Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BMT CORT 4.5 40MM 235140

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612182
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

SCREW BMT CORT 4.5 46MM 235146

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612877
Hospital Revenue Code	278
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

SCREW BMT CORT 4.5 46MM 235146

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	270612877
Hospital Revenue Code	278
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$37.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.51
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

SCREW BMT TRNV 6.5 15 103530

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615803
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW BMT TRNV 6.5 15 103530

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615803
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

SCREW BMT TRNV 6.5 25 103532

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615802
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW BMT TRNV 6.5 25 103532

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270615802
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

SCREW BOLT 2 PIECE SCHANZ

Facility

$1,144.90

Hospital Charge Code	270691905
Hospital Revenue Code	272
Min. Negotiated Rate	$32.52
Max. Negotiated Rate	$572.45
Rate for Payer: Aetna Commercial	$435.06
Rate for Payer: Aetna Medicare Advantage	$343.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.95
Rate for Payer: Cigna Commercial	$572.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$297.67
Rate for Payer: Oxford Commercial	$228.98
Rate for Payer: Qualcare PPO/HMO/WC	$171.74
Rate for Payer: UnitedHealthcare Commercial	$228.98
Rate for Payer: UnitedHealthcare Community & State	$36.18
Rate for Payer: Wellpoint Medicaid Managed Care	$32.52

SCREW BOLT 2 PIECE SCHANZ

Facility

$1,144.90

Hospital Charge Code	270691905
Hospital Revenue Code	272
Min. Negotiated Rate	$171.74
Max. Negotiated Rate	$171.74
Rate for Payer: Qualcare PPO/HMO/WC	$171.74

SCREW BOLT CANN POSTMNT SCHANZ

Facility

$1,265.90

Hospital Charge Code	270691906
Hospital Revenue Code	272
Min. Negotiated Rate	$35.95
Max. Negotiated Rate	$632.95
Rate for Payer: Aetna Commercial	$481.04
Rate for Payer: Aetna Medicare Advantage	$379.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.80
Rate for Payer: Cigna Commercial	$632.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.13
Rate for Payer: Oxford Commercial	$253.18
Rate for Payer: Qualcare PPO/HMO/WC	$189.88
Rate for Payer: UnitedHealthcare Commercial	$253.18
Rate for Payer: UnitedHealthcare Community & State	$40.00
Rate for Payer: Wellpoint Medicaid Managed Care	$35.95

SCREW BOLT CANN POSTMNT SCHANZ

Facility

$1,265.90

Hospital Charge Code	270691906
Hospital Revenue Code	272
Min. Negotiated Rate	$189.88
Max. Negotiated Rate	$189.88
Rate for Payer: Qualcare PPO/HMO/WC	$189.88

SCREW BOLT POST MOUNT SCHANZ

Facility

$1,232.00

Hospital Charge Code	270691904
Hospital Revenue Code	272
Min. Negotiated Rate	$34.99
Max. Negotiated Rate	$616.00
Rate for Payer: Aetna Commercial	$468.16
Rate for Payer: Aetna Medicare Advantage	$369.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.16
Rate for Payer: Cigna Commercial	$616.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.32
Rate for Payer: Oxford Commercial	$246.40
Rate for Payer: Qualcare PPO/HMO/WC	$184.80
Rate for Payer: UnitedHealthcare Commercial	$246.40
Rate for Payer: UnitedHealthcare Community & State	$38.93
Rate for Payer: Wellpoint Medicaid Managed Care	$34.99

SCREW BOLT POST MOUNT SCHANZ

Facility

$1,232.00

Hospital Charge Code	270691904
Hospital Revenue Code	272
Min. Negotiated Rate	$184.80
Max. Negotiated Rate	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$184.80

SCREW BONE 16.0MM ACUTRAK

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270682431
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$652.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

SCREW BONE 16.0MM ACUTRAK

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270682431
Hospital Revenue Code	278
Min. Negotiated Rate	$76.54
Max. Negotiated Rate	$1,347.50
Rate for Payer: Aetna Commercial	$1,024.10
Rate for Payer: Aetna Medicare Advantage	$808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$687.23
Rate for Payer: Cigna Commercial	$1,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25
Rate for Payer: UnitedHealthcare Community & State	$85.16
Rate for Payer: Wellpoint Medicaid Managed Care	$76.54

SCREW BONE 2.3MM X 14MM

Facility

$675.00

Hospital Charge Code	270667224
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW BONE 2.3MM X 14MM

Facility

$675.00

Hospital Charge Code	270667224
Hospital Revenue Code	278
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

SCREW BONE 2.3x13MM

Facility

$555.00

Service Code	HCPCS C1713
Hospital Charge Code	270657987
Hospital Revenue Code	278
Min. Negotiated Rate	$15.76
Max. Negotiated Rate	$277.50
Rate for Payer: Aetna Commercial	$210.90
Rate for Payer: Aetna Medicare Advantage	$166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.53
Rate for Payer: Cigna Commercial	$277.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.31
Rate for Payer: Qualcare PPO/HMO/WC	$83.25
Rate for Payer: UnitedHealthcare Community & State	$17.54
Rate for Payer: Wellpoint Medicaid Managed Care	$15.76

SCREW BONE 2.3x13MM

Facility

$555.00

Service Code	HCPCS C1713
Hospital Charge Code	270657987
Hospital Revenue Code	278
Min. Negotiated Rate	$83.25
Max. Negotiated Rate	$134.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.31
Rate for Payer: Qualcare PPO/HMO/WC	$83.25

SCREW BONE 2.3X15MM

Facility

$685.00

Hospital Charge Code	270669550
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE 2.3X15MM

Facility

$685.00

Hospital Charge Code	270669550
Hospital Revenue Code	278
Min. Negotiated Rate	$19.45
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$260.30
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75
Rate for Payer: UnitedHealthcare Community & State	$21.65
Rate for Payer: Wellpoint Medicaid Managed Care	$19.45

SCREW BONE 2.7 20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270665824
Hospital Revenue Code	278
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

SCREW BONE 2.7 20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270665824
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW BONE 2.7X10MM

Facility

$412.50

Hospital Charge Code	270648953
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$99.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.83
Rate for Payer: Qualcare PPO/HMO/WC	$61.88

SCREW BONE 2.7X10MM

Facility

$412.50

Hospital Charge Code	270648953
Hospital Revenue Code	278
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$206.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.19
Rate for Payer: Cigna Commercial	$206.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.83
Rate for Payer: Qualcare PPO/HMO/WC	$61.88
Rate for Payer: UnitedHealthcare Community & State	$13.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.71

Know your out-of-pocket cost for care.

All Charges