Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN PART THD 2.4X16MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682092
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

SCREW CANN PART THD 2.4X16MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682092
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 2.4X18MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270671791
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

SCREW CANN PART THD 2.4X18MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270671791
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 4x60MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674954
Hospital Revenue Code	278
Min. Negotiated Rate	$26.45
Max. Negotiated Rate	$465.60
Rate for Payer: Aetna Commercial	$353.86
Rate for Payer: Aetna Medicare Advantage	$279.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.46
Rate for Payer: Cigna Commercial	$465.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.68
Rate for Payer: UnitedHealthcare Community & State	$29.43
Rate for Payer: Wellpoint Medicaid Managed Care	$26.45

SCREW CANN PART THD 4x60MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674954
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$225.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN PART THD 4x65MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674955
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$225.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN PART THD 4x65MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674955
Hospital Revenue Code	278
Min. Negotiated Rate	$26.45
Max. Negotiated Rate	$465.60
Rate for Payer: Aetna Commercial	$353.86
Rate for Payer: Aetna Medicare Advantage	$279.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.46
Rate for Payer: Cigna Commercial	$465.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.68
Rate for Payer: UnitedHealthcare Community & State	$29.43
Rate for Payer: Wellpoint Medicaid Managed Care	$26.45

SCREW CANN PART THRD 3.0X36MM

Facility

$942.50

Service Code	HCPCS C1713
Hospital Charge Code	270694750
Hospital Revenue Code	278
Min. Negotiated Rate	$141.38
Max. Negotiated Rate	$228.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.09
Rate for Payer: Qualcare PPO/HMO/WC	$141.38

SCREW CANN PART THRD 3.0X36MM

Facility

$942.50

Service Code	HCPCS C1713
Hospital Charge Code	270694750
Hospital Revenue Code	278
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$471.25
Rate for Payer: Aetna Commercial	$358.15
Rate for Payer: Aetna Medicare Advantage	$282.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.34
Rate for Payer: Cigna Commercial	$471.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.09
Rate for Payer: Qualcare PPO/HMO/WC	$141.38
Rate for Payer: UnitedHealthcare Community & State	$29.78
Rate for Payer: Wellpoint Medicaid Managed Care	$26.77

SCREW CANN. PART THRD 3.5X18MM

Facility

$780.00

Hospital Charge Code	270667997
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW CANN. PART THRD 3.5X18MM

Facility

$780.00

Hospital Charge Code	270667997
Hospital Revenue Code	278
Min. Negotiated Rate	$22.15
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Community & State	$24.65
Rate for Payer: Wellpoint Medicaid Managed Care	$22.15

SCREW CANN PART/THREAD 4.5/64

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604898
Hospital Revenue Code	278
Min. Negotiated Rate	$25.04
Max. Negotiated Rate	$440.82
Rate for Payer: Aetna Commercial	$335.03
Rate for Payer: Aetna Medicare Advantage	$264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.82
Rate for Payer: Cigna Commercial	$440.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25
Rate for Payer: UnitedHealthcare Community & State	$27.86
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

SCREW CANN PART/THREAD 4.5/64

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604898
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$213.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN POLYAXIAL 2.5X30

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664430
Hospital Revenue Code	278
Min. Negotiated Rate	$21.16
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$283.10
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Community & State	$23.54
Rate for Payer: Wellpoint Medicaid Managed Care	$21.16

SCREW CANN POLYAXIAL 2.5X30

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664430
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

SCREW CANN PT 4.3X16MM

Facility

$3,125.00

Hospital Charge Code	270702505
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

SCREW CANN PT 4.3X16MM

Facility

$3,125.00

Hospital Charge Code	270702505
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW CANN P/THD 4.5X48MM

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604892
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$213.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN P/THD 4.5X48MM

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604892
Hospital Revenue Code	278
Min. Negotiated Rate	$25.04
Max. Negotiated Rate	$440.82
Rate for Payer: Aetna Commercial	$335.03
Rate for Payer: Aetna Medicare Advantage	$264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.82
Rate for Payer: Cigna Commercial	$440.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25
Rate for Payer: UnitedHealthcare Community & State	$27.86
Rate for Payer: Wellpoint Medicaid Managed Care	$25.04

SCREW CANN P/THD 4x32MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270673666
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW CANN P/THD 4x32MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270673666
Hospital Revenue Code	278
Min. Negotiated Rate	$38.62
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$516.80
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00
Rate for Payer: UnitedHealthcare Community & State	$42.98
Rate for Payer: Wellpoint Medicaid Managed Care	$38.62

SCREW CANN P/THRD 3.5x30MM

Facility

$827.50

Service Code	HCPCS C1713
Hospital Charge Code	270622122
Hospital Revenue Code	278
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$413.75
Rate for Payer: Aetna Commercial	$314.45
Rate for Payer: Aetna Medicare Advantage	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.01
Rate for Payer: Cigna Commercial	$413.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$124.12
Rate for Payer: UnitedHealthcare Community & State	$26.15
Rate for Payer: Wellpoint Medicaid Managed Care	$23.50

SCREW CANN P/THRD 3.5x30MM

Facility

$827.50

Service Code	HCPCS C1713
Hospital Charge Code	270622122
Hospital Revenue Code	278
Min. Negotiated Rate	$124.12
Max. Negotiated Rate	$200.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$124.12

SCREW CANN P/THRD 3.5x32MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270608217
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$194.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

Know your out-of-pocket cost for care.

All Charges