Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANN P/THD 4x16MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604266
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 4x18MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604267
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 P/THD 4x18MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604267
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 P/THD 4x20MM

Facility

$72.40

Service Code	HCPCS C1713
Hospital Charge Code	270604268
Hospital Revenue Code	278
Min. Negotiated Rate	$10.86
Max. Negotiated Rate	$17.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.52
Rate for Payer: Qualcare PPO/HMO/WC	$10.86

SCREW BONE CANN P/THD 4x20MM

Facility

$72.40

Service Code	HCPCS C1713
Hospital Charge Code	270604268
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.20
Rate for Payer: Aetna Commercial	$27.51
Rate for Payer: Aetna Medicare Advantage	$21.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.46
Rate for Payer: Cigna Commercial	$36.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.52
Rate for Payer: Qualcare PPO/HMO/WC	$10.86
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

SCREW BONE CANN P/THD 4x22MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604269
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 4x22MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604269
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 4x24MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604270
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 4x24MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604270
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 4x28MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604272
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 4x28MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604272
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 4x30MM

Facility

$68.25

Service Code	HCPCS C1713
Hospital Charge Code	270604273
Hospital Revenue Code	278
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$10.24

SCREW BONE CANN P/THD 4x30MM

Facility

$68.25

Service Code	HCPCS C1713
Hospital Charge Code	270604273
Hospital Revenue Code	278
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$34.12
Rate for Payer: Aetna Commercial	$25.93
Rate for Payer: Aetna Medicare Advantage	$20.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.40
Rate for Payer: Cigna Commercial	$34.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$10.24
Rate for Payer: UnitedHealthcare Community & State	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$1.94

SCREW BONE CANN P/THD 4x35MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604274
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 4x35MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604274
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 4x40MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604275
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 4x40MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604275
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 4x45MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604276
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 4x45MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604276
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 4x50MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604277
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 4x50MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604277
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 4x55MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604278
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 4x55MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604278
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 4x60MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604279
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 4x60MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604279
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