.96
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.29
Rate for Payer: Oxford Commercial	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$9.45
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

COVER PLATE 12MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703636
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

COVER PLATE 12MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703636
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

COVER PLATE 14MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703634
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

COVER PLATE 14MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703634
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

COVER PROBE GENERAL PURPOSE

Facility

$29.08

Hospital Charge Code	270648023
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$14.54
Rate for Payer: Aetna Commercial	$11.05
Rate for Payer: Aetna Medicare Advantage	$8.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.42
Rate for Payer: Cigna Commercial	$14.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.56
Rate for Payer: Oxford Commercial	$5.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.36
Rate for Payer: UnitedHealthcare Commercial	$5.82
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

Know your out-of-pocket cost for care.

All Charges