Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC Q/FIX P/THD 3x40MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676999
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 CANC TL 7.3x16mm 95mm

Facility

$1,128.35

Service Code	HCPCS C1713
Hospital Charge Code	270605032
Hospital Revenue Code	278
Min. Negotiated Rate	$32.05
Max. Negotiated Rate	$564.17
Rate for Payer: Aetna Commercial	$428.77
Rate for Payer: Aetna Medicare Advantage	$338.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.73
Rate for Payer: Cigna Commercial	$564.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.06
Rate for Payer: Qualcare PPO/HMO/WC	$169.25
Rate for Payer: UnitedHealthcare Community & State	$35.66
Rate for Payer: Wellpoint Medicaid Managed Care	$32.05

SCREW CANC TL 7.3x16mm 95mm

Facility

$1,128.35

Service Code	HCPCS C1713
Hospital Charge Code	270605032
Hospital Revenue Code	278
Min. Negotiated Rate	$169.25
Max. Negotiated Rate	$273.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.06
Rate for Payer: Qualcare PPO/HMO/WC	$169.25

SCREW CAN FULL THRD HD 3X20MM

Facility

$962.50

Hospital Charge Code	270702430
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW CAN FULL THRD HD 3X20MM

Facility

$962.50

Hospital Charge Code	270702430
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN FULL THRD HD 3X36MM

Facility

$962.00

Hospital Charge Code	270702431
Hospital Revenue Code	278
Min. Negotiated Rate	$144.30
Max. Negotiated Rate	$232.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.80
Rate for Payer: Qualcare PPO/HMO/WC	$144.30

SCREW CAN FULL THRD HD 3X36MM

Facility

$962.00

Hospital Charge Code	270702431
Hospital Revenue Code	278
Min. Negotiated Rate	$27.32
Max. Negotiated Rate	$481.00
Rate for Payer: Aetna Commercial	$365.56
Rate for Payer: Aetna Medicare Advantage	$288.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.31
Rate for Payer: Cigna Commercial	$481.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.80
Rate for Payer: Qualcare PPO/HMO/WC	$144.30
Rate for Payer: UnitedHealthcare Community & State	$30.40
Rate for Payer: Wellpoint Medicaid Managed Care	$27.32

SCREW CAN HD 3X14MM

Facility

$972.50

Service Code	HCPCS C1713
Hospital Charge Code	270701407
Hospital Revenue Code	278
Min. Negotiated Rate	$145.88
Max. Negotiated Rate	$235.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.34
Rate for Payer: Qualcare PPO/HMO/WC	$145.88

SCREW CAN HD 3X14MM

Facility

$972.50

Service Code	HCPCS C1713
Hospital Charge Code	270701407
Hospital Revenue Code	278
Min. Negotiated Rate	$27.62
Max. Negotiated Rate	$486.25
Rate for Payer: Aetna Commercial	$369.55
Rate for Payer: Aetna Medicare Advantage	$291.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.99
Rate for Payer: Cigna Commercial	$486.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.34
Rate for Payer: Qualcare PPO/HMO/WC	$145.88
Rate for Payer: UnitedHealthcare Community & State	$30.73
Rate for Payer: Wellpoint Medicaid Managed Care	$27.62

SCREW CAN HD 3X16MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701337
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3X16MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701337
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW CAN HD 3 X 20MM

Facility

$962.50

Hospital Charge Code	270701956
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3 X 20MM

Facility

$962.50

Hospital Charge Code	270701956
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW CAN HD 3 X 22MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701406
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3 X 22MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701406
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW CAN HD 3 X 26 MM

Facility

$962.50

Hospital Charge Code	270701880
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN HD 3 X 26 MM

Facility

$962.50

Hospital Charge Code	270701880
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW CAN HD 3X34MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701336
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW CAN HD 3X34MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701336
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW CAN MOD CREOAMP 6.5X35MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270697220
Hospital Revenue Code	278
Min. Negotiated Rate	$102.95
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$114.55
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

SCREW CAN MOD CREOAMP 6.5X35MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270697220
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW CANN 20MM THD 6.5x75MM

Facility

$2,120.00

Hospital Charge Code	270674057
Hospital Revenue Code	278
Min. Negotiated Rate	$318.00
Max. Negotiated Rate	$513.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.04
Rate for Payer: Qualcare PPO/HMO/WC	$318.00

SCREW CANN 20MM THD 6.5x75MM

Facility

$2,120.00

Hospital Charge Code	270674057
Hospital Revenue Code	278
Min. Negotiated Rate	$60.21
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$805.60
Rate for Payer: Aetna Medicare Advantage	$636.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$424.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$540.60
Rate for Payer: Cigna Commercial	$1,060.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.04
Rate for Payer: Qualcare PPO/HMO/WC	$318.00
Rate for Payer: UnitedHealthcare Community & State	$66.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.21

SCREW CANN 20MM THD 6.5x80MM

Facility

$2,120.00

Hospital Charge Code	270674056
Hospital Revenue Code	278
Min. Negotiated Rate	$318.00
Max. Negotiated Rate	$513.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$424.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.04
Rate for Payer: Qualcare PPO/HMO/WC	$318.00

SCREW CANN 20MM THD 6.5x80MM

Facility

$2,120.00

Hospital Charge Code	270674056
Hospital Revenue Code	278
Min. Negotiated Rate	$60.21
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$805.60
Rate for Payer: Aetna Medicare Advantage	$636.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$424.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$540.60
Rate for Payer: Cigna Commercial	$1,060.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.04
Rate for Payer: Qualcare PPO/HMO/WC	$318.00
Rate for Payer: UnitedHealthcare Community & State	$66.99
Rate for Payer: Wellpoint Medicaid Managed Care	$60.21

Know your out-of-pocket cost for care.

All Charges