Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 6.5X 45 MM

Facility

$9,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691517
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

SCREW 6.5X 45 MM

Facility

$9,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270691517
Hospital Revenue Code	278
Min. Negotiated Rate	$262.70
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$292.30
Rate for Payer: Wellpoint Medicaid Managed Care	$262.70

SCREW 6.5X45MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270691939
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 6.5X45MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270702662
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW 6.5X45MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270691939
Hospital Revenue Code	278
Min. Negotiated Rate	$191.42
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$212.98
Rate for Payer: Wellpoint Medicaid Managed Care	$191.42

SCREW 6.5X45MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270704680
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

SCREW 6.5X45MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270702662
Hospital Revenue Code	278
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

SCREW 6.5X45MM

Facility

$8,180.75

Service Code	HCPCS C1713
Hospital Charge Code	270705420
Hospital Revenue Code	278
Min. Negotiated Rate	$232.33
Max. Negotiated Rate	$4,090.38
Rate for Payer: Aetna Commercial	$3,108.68
Rate for Payer: Aetna Medicare Advantage	$2,454.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,086.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,086.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,636.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,086.09
Rate for Payer: Cigna Commercial	$4,090.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,979.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.11
Rate for Payer: UnitedHealthcare Community & State	$258.51
Rate for Payer: Wellpoint Medicaid Managed Care	$232.33

SCREW 6.5X45MM

Facility

$5,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704029
Hospital Revenue Code	278
Min. Negotiated Rate	$154.78
Max. Negotiated Rate	$2,725.00
Rate for Payer: Aetna Commercial	$2,071.00
Rate for Payer: Aetna Medicare Advantage	$1,635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,389.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,090.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,389.75
Rate for Payer: Cigna Commercial	$2,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.90
Rate for Payer: Qualcare PPO/HMO/WC	$817.50
Rate for Payer: UnitedHealthcare Community & State	$172.22
Rate for Payer: Wellpoint Medicaid Managed Care	$154.78

SCREW 6.5X45MM

Facility

$4,500.00

Hospital Charge Code	270703136
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

SCREW 6.5X45MM

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270704680
Hospital Revenue Code	278
Min. Negotiated Rate	$62.48
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$69.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.48

SCREW 6.5X45MM

Facility

$4,500.00

Hospital Charge Code	270703136
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

SCREW 6.5X45MM

Facility

$5,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704029
Hospital Revenue Code	278
Min. Negotiated Rate	$817.50
Max. Negotiated Rate	$1,318.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,318.90
Rate for Payer: Qualcare PPO/HMO/WC	$817.50

SCREW 6.5X45MM

Facility

$8,180.75

Service Code	HCPCS C1713
Hospital Charge Code	270705420
Hospital Revenue Code	278
Min. Negotiated Rate	$1,227.11
Max. Negotiated Rate	$1,979.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,636.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,979.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.11

SCREW 6.5X45MM #11-4645

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705468
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

SCREW 6.5X45MM #11-4645

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705468
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

SCREW 6.5X45MM ACCELUS

Facility

$2,000.00

Hospital Charge Code	270703471
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW 6.5X45MM ACCELUS

Facility

$2,000.00

Hospital Charge Code	270703471
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

SCREW 6.5X45MM POLYAXIAL

Facility

$10,285.00

Hospital Charge Code	270662658
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$2,488.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

SCREW 6.5X45MM POLYAXIAL

Facility

$10,285.00

Hospital Charge Code	270662658
Hospital Revenue Code	278
Min. Negotiated Rate	$292.09
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,908.30
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75
Rate for Payer: UnitedHealthcare Community & State	$325.01
Rate for Payer: Wellpoint Medicaid Managed Care	$292.09

SCREW 6.5X45MM POLY RELINE 2C

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691823
Hospital Revenue Code	278
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.93

SCREW 6.5X45MM POLY RELINE 2C

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691823
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$93.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

SCREW 6.5 X 45 MM RELINE

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270682865
Hospital Revenue Code	278
Min. Negotiated Rate	$255.60
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$284.40
Rate for Payer: Wellpoint Medicaid Managed Care	$255.60

SCREW 6.5 X 45 MM RELINE

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270682865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SCREW 6.5X50

Facility

$11,205.60

Service Code	HCPCS C1713
Hospital Charge Code	270699238
Hospital Revenue Code	278
Min. Negotiated Rate	$318.24
Max. Negotiated Rate	$5,602.80
Rate for Payer: Aetna Commercial	$4,258.13
Rate for Payer: Aetna Medicare Advantage	$3,361.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,857.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,857.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,241.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,857.43
Rate for Payer: Cigna Commercial	$5,602.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.84
Rate for Payer: UnitedHealthcare Community & State	$354.10
Rate for Payer: Wellpoint Medicaid Managed Care	$318.24

Know your out-of-pocket cost for care.

All Charges