Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE T10 FT 3.5X42MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692176
Hospital Revenue Code	278
Min. Negotiated Rate	$20.21
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$270.39
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73
Rate for Payer: UnitedHealthcare Community & State	$22.48
Rate for Payer: Wellpoint Medicaid Managed Care	$20.21

SCREW BONE T8 2.7X14MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270699915
Hospital Revenue Code	278
Min. Negotiated Rate	$29.96
Max. Negotiated Rate	$527.50
Rate for Payer: Aetna Commercial	$400.90
Rate for Payer: Aetna Medicare Advantage	$316.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.02
Rate for Payer: Cigna Commercial	$527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$158.25
Rate for Payer: UnitedHealthcare Community & State	$33.34
Rate for Payer: Wellpoint Medicaid Managed Care	$29.96

SCREW BONE T8 2.7X14MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270699915
Hospital Revenue Code	278
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$255.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$158.25

SCREW BONE T8 FUL THD 2.7 28MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270703685
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 T8 FUL THD 2.7 28MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270703685
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 THD 3.5MM X L26MM

Facility

$752.45

Service Code	HCPCS C1713
Hospital Charge Code	270700877
Hospital Revenue Code	278
Min. Negotiated Rate	$112.87
Max. Negotiated Rate	$182.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.09
Rate for Payer: Qualcare PPO/HMO/WC	$112.87

SCREW BONE THD 3.5MM X L26MM

Facility

$752.45

Service Code	HCPCS C1713
Hospital Charge Code	270700877
Hospital Revenue Code	278
Min. Negotiated Rate	$21.37
Max. Negotiated Rate	$376.23
Rate for Payer: Aetna Commercial	$285.93
Rate for Payer: Aetna Medicare Advantage	$225.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.87
Rate for Payer: Cigna Commercial	$376.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.09
Rate for Payer: Qualcare PPO/HMO/WC	$112.87
Rate for Payer: UnitedHealthcare Community & State	$23.78
Rate for Payer: Wellpoint Medicaid Managed Care	$21.37

SCREW BONE TI 1.7x12mm

Facility

$685.00

Hospital Charge Code	270669955
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 TI 1.7x12mm

Facility

$685.00

Hospital Charge Code	270669955
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 TI 2.3x16mm

Facility

$685.00

Hospital Charge Code	270669954
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 TI 2.3x16mm

Facility

$685.00

Hospital Charge Code	270669954
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 VARIAX 3.5X24MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694743
Hospital Revenue Code	278
Min. Negotiated Rate	$29.11
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$389.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75
Rate for Payer: UnitedHealthcare Community & State	$32.39
Rate for Payer: Wellpoint Medicaid Managed Care	$29.11

SCREW BONE VARIAX 3.5X24MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270694743
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW BONW FULL THD 2.4 X L22M

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705690
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 BONW FULL THD 2.4 X L22M

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705690
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 BREAK OFF 1/2 2X 12 MM

Facility

$1,069.75

Service Code	HCPCS C1713
Hospital Charge Code	270701230
Hospital Revenue Code	278
Min. Negotiated Rate	$160.46
Max. Negotiated Rate	$258.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.88
Rate for Payer: Qualcare PPO/HMO/WC	$160.46

SCREW BREAK OFF 1/2 2X 12 MM

Facility

$1,069.75

Service Code	HCPCS C1713
Hospital Charge Code	270701230
Hospital Revenue Code	278
Min. Negotiated Rate	$30.38
Max. Negotiated Rate	$534.88
Rate for Payer: Aetna Commercial	$406.50
Rate for Payer: Aetna Medicare Advantage	$320.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.79
Rate for Payer: Cigna Commercial	$534.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.88
Rate for Payer: Qualcare PPO/HMO/WC	$160.46
Rate for Payer: UnitedHealthcare Community & State	$33.80
Rate for Payer: Wellpoint Medicaid Managed Care	$30.38

SCREW BREAK OFF 1/2 THRD 2X13M

Facility

$991.95

Hospital Charge Code	270701186
Hospital Revenue Code	278
Min. Negotiated Rate	$148.79
Max. Negotiated Rate	$240.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.05
Rate for Payer: Qualcare PPO/HMO/WC	$148.79

SCREW BREAK OFF 1/2 THRD 2X13M

Facility

$991.95

Hospital Charge Code	270701186
Hospital Revenue Code	278
Min. Negotiated Rate	$28.17
Max. Negotiated Rate	$495.98
Rate for Payer: Aetna Commercial	$376.94
Rate for Payer: Aetna Medicare Advantage	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.95
Rate for Payer: Cigna Commercial	$495.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.05
Rate for Payer: Qualcare PPO/HMO/WC	$148.79
Rate for Payer: UnitedHealthcare Community & State	$31.35
Rate for Payer: Wellpoint Medicaid Managed Care	$28.17

SCREW BUTTRESS 30MM

Facility

$4,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270671021
Hospital Revenue Code	278
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$2,015.00
Rate for Payer: Aetna Commercial	$1,531.40
Rate for Payer: Aetna Medicare Advantage	$1,209.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,027.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,027.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,027.65
Rate for Payer: Cigna Commercial	$2,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.26
Rate for Payer: Qualcare PPO/HMO/WC	$604.50
Rate for Payer: UnitedHealthcare Community & State	$127.35
Rate for Payer: Wellpoint Medicaid Managed Care	$114.45

SCREW BUTTRESS 30MM

Facility

$4,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270671021
Hospital Revenue Code	278
Min. Negotiated Rate	$604.50
Max. Negotiated Rate	$975.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$806.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.26
Rate for Payer: Qualcare PPO/HMO/WC	$604.50

SCREW CAN 2.4 18 LONG 3 211818

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270634247
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW CAN 2.4 18 LONG 3 211818

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270634247
Hospital Revenue Code	278
Min. Negotiated Rate	$21.41
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$23.83
Rate for Payer: Wellpoint Medicaid Managed Care	$21.41

SCREW CAN 2.4 20 LONG 3 211820

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270634248
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW CAN 2.4 20 LONG 3 211820

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270634248
Hospital Revenue Code	278
Min. Negotiated Rate	$21.41
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$286.52
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10
Rate for Payer: UnitedHealthcare Community & State	$23.83
Rate for Payer: Wellpoint Medicaid Managed Care	$21.41

Know your out-of-pocket cost for care.

All Charges