Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 3.5X12MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694813
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW 3.5X12MM IRIXC SELFDRILL

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693291
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

SCREW 3.5X12MM IRIXC SELFDRILL

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW 3.5x12MM POLY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679254
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

SCREW 3.5x12MM POLY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679254
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

SCREW 3.5x14 LP LCK8161-35-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270658901
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW 3.5x14 LP LCK8161-35-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270658901
Hospital Revenue Code	278
Min. Negotiated Rate	$17.96
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$19.99
Rate for Payer: Wellpoint Medicaid Managed Care	$17.96

SCREW 3.5 X 14 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693201
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 3.5 X 14 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693201
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW 3.5 X 14MM

Facility

$354.90

Service Code	HCPCS C1713
Hospital Charge Code	270664089
Hospital Revenue Code	278
Min. Negotiated Rate	$53.23
Max. Negotiated Rate	$85.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.23

SCREW 3.5 X 14MM

Facility

$354.90

Service Code	HCPCS C1713
Hospital Charge Code	270664089
Hospital Revenue Code	278
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$177.45
Rate for Payer: Aetna Commercial	$134.86
Rate for Payer: Aetna Medicare Advantage	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.50
Rate for Payer: Cigna Commercial	$177.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.89
Rate for Payer: Qualcare PPO/HMO/WC	$53.23
Rate for Payer: UnitedHealthcare Community & State	$11.21
Rate for Payer: Wellpoint Medicaid Managed Care	$10.08

SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704844
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 3.5X14MM

Facility

$3,900.00

Hospital Charge Code	270669222
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$1,950.00
Rate for Payer: Aetna Commercial	$1,482.00
Rate for Payer: Aetna Medicare Advantage	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.50
Rate for Payer: Cigna Commercial	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: Qualcare PPO/HMO/WC	$585.00
Rate for Payer: UnitedHealthcare Community & State	$123.24
Rate for Payer: Wellpoint Medicaid Managed Care	$110.76

SCREW 3.5X14MM

Facility

$3,900.00

Hospital Charge Code	270669222
Hospital Revenue Code	278
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$943.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: Qualcare PPO/HMO/WC	$585.00

SCREW 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704844
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SCREW 3.5X14MM LOCKING

Facility

$2,889.15

Service Code	HCPCS C1713
Hospital Charge Code	270705392
Hospital Revenue Code	278
Min. Negotiated Rate	$433.37
Max. Negotiated Rate	$699.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.17
Rate for Payer: Qualcare PPO/HMO/WC	$433.37

SCREW 3.5X14MM LOCKING

Facility

$2,889.15

Service Code	HCPCS C1713
Hospital Charge Code	270705392
Hospital Revenue Code	278
Min. Negotiated Rate	$82.05
Max. Negotiated Rate	$1,444.58
Rate for Payer: Aetna Commercial	$1,097.88
Rate for Payer: Aetna Medicare Advantage	$866.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$736.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$736.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$736.73
Rate for Payer: Cigna Commercial	$1,444.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.17
Rate for Payer: Qualcare PPO/HMO/WC	$433.37
Rate for Payer: UnitedHealthcare Community & State	$91.30
Rate for Payer: Wellpoint Medicaid Managed Care	$82.05

SCREW 3.5X14MM NL

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703461
Hospital Revenue Code	278
Min. Negotiated Rate	$40.15
Max. Negotiated Rate	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.15

SCREW 3.5X14MM NL

Facility

$267.65

Service Code	HCPCS C1713
Hospital Charge Code	270703461
Hospital Revenue Code	278
Min. Negotiated Rate	$7.60
Max. Negotiated Rate	$133.82
Rate for Payer: Aetna Commercial	$101.71
Rate for Payer: Aetna Medicare Advantage	$80.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.25
Rate for Payer: Cigna Commercial	$133.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.77
Rate for Payer: Qualcare PPO/HMO/WC	$40.15
Rate for Payer: UnitedHealthcare Community & State	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.60

SCREW 3.5x14MM POLY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270657223
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

SCREW 3.5x14MM POLY

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270657223
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

SCREW 3.5X16MM

Facility

$1,250.00

Hospital Charge Code	270703473
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW 3.5X16MM

Facility

$1,250.00

Hospital Charge Code	270693119
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW 3.5X16MM

Facility

$1,250.00

Hospital Charge Code	270693119
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 3.5X16MM

Facility

$1,250.00

Hospital Charge Code	270703473
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

Know your out-of-pocket cost for care.

All Charges