Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANC 6.5x25MM

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270676581
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

SCREW BONE CANCELLOUS 6.5x15MM

Facility

$500.00

Hospital Charge Code	270672543
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW BONE CANCELLOUS 6.5x15MM

Facility

$500.00

Hospital Charge Code	270672543
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x16MM

Facility

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	270676686
Hospital Revenue Code	278
Min. Negotiated Rate	$64.80
Max. Negotiated Rate	$104.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$64.80

SCREW BONE CANCELLOUS 6.5x16MM

Facility

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	270676686
Hospital Revenue Code	278
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$216.00
Rate for Payer: Aetna Commercial	$164.16
Rate for Payer: Aetna Medicare Advantage	$129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.16
Rate for Payer: Cigna Commercial	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$64.80
Rate for Payer: UnitedHealthcare Community & State	$13.65
Rate for Payer: Wellpoint Medicaid Managed Care	$12.27

SCREW BONE CANCELLOUS 6.5x25MM

Facility

$500.00

Hospital Charge Code	270672544
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x25MM

Facility

$500.00

Hospital Charge Code	270672544
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW BONE CANCELLOUS 6.5x35MM

Facility

$500.00

Hospital Charge Code	270672545
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW BONE CANCELLOUS 6.5x35MM

Facility

$500.00

Hospital Charge Code	270672545
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671853
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$177.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270672546
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270672546
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671853
Hospital Revenue Code	278
Min. Negotiated Rate	$20.83
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$278.73
Rate for Payer: Aetna Medicare Advantage	$220.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.04
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03
Rate for Payer: UnitedHealthcare Community & State	$23.18
Rate for Payer: Wellpoint Medicaid Managed Care	$20.83

SCREW BONE CANN F/THD 4x10MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604232
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x10MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604232
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$28.18
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

SCREW BONE CANN F/THD 4x12MM

Facility

$72.00

Service Code	HCPCS C1713
Hospital Charge Code	270604233
Hospital Revenue Code	278
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

SCREW BONE CANN F/THD 4x12MM

Facility

$72.00

Service Code	HCPCS C1713
Hospital Charge Code	270604233
Hospital Revenue Code	278
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$27.36
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Community & State	$2.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

SCREW BONE CANN F/THD 4x14MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604234
Hospital Revenue Code	278
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$38.17
Rate for Payer: Aetna Commercial	$29.01
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.47
Rate for Payer: Cigna Commercial	$38.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

SCREW BONE CANN F/THD 4x14MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604234
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x16MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604235
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x16MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604235
Hospital Revenue Code	278
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$38.17
Rate for Payer: Aetna Commercial	$29.01
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.47
Rate for Payer: Cigna Commercial	$38.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

SCREW BONE CANN F/THD 4x20MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604237
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x20MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604237
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$28.18
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

SCREW BONE CANN F/THD 4x22MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604238
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x22MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604238
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$28.18
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

Know your out-of-pocket cost for care.

All Charges