Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 5X20MM

Facility

$2,500.00

Hospital Charge Code	270701766
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW 5X20MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704663
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 5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704863
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 5X25MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704098
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW 5X25MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701767
Hospital Revenue Code	278
Min. Negotiated Rate	$71.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Community & State	$79.00
Rate for Payer: Wellpoint Medicaid Managed Care	$71.00

SCREW 5X25MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701767
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW 5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704863
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 5X25MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704098
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

SCREW 5X28MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705625
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW 5X28MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705625
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

SCREW 5x30mm 14-405030

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270640416
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW 5x30mm 14-405030

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270640416
Hospital Revenue Code	278
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

SCREW 5X30MM SELF TAPPING

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691218
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW 5X30MM SELF TAPPING

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691218
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW 5X30MM SELF TAPPING

Facility

$2,260.00

Service Code	HCPCS C1713
Hospital Charge Code	270691215
Hospital Revenue Code	278
Min. Negotiated Rate	$339.00
Max. Negotiated Rate	$546.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$452.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.92
Rate for Payer: Qualcare PPO/HMO/WC	$339.00

SCREW 5X30MM SELF TAPPING

Facility

$2,260.00

Service Code	HCPCS C1713
Hospital Charge Code	270691215
Hospital Revenue Code	278
Min. Negotiated Rate	$64.18
Max. Negotiated Rate	$1,130.00
Rate for Payer: Aetna Commercial	$858.80
Rate for Payer: Aetna Medicare Advantage	$678.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$576.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$576.30
Rate for Payer: Cigna Commercial	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.92
Rate for Payer: Qualcare PPO/HMO/WC	$339.00
Rate for Payer: UnitedHealthcare Community & State	$71.42
Rate for Payer: Wellpoint Medicaid Managed Care	$64.18

SCREW 5X40

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270677499
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

SCREW 5X40

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270677499
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW 6.5 CAN 16 TH 55 2332056

Facility

$95.00

Service Code	HCPCS C1713
Hospital Charge Code	270610372
Hospital Revenue Code	278
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$22.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.99
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

SCREW 6.5 CAN 16 TH 55 2332056

Facility

$95.00

Service Code	HCPCS C1713
Hospital Charge Code	270610372
Hospital Revenue Code	278
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.99
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Community & State	$3.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

SCREW 6.5 CANC 26 X 65 THD

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270687892
Hospital Revenue Code	278
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

SCREW 6.5 CANC 26 X 65 THD

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270687892
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW 6.5 CANC 32 X 60 THD

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270687891
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW 6.5 CANC 32 X 60 THD

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270687891
Hospital Revenue Code	278
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$52.84
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86
Rate for Payer: UnitedHealthcare Community & State	$4.39
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

SCREW 6.5 CANN 16MM THR 95M

Facility

$1,139.10

Service Code	HCPCS C1713
Hospital Charge Code	270693463
Hospital Revenue Code	278
Min. Negotiated Rate	$170.87
Max. Negotiated Rate	$275.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.66
Rate for Payer: Qualcare PPO/HMO/WC	$170.87

Know your out-of-pocket cost for care.

All Charges