Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN CAN 40 6.5x75mm

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270673602
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

SCREW CANN CAN 40 6.5x80mm

Facility

$1,765.00

Service Code	HCPCS C1713
Hospital Charge Code	270662013
Hospital Revenue Code	278
Min. Negotiated Rate	$264.75
Max. Negotiated Rate	$427.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.13
Rate for Payer: Qualcare PPO/HMO/WC	$264.75

SCREW CANN CAN 40 6.5x80mm

Facility

$1,765.00

Service Code	HCPCS C1713
Hospital Charge Code	270662013
Hospital Revenue Code	278
Min. Negotiated Rate	$50.13
Max. Negotiated Rate	$882.50
Rate for Payer: Aetna Commercial	$670.70
Rate for Payer: Aetna Medicare Advantage	$529.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.07
Rate for Payer: Cigna Commercial	$882.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.13
Rate for Payer: Qualcare PPO/HMO/WC	$264.75
Rate for Payer: UnitedHealthcare Community & State	$55.77
Rate for Payer: Wellpoint Medicaid Managed Care	$50.13

SCREW CANN CANC 4.0 X 42 MM

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270684092
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

SCREW CANN CANC 4.0 X 42 MM

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270684092
Hospital Revenue Code	278
Min. Negotiated Rate	$41.18
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$45.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.18

SCREW CANN COMP 6.5 HDLS 56MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270697159
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

SCREW CANN COMP 6.5 HDLS 56MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270697159
Hospital Revenue Code	278
Min. Negotiated Rate	$136.32
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Community & State	$151.68
Rate for Payer: Wellpoint Medicaid Managed Care	$136.32

SCREW CANN COMP HDLESS ST18MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691912
Hospital Revenue Code	278
Min. Negotiated Rate	$53.90
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$59.98
Rate for Payer: Wellpoint Medicaid Managed Care	$53.90

SCREW CANN COMP HDLESS ST18MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691912
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW CANN COMP HDLS 2.5X10MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700720
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HDLS 2.5X10MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700720
Hospital Revenue Code	278
Min. Negotiated Rate	$152.65
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$169.85
Rate for Payer: Wellpoint Medicaid Managed Care	$152.65

SCREW CANN COMP HDLS 2.5X12MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700719
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HDLS 2.5X12MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700719
Hospital Revenue Code	278
Min. Negotiated Rate	$152.65
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$169.85
Rate for Payer: Wellpoint Medicaid Managed Care	$152.65

SCREW CANN COMP HDLS 4.5X75MM

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270698818
Hospital Revenue Code	278
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$1,177.50
Rate for Payer: Aetna Commercial	$894.90
Rate for Payer: Aetna Medicare Advantage	$706.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$600.52
Rate for Payer: Cigna Commercial	$1,177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.91
Rate for Payer: Qualcare PPO/HMO/WC	$353.25
Rate for Payer: UnitedHealthcare Community & State	$74.42
Rate for Payer: Wellpoint Medicaid Managed Care	$66.88

SCREW CANN COMP HDLS 4.5X75MM

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270698818
Hospital Revenue Code	278
Min. Negotiated Rate	$353.25
Max. Negotiated Rate	$569.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.91
Rate for Payer: Qualcare PPO/HMO/WC	$353.25

SCREW CANN COMP HL 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700248
Hospital Revenue Code	278
Min. Negotiated Rate	$152.65
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$169.85
Rate for Payer: Wellpoint Medicaid Managed Care	$152.65

SCREW CANN COMP HL 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700248
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HL 4.5X65MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700247
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CANN COMP HL 4.5X65MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700247
Hospital Revenue Code	278
Min. Negotiated Rate	$152.65
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$169.85
Rate for Payer: Wellpoint Medicaid Managed Care	$152.65

SCREW CANN COMPR 3x26MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675273
Hospital Revenue Code	278
Min. Negotiated Rate	$59.36
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$794.20
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50
Rate for Payer: UnitedHealthcare Community & State	$66.04
Rate for Payer: Wellpoint Medicaid Managed Care	$59.36

SCREW CANN COMPR 3x26MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675273
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$505.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPR 3x40MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675274
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$505.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPR 3x40MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675274
Hospital Revenue Code	278
Min. Negotiated Rate	$59.36
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$794.20
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50
Rate for Payer: UnitedHealthcare Community & State	$66.04
Rate for Payer: Wellpoint Medicaid Managed Care	$59.36

SCREW CANN COMPRESS 3.5X50MM

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270698547
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$186.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

SCREW CANN COMPRESS 3.5X50MM

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270698547
Hospital Revenue Code	278
Min. Negotiated Rate	$21.87
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$292.60
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Community & State	$24.33
Rate for Payer: Wellpoint Medicaid Managed Care	$21.87

Know your out-of-pocket cost for care.

All Charges