Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW AXSOS LKG TI ST 5X60MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673769
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

SCREW AXSOS LKG TI ST 5X60MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673769
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 5X65MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673766
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 5X65MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673766
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

SCREW AXSOS LOCKING 4X16MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699638
Hospital Revenue Code	278
Min. Negotiated Rate	$34.28
Max. Negotiated Rate	$603.48
Rate for Payer: Aetna Commercial	$458.64
Rate for Payer: Aetna Medicare Advantage	$362.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.77
Rate for Payer: Cigna Commercial	$603.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04
Rate for Payer: UnitedHealthcare Community & State	$38.14
Rate for Payer: Wellpoint Medicaid Managed Care	$34.28

SCREW AXSOS LOCKING 4X16MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699638
Hospital Revenue Code	278
Min. Negotiated Rate	$181.04
Max. Negotiated Rate	$292.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04

SCREW AXSOS LOCKING 4X20MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699639
Hospital Revenue Code	278
Min. Negotiated Rate	$34.28
Max. Negotiated Rate	$603.48
Rate for Payer: Aetna Commercial	$458.64
Rate for Payer: Aetna Medicare Advantage	$362.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.77
Rate for Payer: Cigna Commercial	$603.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04
Rate for Payer: UnitedHealthcare Community & State	$38.14
Rate for Payer: Wellpoint Medicaid Managed Care	$34.28

SCREW AXSOS LOCKING 4X20MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699639
Hospital Revenue Code	278
Min. Negotiated Rate	$181.04
Max. Negotiated Rate	$292.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04

SCREW AXSOS LOCKING 4X30MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696727
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X30MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696727
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SCREW AXSOS LOCKING 4X32MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696728
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SCREW AXSOS LOCKING 4X32MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696728
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X75MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696746
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X75MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696746
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SCREW AXSOS LOCKING 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697988
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 LOCKING 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697988
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 LOCKING 5.0X85MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697987
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 LOCKING 5.0X85MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697987
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 LOCKING 5.0X90MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697986
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 LOCKING 5.0X90MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697986
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 BENT DYNANITE BENT 12MM

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691639
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.25
Max. Negotiated Rate	$2,292.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25

SCREW BENT DYNANITE BENT 12MM

Facility

$9,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691639
Hospital Revenue Code	278
Min. Negotiated Rate	$269.09
Max. Negotiated Rate	$4,737.50
Rate for Payer: Aetna Commercial	$3,600.50
Rate for Payer: Aetna Medicare Advantage	$2,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.12
Rate for Payer: Cigna Commercial	$4,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,292.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.25
Rate for Payer: UnitedHealthcare Community & State	$299.41
Rate for Payer: Wellpoint Medicaid Managed Care	$269.09

SCREW BG LOCKING 2 X 10MM

Facility

$893.75

Service Code	HCPCS C1713
Hospital Charge Code	270701755
Hospital Revenue Code	278
Min. Negotiated Rate	$134.06
Max. Negotiated Rate	$216.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.29
Rate for Payer: Qualcare PPO/HMO/WC	$134.06

SCREW BG LOCKING 2 X 10MM

Facility

$893.75

Service Code	HCPCS C1713
Hospital Charge Code	270701755
Hospital Revenue Code	278
Min. Negotiated Rate	$25.38
Max. Negotiated Rate	$446.88
Rate for Payer: Aetna Commercial	$339.62
Rate for Payer: Aetna Medicare Advantage	$268.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.91
Rate for Payer: Cigna Commercial	$446.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.29
Rate for Payer: Qualcare PPO/HMO/WC	$134.06
Rate for Payer: UnitedHealthcare Community & State	$28.24
Rate for Payer: Wellpoint Medicaid Managed Care	$25.38

SCREW BG LOCKING 2 X 8MM

Facility

$893.75

Hospital Charge Code	270701754
Hospital Revenue Code	278
Min. Negotiated Rate	$134.06
Max. Negotiated Rate	$216.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.29
Rate for Payer: Qualcare PPO/HMO/WC	$134.06

Know your out-of-pocket cost for care.

All Charges