Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CORTICAL 4.5X26MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694690
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X26MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694690
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

SCREW BONE CORTICAL 4.5X28MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694692
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X28MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694692
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

SCREW BONE CORTICAL 5.0MMX38

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270702721
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW BONE CORTICAL 5.0MMX38

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270702721
Hospital Revenue Code	278
Min. Negotiated Rate	$37.49
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$501.60
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00
Rate for Payer: UnitedHealthcare Community & State	$41.71
Rate for Payer: Wellpoint Medicaid Managed Care	$37.49

SCREW BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705671
Hospital Revenue Code	278
Min. Negotiated Rate	$115.63
Max. Negotiated Rate	$186.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: Qualcare PPO/HMO/WC	$115.63

SCREW BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705671
Hospital Revenue Code	278
Min. Negotiated Rate	$21.89
Max. Negotiated Rate	$385.43
Rate for Payer: Aetna Commercial	$292.92
Rate for Payer: Aetna Medicare Advantage	$231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.57
Rate for Payer: Cigna Commercial	$385.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: Qualcare PPO/HMO/WC	$115.63
Rate for Payer: UnitedHealthcare Community & State	$24.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21.89

SCREW BONE INBONE

Facility

$680.00

Service Code	HCPCS C1713
Hospital Charge Code	270670899
Hospital Revenue Code	278
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$258.40
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: Qualcare PPO/HMO/WC	$102.00
Rate for Payer: UnitedHealthcare Community & State	$21.49
Rate for Payer: Wellpoint Medicaid Managed Care	$19.31

SCREW BONE INBONE

Facility

$680.00

Service Code	HCPCS C1713
Hospital Charge Code	270670899
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$164.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

SCREW BONE LOCKING 1.7X 10MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270655375
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X 10MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270655375
Hospital Revenue Code	278
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$22.28
Rate for Payer: Wellpoint Medicaid Managed Care	$20.02

SCREW BONE LOCKING 1.7X7MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656394
Hospital Revenue Code	278
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$22.28
Rate for Payer: Wellpoint Medicaid Managed Care	$20.02

SCREW BONE LOCKING 1.7X7MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656394
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X8MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656396
Hospital Revenue Code	278
Min. Negotiated Rate	$20.02
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$267.90
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75
Rate for Payer: UnitedHealthcare Community & State	$22.28
Rate for Payer: Wellpoint Medicaid Managed Care	$20.02

SCREW BONE LOCKING 1.7X8MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656396
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 2.0x18mm

Facility

$875.00

Hospital Charge Code	270666944
Hospital Revenue Code	278
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

SCREW BONE LOCKING 2.0x18mm

Facility

$875.00

Hospital Charge Code	270666944
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW BONE LOCKING 2.3x10MM

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270657991
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$24.96
Rate for Payer: Wellpoint Medicaid Managed Care	$22.44

SCREW BONE LOCKING 2.3x10MM

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270657991
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW BONE LOCKING 2.3x12MM

Facility

$750.00

Hospital Charge Code	270665822
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SCREW BONE LOCKING 2.3x12MM

Facility

$750.00

Hospital Charge Code	270665822
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW BONE LOCKING 2.3X14MM

Facility

$750.00

Hospital Charge Code	270667936
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW BONE LOCKING 2.3X14MM

Facility

$750.00

Hospital Charge Code	270667936
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SCREW BONE N/LOCKING 2.3x16mm

Facility

$507.00

Hospital Charge Code	270672689
Hospital Revenue Code	278
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$253.50
Rate for Payer: Aetna Commercial	$192.66
Rate for Payer: Aetna Medicare Advantage	$152.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.28
Rate for Payer: Cigna Commercial	$253.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.69
Rate for Payer: Qualcare PPO/HMO/WC	$76.05
Rate for Payer: UnitedHealthcare Community & State	$16.02
Rate for Payer: Wellpoint Medicaid Managed Care	$14.40

Know your out-of-pocket cost for care.

All Charges