Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.0 POLY SYMPH 3.5X14MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693353
Hospital Revenue Code	278
Min. Negotiated Rate	$222.55
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,977.74
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42
Rate for Payer: UnitedHealthcare Community & State	$247.62
Rate for Payer: Wellpoint Medicaid Managed Care	$222.55

SCREW 4.0 POLY SYMPH 3.5X14MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693353
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW 4.0 POLY SYMPH 3.5X16MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW 4.0 POLY SYMPH 3.5X16MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693346
Hospital Revenue Code	278
Min. Negotiated Rate	$222.55
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,977.74
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42
Rate for Payer: UnitedHealthcare Community & State	$247.62
Rate for Payer: Wellpoint Medicaid Managed Care	$222.55

SCREW 4.0 TI CANN HDLESS 38MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696215
Hospital Revenue Code	278
Min. Negotiated Rate	$301.12
Max. Negotiated Rate	$485.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: Qualcare PPO/HMO/WC	$301.12

SCREW 4.0 TI CANN HDLESS 38MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696215
Hospital Revenue Code	278
Min. Negotiated Rate	$57.01
Max. Negotiated Rate	$1,003.75
Rate for Payer: Aetna Commercial	$762.85
Rate for Payer: Aetna Medicare Advantage	$602.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.91
Rate for Payer: Cigna Commercial	$1,003.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: Qualcare PPO/HMO/WC	$301.12
Rate for Payer: UnitedHealthcare Community & State	$63.44
Rate for Payer: Wellpoint Medicaid Managed Care	$57.01

SCREW 4.0 TI CANN HDLESS 40MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696216
Hospital Revenue Code	278
Min. Negotiated Rate	$301.12
Max. Negotiated Rate	$485.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: Qualcare PPO/HMO/WC	$301.12

SCREW 4.0 TI CANN HDLESS 40MM

Facility

$2,007.50

Service Code	HCPCS C1713
Hospital Charge Code	270696216
Hospital Revenue Code	278
Min. Negotiated Rate	$57.01
Max. Negotiated Rate	$1,003.75
Rate for Payer: Aetna Commercial	$762.85
Rate for Payer: Aetna Medicare Advantage	$602.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.91
Rate for Payer: Cigna Commercial	$1,003.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$485.81
Rate for Payer: Qualcare PPO/HMO/WC	$301.12
Rate for Payer: UnitedHealthcare Community & State	$63.44
Rate for Payer: Wellpoint Medicaid Managed Care	$57.01

SCREW 40X12M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685320
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

SCREW 40X12M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685320
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

SCREW 4.0 X 12MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270657250
Hospital Revenue Code	278
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

SCREW 4.0 X 12MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270657250
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW 4.0X 12MM

Facility

$11,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270694870
Hospital Revenue Code	278
Min. Negotiated Rate	$1,760.25
Max. Negotiated Rate	$2,839.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25

SCREW 4.0X 12MM

Facility

$11,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270694870
Hospital Revenue Code	278
Min. Negotiated Rate	$333.27
Max. Negotiated Rate	$5,867.50
Rate for Payer: Aetna Commercial	$4,459.30
Rate for Payer: Aetna Medicare Advantage	$3,520.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,992.43
Rate for Payer: Cigna Commercial	$5,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25
Rate for Payer: UnitedHealthcare Community & State	$370.83
Rate for Payer: Wellpoint Medicaid Managed Care	$333.27

SCREW 4.0 X 12MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686428
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 4.0 X 12MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686428
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 40 X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687500
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

SCREW 40 X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687500
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

SCREW 4.0X14MM CERES-C SELFTAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692584
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 4.0X14MM CERES-C SELFTAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692584
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 4.0 X 14MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686429
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 4.0 X 14MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686429
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 4.0X16MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694164
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 4.0X16MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694164
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 4.0X16MM CERES-C SELF TA

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692578
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