Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

screw cancellous 6.5x30

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684679
Hospital Revenue Code	278
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$71.60
Rate for Payer: Aetna Commercial	$54.42
Rate for Payer: Aetna Medicare Advantage	$42.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.52
Rate for Payer: Cigna Commercial	$71.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48
Rate for Payer: UnitedHealthcare Community & State	$4.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SCREW CANCELLOUS 6.5 X 35MM

Facility

$320.00

Hospital Charge Code	270668343
Hospital Revenue Code	278
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$121.60
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Community & State	$10.11
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

SCREW CANCELLOUS 6.5 X 35MM

Facility

$320.00

Hospital Charge Code	270668343
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

screw cancellous 6.5x80

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270384680
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

screw cancellous 6.5x80

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270384680
Hospital Revenue Code	278
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$71.60
Rate for Payer: Aetna Commercial	$54.42
Rate for Payer: Aetna Medicare Advantage	$42.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.52
Rate for Payer: Cigna Commercial	$71.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48
Rate for Payer: UnitedHealthcare Community & State	$4.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

SCREW CANCELLOUS 70-100MM ALTA

Facility

$1,872.00

Hospital Charge Code	270335179
Hospital Revenue Code	278
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$453.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.02
Rate for Payer: Qualcare PPO/HMO/WC	$280.80

SCREW CANCELLOUS 70-100MM ALTA

Facility

$1,872.00

Hospital Charge Code	270335179
Hospital Revenue Code	278
Min. Negotiated Rate	$53.16
Max. Negotiated Rate	$936.00
Rate for Payer: Aetna Commercial	$711.36
Rate for Payer: Aetna Medicare Advantage	$561.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$477.36
Rate for Payer: Cigna Commercial	$936.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.02
Rate for Payer: Qualcare PPO/HMO/WC	$280.80
Rate for Payer: UnitedHealthcare Community & State	$59.16
Rate for Payer: Wellpoint Medicaid Managed Care	$53.16

SCREW CANCELLOUS BONE 6.5 MM 2

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688632
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW CANCELLOUS BONE 6.5 MM 2

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688632
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW CANCELLOUS BONE 6.5 MMX

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688142
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW CANCELLOUS BONE 6.5 MMX

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688142
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW CANCELLOUS BONE 6.5X20MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270680638
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

SCREW CANCELLOUS BONE 6.5X20MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270680638
Hospital Revenue Code	278
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$256.88
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.40
Rate for Payer: UnitedHealthcare Community & State	$21.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.20

SCREW CANCELLOUS BONE 6.5X35MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671316
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$177.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW CANCELLOUS BONE 6.5X35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697694
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CANCELLOUS BONE 6.5X35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697694
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SCREW CANCELLOUS BONE 6.5X35MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671316
Hospital Revenue Code	278
Min. Negotiated Rate	$20.83
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$278.73
Rate for Payer: Aetna Medicare Advantage	$220.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.04
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03
Rate for Payer: UnitedHealthcare Community & State	$23.18
Rate for Payer: Wellpoint Medicaid Managed Care	$20.83

SCREW CANCELLOUS F/THD 4x45MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270601874
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 CANCELLOUS F/THD 4x45MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270601874
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 CANCELLOUS LO PRO 3x10MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270660207
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 LO PRO 3x10MM

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270660207
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 LO PRO 3x12MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270656445
Hospital Revenue Code	278
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

SCREW CANCELLOUS LO PRO 3x12MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270656445
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW CANCELLOUS LO PRO 3X14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270662178
Hospital Revenue Code	278
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

SCREW CANCELLOUS LO PRO 3X14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270662178
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

Know your out-of-pocket cost for care.

All Charges