Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN TI ST 4.0X42MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697385
Hospital Revenue Code	278
Min. Negotiated Rate	$36.82
Max. Negotiated Rate	$648.25
Rate for Payer: Aetna Commercial	$492.67
Rate for Payer: Aetna Medicare Advantage	$388.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.61
Rate for Payer: Cigna Commercial	$648.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: Qualcare PPO/HMO/WC	$194.47
Rate for Payer: UnitedHealthcare Community & State	$40.97
Rate for Payer: Wellpoint Medicaid Managed Care	$36.82

SCREW CANN TI ST 4.0X42MM

Facility

$1,296.50

Service Code	HCPCS C1713
Hospital Charge Code	270697385
Hospital Revenue Code	278
Min. Negotiated Rate	$194.47
Max. Negotiated Rate	$313.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.75
Rate for Payer: Qualcare PPO/HMO/WC	$194.47

SCREW CANN TI ST 5.5X75MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697381
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$437.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW CANN TI ST 5.5X75MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697381
Hospital Revenue Code	278
Min. Negotiated Rate	$51.39
Max. Negotiated Rate	$904.75
Rate for Payer: Aetna Commercial	$687.61
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43
Rate for Payer: UnitedHealthcare Community & State	$57.18
Rate for Payer: Wellpoint Medicaid Managed Care	$51.39

SCREW CANN TI ST 7.5X65MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700705
Hospital Revenue Code	278
Min. Negotiated Rate	$119.14
Max. Negotiated Rate	$2,097.50
Rate for Payer: Aetna Commercial	$1,594.10
Rate for Payer: Aetna Medicare Advantage	$1,258.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.72
Rate for Payer: Cigna Commercial	$2,097.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: Qualcare PPO/HMO/WC	$629.25
Rate for Payer: UnitedHealthcare Community & State	$132.56
Rate for Payer: Wellpoint Medicaid Managed Care	$119.14

SCREW CANN TI ST 7.5X65MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700705
Hospital Revenue Code	278
Min. Negotiated Rate	$629.25
Max. Negotiated Rate	$1,015.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: Qualcare PPO/HMO/WC	$629.25

SCREW CANN TI ST 7.5X70MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700706
Hospital Revenue Code	278
Min. Negotiated Rate	$119.14
Max. Negotiated Rate	$2,097.50
Rate for Payer: Aetna Commercial	$1,594.10
Rate for Payer: Aetna Medicare Advantage	$1,258.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.72
Rate for Payer: Cigna Commercial	$2,097.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: Qualcare PPO/HMO/WC	$629.25
Rate for Payer: UnitedHealthcare Community & State	$132.56
Rate for Payer: Wellpoint Medicaid Managed Care	$119.14

SCREW CANN TI ST 7.5X70MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700706
Hospital Revenue Code	278
Min. Negotiated Rate	$629.25
Max. Negotiated Rate	$1,015.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: Qualcare PPO/HMO/WC	$629.25

SCREW CANN TI ST 7.5X75MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700707
Hospital Revenue Code	278
Min. Negotiated Rate	$629.25
Max. Negotiated Rate	$1,015.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: Qualcare PPO/HMO/WC	$629.25

SCREW CANN TI ST 7.5X75MM

Facility

$4,195.00

Service Code	HCPCS C1713
Hospital Charge Code	270700707
Hospital Revenue Code	278
Min. Negotiated Rate	$119.14
Max. Negotiated Rate	$2,097.50
Rate for Payer: Aetna Commercial	$1,594.10
Rate for Payer: Aetna Medicare Advantage	$1,258.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.72
Rate for Payer: Cigna Commercial	$2,097.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.19
Rate for Payer: Qualcare PPO/HMO/WC	$629.25
Rate for Payer: UnitedHealthcare Community & State	$132.56
Rate for Payer: Wellpoint Medicaid Managed Care	$119.14

SCREW CANN TYB 2.0 HD 12 MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270691399
Hospital Revenue Code	278
Min. Negotiated Rate	$45.44
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$608.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00
Rate for Payer: UnitedHealthcare Community & State	$50.56
Rate for Payer: Wellpoint Medicaid Managed Care	$45.44

SCREW CANN TYB 2.0 HD 12 MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270691399
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW CANNUALTED 2.4X12MM LONG

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270684720
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANNUALTED 2.4X12MM LONG

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270684720
Hospital Revenue Code	278
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$326.55
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90
Rate for Payer: UnitedHealthcare Community & State	$27.16
Rate for Payer: Wellpoint Medicaid Managed Care	$24.41

SCREW CANNULATD 4.0 X 42MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270663660
Hospital Revenue Code	278
Min. Negotiated Rate	$36.78
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$492.10
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25
Rate for Payer: UnitedHealthcare Community & State	$40.92
Rate for Payer: Wellpoint Medicaid Managed Care	$36.78

SCREW CANNULATD 4.0 X 42MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270663660
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW CANNULATD 4.0 x 46mm

Facility

$1,448.00

Service Code	HCPCS C1713
Hospital Charge Code	270663659
Hospital Revenue Code	278
Min. Negotiated Rate	$41.12
Max. Negotiated Rate	$724.00
Rate for Payer: Aetna Commercial	$550.24
Rate for Payer: Aetna Medicare Advantage	$434.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.24
Rate for Payer: Cigna Commercial	$724.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.42
Rate for Payer: Qualcare PPO/HMO/WC	$217.20
Rate for Payer: UnitedHealthcare Community & State	$45.76
Rate for Payer: Wellpoint Medicaid Managed Care	$41.12

SCREW CANNULATD 4.0 x 46mm

Facility

$1,448.00

Service Code	HCPCS C1713
Hospital Charge Code	270663659
Hospital Revenue Code	278
Min. Negotiated Rate	$217.20
Max. Negotiated Rate	$350.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.42
Rate for Payer: Qualcare PPO/HMO/WC	$217.20

SCREW CANNULATED 2.0MM X10 MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270681790
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 CANNULATED 2.0MM X10 MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270681790
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 CANNULATED 2.4x12MM

Facility

$950.00

Hospital Charge Code	270674378
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 2.4x12MM

Facility

$950.00

Hospital Charge Code	270674378
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

SCREW CANNULATED 2.5MM X 18MM

Facility

$2,935.00

Service Code	HCPCS C1713
Hospital Charge Code	270678563
Hospital Revenue Code	278
Min. Negotiated Rate	$83.35
Max. Negotiated Rate	$1,467.50
Rate for Payer: Aetna Commercial	$1,115.30
Rate for Payer: Aetna Medicare Advantage	$880.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.42
Rate for Payer: Cigna Commercial	$1,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.27
Rate for Payer: Qualcare PPO/HMO/WC	$440.25
Rate for Payer: UnitedHealthcare Community & State	$92.75
Rate for Payer: Wellpoint Medicaid Managed Care	$83.35

SCREW CANNULATED 2.5MM X 18MM

Facility

$2,935.00

Service Code	HCPCS C1713
Hospital Charge Code	270678563
Hospital Revenue Code	278
Min. Negotiated Rate	$440.25
Max. Negotiated Rate	$710.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.27
Rate for Payer: Qualcare PPO/HMO/WC	$440.25

SCREW CANNULATED 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688590
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

Know your out-of-pocket cost for care.

All Charges