Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANCELLOUS 4.0x30MM

Facility

$560.00

Hospital Charge Code	270672115
Hospital Revenue Code	278
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$17.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW CANCELLOUS 4.0x30MM

Facility

$560.00

Hospital Charge Code	270672115
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW CANCELLOUS 4.0 X 34MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270665937
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CANCELLOUS 4.0 X 34MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270665937
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

SCREW CANCELLOUS 4.0 X 34MM

Facility

$195.00

Hospital Charge Code	270665228
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

SCREW CANCELLOUS 4.0 X 34MM

Facility

$195.00

Hospital Charge Code	270665228
Hospital Revenue Code	278
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Community & State	$6.16
Rate for Payer: Wellpoint Medicaid Managed Care	$5.54

SCREW CANCELLOUS 4.0 X 40

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270687702
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW CANCELLOUS 4.0 X 40

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270687702
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW CANCELLOUS 4.0 X 44MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679453
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW CANCELLOUS 4.0 X 44MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679453
Hospital Revenue Code	278
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$17.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW CANCELLOUS 4.0 X 46MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679454
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW CANCELLOUS 4.0 X 46MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270679454
Hospital Revenue Code	278
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$17.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREW CANCELLOUS 4.8X42MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694688
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

SCREW CANCELLOUS 4.8X42MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694688
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW CANCELLOUS 4.8X44MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694689
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW CANCELLOUS 4.8X44MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270694689
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

SCREW CANCELLOUS 4X16MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270705087
Hospital Revenue Code	278
Min. Negotiated Rate	$13.29
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna Commercial	$177.84
Rate for Payer: Aetna Medicare Advantage	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.34
Rate for Payer: Cigna Commercial	$234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Qualcare PPO/HMO/WC	$70.20
Rate for Payer: UnitedHealthcare Community & State	$14.79
Rate for Payer: Wellpoint Medicaid Managed Care	$13.29

SCREW CANCELLOUS 4X16MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270705087
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$113.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANCELLOUS 5.5mm x 45mm

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678709
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

SCREW CANCELLOUS 5.5mm x 45mm

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678709
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCREW CANCELLOUS 5X37.5MM

Facility

$995.00

Hospital Charge Code	270671058
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

SCREW CANCELLOUS 5X37.5MM

Facility

$995.00

Hospital Charge Code	270671058
Hospital Revenue Code	278
Min. Negotiated Rate	$28.26
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$31.44
Rate for Payer: Wellpoint Medicaid Managed Care	$28.26

SCREW CANCELLOUS 5X40MM

Facility

$995.00

Hospital Charge Code	270671059
Hospital Revenue Code	278
Min. Negotiated Rate	$28.26
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$378.10
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25
Rate for Payer: UnitedHealthcare Community & State	$31.44
Rate for Payer: Wellpoint Medicaid Managed Care	$28.26

SCREW CANCELLOUS 5X40MM

Facility

$995.00

Hospital Charge Code	270671059
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

screw cancellous 6.5x30

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684679
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

Know your out-of-pocket cost for care.

All Charges