Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANN F/THD 4x24MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604239
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 4x24MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604239
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 4x26MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604240
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 4x26MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604240
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 4x28MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604241
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 4x28MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604241
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 4x30MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604242
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 4x30MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604242
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 4x35MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603210
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 4x35MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603210
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 4x40MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604246
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 4x40MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604246
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 4x45MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604247
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 4x45MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604247
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 4x50MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604248
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 4x50MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604248
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 4x55MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604249
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 4x55MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604249
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 4x60MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603220
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 4x60MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603220
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 P/THD 4x10MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604263
Hospital Revenue Code	278
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

SCREW BONE CANN P/THD 4x10MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604263
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x12MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604264
Hospital Revenue Code	278
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$26.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

SCREW BONE CANN P/THD 4x12MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604264
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x16MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604266
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

Know your out-of-pocket cost for care.

All Charges