Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692582
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 4X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692582
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 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705705
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 4X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703038
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 4X14MM

Facility

$1,495.00

Service Code	HCPCS 1495
Hospital Charge Code	270705763
Hospital Revenue Code	278
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$568.10
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$42.46

SCREW 4X14MM

Facility

$1,495.00

Service Code	HCPCS 1495
Hospital Charge Code	270705763
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

SCREW 4X14MM

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704158
Hospital Revenue Code	278
Min. Negotiated Rate	$376.30
Max. Negotiated Rate	$6,625.00
Rate for Payer: Aetna Commercial	$5,035.00
Rate for Payer: Aetna Medicare Advantage	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.75
Rate for Payer: Cigna Commercial	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50
Rate for Payer: UnitedHealthcare Community & State	$418.70
Rate for Payer: Wellpoint Medicaid Managed Care	$376.30

SCREW 4X16MM

Facility

$1,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270705764
Hospital Revenue Code	278
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$568.10
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$42.46

SCREW 4X16MM

Facility

$1,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270705764
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657163
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657155
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657153
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657161
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657161
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657163
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657143
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657153
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657143
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657146
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657146
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657151
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657155
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 CANNULATED CONICAL

Facility

$717.00

Hospital Charge Code	270657151
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW 5.0 LG 36 MM

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691766
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

SCREW 5.0 LG 36 MM

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691766
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

Know your out-of-pocket cost for care.

All Charges