Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW AVATAR T25 EXT 5.5X45MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW AVS ANCHOR-C SD 3.5X8MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270697591
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW AVS ANCHOR-C SD 3.5X8MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270697591
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW AVS ANCHOR-C ST 4X12MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270697592
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

SCREW AVS ANCHOR-C ST 4X12MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270697592
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW AXIAL POLY CANNULA 7.5X4

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692235
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 AXIAL POLY CANNULA 7.5X4

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692235
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 AXSOS CANN 4.0X50MM

Facility

$272.70

Service Code	HCPCS C1713
Hospital Charge Code	270699449
Hospital Revenue Code	278
Min. Negotiated Rate	$40.91
Max. Negotiated Rate	$65.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.99
Rate for Payer: Qualcare PPO/HMO/WC	$40.91

SCREW AXSOS CANN 4.0X50MM

Facility

$272.70

Service Code	HCPCS C1713
Hospital Charge Code	270699449
Hospital Revenue Code	278
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$136.35
Rate for Payer: Aetna Commercial	$103.63
Rate for Payer: Aetna Medicare Advantage	$81.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.54
Rate for Payer: Cigna Commercial	$136.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.99
Rate for Payer: Qualcare PPO/HMO/WC	$40.91
Rate for Payer: UnitedHealthcare Community & State	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$7.74

SCREW AXSOS CORTEX TI 4.5X40MM

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270697985
Hospital Revenue Code	278
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$143.93
Rate for Payer: Aetna Commercial	$109.38
Rate for Payer: Aetna Medicare Advantage	$86.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.40
Rate for Payer: Cigna Commercial	$143.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.18
Rate for Payer: UnitedHealthcare Community & State	$9.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

SCREW AXSOS CORTEX TI 4.5X40MM

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270697985
Hospital Revenue Code	278
Min. Negotiated Rate	$43.18
Max. Negotiated Rate	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.18

SCREW AXSOS CORTEX TI 4.5X46MM

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270697984
Hospital Revenue Code	278
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$143.93
Rate for Payer: Aetna Commercial	$109.38
Rate for Payer: Aetna Medicare Advantage	$86.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.40
Rate for Payer: Cigna Commercial	$143.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.18
Rate for Payer: UnitedHealthcare Community & State	$9.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.17

SCREW AXSOS CORTEX TI 4.5X46MM

Facility

$287.85

Service Code	HCPCS C1713
Hospital Charge Code	270697984
Hospital Revenue Code	278
Min. Negotiated Rate	$43.18
Max. Negotiated Rate	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.18

SCREW AXSOS LKG 5.0X30MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697353
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X30MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270661130
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X30MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270661130
Hospital Revenue Code	278
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$483.59
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89
Rate for Payer: UnitedHealthcare Community & State	$40.21
Rate for Payer: Wellpoint Medicaid Managed Care	$36.14

SCREW AXSOS LKG 5.0X30MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697353
Hospital Revenue Code	278
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$483.59
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89
Rate for Payer: UnitedHealthcare Community & State	$40.21
Rate for Payer: Wellpoint Medicaid Managed Care	$36.14

SCREW AXSOS LKG 5.0X36MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697355
Hospital Revenue Code	278
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$483.59
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89
Rate for Payer: UnitedHealthcare Community & State	$40.21
Rate for Payer: Wellpoint Medicaid Managed Care	$36.14

SCREW AXSOS LKG 5.0X36MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697355
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697356
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697356
Hospital Revenue Code	278
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$483.59
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89
Rate for Payer: UnitedHealthcare Community & State	$40.21
Rate for Payer: Wellpoint Medicaid Managed Care	$36.14

SCREW AXSOS LKG TI ST 5X34MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697354
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG TI ST 5X34MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697354
Hospital Revenue Code	278
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$483.59
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89
Rate for Payer: UnitedHealthcare Community & State	$40.21
Rate for Payer: Wellpoint Medicaid Managed Care	$36.14

SCREW AXSOS LKG TI ST 5X40MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673770
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$374.00
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63
Rate for Payer: UnitedHealthcare Community & State	$31.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

SCREW AXSOS LKG TI ST 5X40MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673770
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

Know your out-of-pocket cost for care.

All Charges