Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNUL MARINER 6.50X45MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694848
Hospital Revenue Code	278
Min. Negotiated Rate	$305.30
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$339.70
Rate for Payer: Wellpoint Medicaid Managed Care	$305.30

SCREW CANNUL MARINER 6.50X45MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL MARINER 7.50X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694849
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL MARINER 7.50X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694849
Hospital Revenue Code	278
Min. Negotiated Rate	$305.30
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$339.70
Rate for Payer: Wellpoint Medicaid Managed Care	$305.30

SCREW CANNUL PED EXT 7.5X30MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694888
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL PED EXT 7.5X30MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694888
Hospital Revenue Code	278
Min. Negotiated Rate	$305.30
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$4,085.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Community & State	$339.70
Rate for Payer: Wellpoint Medicaid Managed Care	$305.30

SCREW CANN VA LCKG 5.0x30MM

Facility

$1,050.60

Hospital Charge Code	270678077
Hospital Revenue Code	278
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$399.23
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59
Rate for Payer: UnitedHealthcare Community & State	$33.20
Rate for Payer: Wellpoint Medicaid Managed Care	$29.84

SCREW CANN VA LCKG 5.0x30MM

Facility

$1,050.60

Hospital Charge Code	270678077
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW CANN VA LCKG 5.0x35MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649685
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x35MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649685
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$30.73

SCREW CANN VA LCKG 5.0x50MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677480
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$30.73

SCREW CANN VA LCKG 5.0x50MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677480
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x55MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677481
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x55MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677481
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$30.73

SCREW CANN VA LCKG 5.0x65MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270677138
Hospital Revenue Code	278
Min. Negotiated Rate	$28.97
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$32.23
Rate for Payer: Wellpoint Medicaid Managed Care	$28.97

SCREW CANN VA LCKG 5.0x65MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270677138
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

SCREW CANN VA LCKG 5.0x75MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649686
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x75MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649686
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$30.73

SCREW CANN VAL OPTILINK 5X30MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699689
Hospital Revenue Code	278
Min. Negotiated Rate	$91.31
Max. Negotiated Rate	$1,607.50
Rate for Payer: Aetna Commercial	$1,221.70
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25
Rate for Payer: UnitedHealthcare Community & State	$101.59
Rate for Payer: Wellpoint Medicaid Managed Care	$91.31

SCREW CANN VAL OPTILINK 5X30MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699689
Hospital Revenue Code	278
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$778.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

SCREW CANN VAL OPTILINK 5X70MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699690
Hospital Revenue Code	278
Min. Negotiated Rate	$91.31
Max. Negotiated Rate	$1,607.50
Rate for Payer: Aetna Commercial	$1,221.70
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25
Rate for Payer: UnitedHealthcare Community & State	$101.59
Rate for Payer: Wellpoint Medicaid Managed Care	$91.31

SCREW CANN VAL OPTILINK 5X70MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699690
Hospital Revenue Code	278
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$778.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

SCREW CANN VAL OPTLNK 5.0X55MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699467
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X55MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699467
Hospital Revenue Code	278
Min. Negotiated Rate	$86.90
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,162.80
Rate for Payer: Aetna Medicare Advantage	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.30
Rate for Payer: Cigna Commercial	$1,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00
Rate for Payer: UnitedHealthcare Community & State	$96.70
Rate for Payer: Wellpoint Medicaid Managed Care	$86.90

SCREW CANN VAL OPTLNK 5.0X65MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699466
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

Know your out-of-pocket cost for care.

All Charges