Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

LOCKING SCREW T10 3.5MMXL2.0

Facility

$703.25

Service Code	HCPCS C1713
Hospital Charge Code	270700423
Hospital Revenue Code	278
Min. Negotiated Rate	$105.49
Max. Negotiated Rate	$170.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.19
Rate for Payer: Qualcare PPO/HMO/WC	$105.49

LOCKING SCREW T 10 3.5X 38 MM

Facility

$2,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270701155
Hospital Revenue Code	278
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$487.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: Qualcare PPO/HMO/WC	$302.25

LOCKING SCREW T 10 3.5X 38 MM

Facility

$2,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270701155
Hospital Revenue Code	278
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$1,007.50
Rate for Payer: Aetna Commercial	$765.70
Rate for Payer: Aetna Medicare Advantage	$604.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$513.83
Rate for Payer: Cigna Commercial	$1,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: Qualcare PPO/HMO/WC	$302.25
Rate for Payer: UnitedHealthcare Community & State	$63.67
Rate for Payer: Wellpoint Medicaid Managed Care	$57.23

LOCKING SCREW T2 F/T 5MMX40MM

Facility

$272.50

Service Code	HCPCS C1713
Hospital Charge Code	270638645
Hospital Revenue Code	278
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$136.25
Rate for Payer: Aetna Commercial	$103.55
Rate for Payer: Aetna Medicare Advantage	$81.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.49
Rate for Payer: Cigna Commercial	$136.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.94
Rate for Payer: Qualcare PPO/HMO/WC	$40.88
Rate for Payer: UnitedHealthcare Community & State	$8.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.74

LOCKING SCREW T2 F/T 5MMX40MM

Facility

$272.50

Service Code	HCPCS C1713
Hospital Charge Code	270638645
Hospital Revenue Code	278
Min. Negotiated Rate	$40.88
Max. Negotiated Rate	$65.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.94
Rate for Payer: Qualcare PPO/HMO/WC	$40.88

LOCKING SCREW T8 2.7MMXL20

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700421
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

LOCKING SCREW T8 2.7MMXL20

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700421
Hospital Revenue Code	278
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$472.07
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34
Rate for Payer: UnitedHealthcare Community & State	$39.26
Rate for Payer: Wellpoint Medicaid Managed Care	$35.28

LOCKING SCREW T8 2.7X22MM

Facility

$1,316.85

Hospital Charge Code	270703217
Hospital Revenue Code	278
Min. Negotiated Rate	$197.53
Max. Negotiated Rate	$318.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.68
Rate for Payer: Qualcare PPO/HMO/WC	$197.53

LOCKING SCREW T8 2.7X22MM

Facility

$1,316.85

Hospital Charge Code	270703217
Hospital Revenue Code	278
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$658.42
Rate for Payer: Aetna Commercial	$500.40
Rate for Payer: Aetna Medicare Advantage	$395.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.80
Rate for Payer: Cigna Commercial	$658.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.68
Rate for Payer: Qualcare PPO/HMO/WC	$197.53
Rate for Payer: UnitedHealthcare Community & State	$41.61
Rate for Payer: Wellpoint Medicaid Managed Care	$37.40

LOCKING STRAIGHT PLATE, T1, 4H

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686572
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

LOCKING STRAIGHT PLATE, T1, 4H

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686572
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

LOCKING STRAIGHT PLATE TI 6H

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270693580
Hospital Revenue Code	278
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

LOCKING STRAIGHT PLATE TI 6H

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270693580
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

LOCKNG SCREW TITANIUM 3.5MMX26

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688391
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

LOCKNG SCREW TITANIUM 3.5MMX26

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688391
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

LOCK PLATE STR 1.5MM

Facility

$2,915.00

Hospital Charge Code	270702794
Hospital Revenue Code	278
Min. Negotiated Rate	$82.79
Max. Negotiated Rate	$1,457.50
Rate for Payer: Aetna Commercial	$1,107.70
Rate for Payer: Aetna Medicare Advantage	$874.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$743.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$743.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$583.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$743.33
Rate for Payer: Cigna Commercial	$1,457.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.43
Rate for Payer: Qualcare PPO/HMO/WC	$437.25
Rate for Payer: UnitedHealthcare Community & State	$92.11
Rate for Payer: Wellpoint Medicaid Managed Care	$82.79

LOCK PLATE STR 1.5MM

Facility

$2,915.00

Hospital Charge Code	270702794
Hospital Revenue Code	278
Min. Negotiated Rate	$437.25
Max. Negotiated Rate	$705.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$583.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.43
Rate for Payer: Qualcare PPO/HMO/WC	$437.25

LOCK RING ALLOY

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270668577
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

LOCK RING ALLOY

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270668577
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

LOCK SCREW 1.5X13MM

Facility

$687.50

Hospital Charge Code	270702797
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

LOCK SCREW 1.5X13MM

Facility

$687.50

Hospital Charge Code	270702797
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$21.73
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

LOCK SCREW 1.5X14MM

Facility

$687.50

Hospital Charge Code	270702803
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$21.73
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

LOCK SCREW 1.5X14MM

Facility

$687.50

Hospital Charge Code	270702803
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

LOCK SCREW 1.5X16MM

Facility

$687.50

Hospital Charge Code	270702798
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$21.73
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

LOCK SCREW 1.5X16MM

Facility

$687.50

Hospital Charge Code	270702798
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

Know your out-of-pocket cost for care.

All Charges