Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN L/THRD 3.0x36MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677402
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$198.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN L/THRD 3.0x40MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677401
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$198.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN L/THRD 3.0x40MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270677401
Hospital Revenue Code	278
Min. Negotiated Rate	$23.26
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Commercial	$311.22
Rate for Payer: Aetna Medicare Advantage	$245.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.84
Rate for Payer: Cigna Commercial	$409.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85
Rate for Payer: UnitedHealthcare Community & State	$25.88
Rate for Payer: Wellpoint Medicaid Managed Care	$23.26

SCREW CANN MEAS DEVICE 3.5/4MM

Facility

$630.00

Hospital Charge Code	270676249
Hospital Revenue Code	272
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$239.40
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.80
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$126.00
Rate for Payer: UnitedHealthcare Community & State	$19.91
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

SCREW CANN MEAS DEVICE 3.5/4MM

Facility

$630.00

Hospital Charge Code	270676249
Hospital Revenue Code	272
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

SCREW CANN MICRO 12/4MM

Facility

$1,074.75

Hospital Charge Code	270677865
Hospital Revenue Code	278
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$33.96
Rate for Payer: Wellpoint Medicaid Managed Care	$30.52

SCREW CANN MICRO 12/4MM

Facility

$1,074.75

Hospital Charge Code	270677865
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANN MICRO 13/6MM

Facility

$1,074.75

Hospital Charge Code	270677866
Hospital Revenue Code	278
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$33.96
Rate for Payer: Wellpoint Medicaid Managed Care	$30.52

SCREW CANN MICRO 13/6MM

Facility

$1,074.75

Hospital Charge Code	270677866
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANN MICRO 15/4MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270677864
Hospital Revenue Code	278
Min. Negotiated Rate	$30.52
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$408.40
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21
Rate for Payer: UnitedHealthcare Community & State	$33.96
Rate for Payer: Wellpoint Medicaid Managed Care	$30.52

SCREW CANN MICRO 15/4MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270677864
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANN MICRO 16/4MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270692083
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

SCREW CANN MICRO 16/4MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270692083
Hospital Revenue Code	278
Min. Negotiated Rate	$40.38
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$540.28
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: Qualcare PPO/HMO/WC	$213.27
Rate for Payer: UnitedHealthcare Community & State	$44.93
Rate for Payer: Wellpoint Medicaid Managed Care	$40.38

SCREW CANN MICRO 3.0 34X7MM

Facility

$2,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270698603
Hospital Revenue Code	278
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$1,275.00
Rate for Payer: Aetna Commercial	$969.00
Rate for Payer: Aetna Medicare Advantage	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.25
Rate for Payer: Cigna Commercial	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.10
Rate for Payer: Qualcare PPO/HMO/WC	$382.50
Rate for Payer: UnitedHealthcare Community & State	$80.58
Rate for Payer: Wellpoint Medicaid Managed Care	$72.42

SCREW CANN MICRO 3.0 34X7MM

Facility

$2,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270698603
Hospital Revenue Code	278
Min. Negotiated Rate	$382.50
Max. Negotiated Rate	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.10
Rate for Payer: Qualcare PPO/HMO/WC	$382.50

SCREW CANN MOD SHANK 6.5X40MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698063
Hospital Revenue Code	278
Min. Negotiated Rate	$609.38
Max. Negotiated Rate	$983.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: Qualcare PPO/HMO/WC	$609.38

SCREW CANN MOD SHANK 6.5X40MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698063
Hospital Revenue Code	278
Min. Negotiated Rate	$115.38
Max. Negotiated Rate	$2,031.25
Rate for Payer: Aetna Commercial	$1,543.75
Rate for Payer: Aetna Medicare Advantage	$1,218.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.94
Rate for Payer: Cigna Commercial	$2,031.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: Qualcare PPO/HMO/WC	$609.38
Rate for Payer: UnitedHealthcare Community & State	$128.38
Rate for Payer: Wellpoint Medicaid Managed Care	$115.38

SCREW CANN MOD SHANK 6.5X45MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698062
Hospital Revenue Code	278
Min. Negotiated Rate	$609.38
Max. Negotiated Rate	$983.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: Qualcare PPO/HMO/WC	$609.38

SCREW CANN MOD SHANK 6.5X45MM

Facility

$4,062.50

Service Code	HCPCS C1713
Hospital Charge Code	270698062
Hospital Revenue Code	278
Min. Negotiated Rate	$115.38
Max. Negotiated Rate	$2,031.25
Rate for Payer: Aetna Commercial	$1,543.75
Rate for Payer: Aetna Medicare Advantage	$1,218.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.94
Rate for Payer: Cigna Commercial	$2,031.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.12
Rate for Payer: Qualcare PPO/HMO/WC	$609.38
Rate for Payer: UnitedHealthcare Community & State	$128.38
Rate for Payer: Wellpoint Medicaid Managed Care	$115.38

SCREW CANN N-FORCE 4.0 2.7MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270687091
Hospital Revenue Code	278
Min. Negotiated Rate	$17.96
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$240.35
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88
Rate for Payer: UnitedHealthcare Community & State	$19.99
Rate for Payer: Wellpoint Medicaid Managed Care	$17.96

SCREW CANN N-FORCE 4.0 2.7MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270687091
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW CANN N-FORCE 7.3

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270687095
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 CANN N-FORCE 7.3

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270687095
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 CANN PART THD 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682091
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682091
Hospital Revenue Code	278
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

Know your out-of-pocket cost for care.

All Charges