Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 5.0X75MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699465
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 5.0X75MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699465
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 5.0X80MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699464
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 5.0X80MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699464
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 CAN SHT THD 30 X32

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270702704
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 CAN SHT THD 30 X32

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270702704
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 CAN, SHT THD HD 3X28MM

Facility

$962.50

Hospital Charge Code	270702193
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 CAN, SHT THD HD 3X28MM

Facility

$962.50

Hospital Charge Code	270702193
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 CAP 4.5 X 15CM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689209
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW CAP 4.5 X 15CM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689209
Hospital Revenue Code	278
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$31.12
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW CAP 4.5 X 15 MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689213
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW CAP 4.5 X 15 MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689213
Hospital Revenue Code	278
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$31.12
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW CAP 4.5 X 20MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689208
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW CAP 4.5 X 20MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689208
Hospital Revenue Code	278
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$31.12
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW CAP 4.5 X 25MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689210
Hospital Revenue Code	278
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$31.12
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW CAP 4.5 X 25MM

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689210
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW CAPTURE LOPRO 2.5x12MM

Facility

$790.00

Hospital Charge Code	270668721
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$24.96
Rate for Payer: Wellpoint Medicaid Managed Care	$22.44

SCREW CAPTURE LOPRO 2.5x12MM

Facility

$790.00

Hospital Charge Code	270668721
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW CAPTURE LOPRO 2.5X14MM

Facility

$790.00

Hospital Charge Code	270669821
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW CAPTURE LOPRO 2.5X14MM

Facility

$790.00

Hospital Charge Code	270669821
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$24.96
Rate for Payer: Wellpoint Medicaid Managed Care	$22.44

SCREW CAPTURE LOPRO 2x14MM

Facility

$790.00

Hospital Charge Code	270669819
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW CAPTURE LOPRO 2x14MM

Facility

$790.00

Hospital Charge Code	270669819
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Community & State	$24.96
Rate for Payer: Wellpoint Medicaid Managed Care	$22.44

screw casncellous 6.5x25

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684678
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

screw casncellous 6.5x25

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684678
Hospital Revenue Code	278
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$71.60
Rate for Payer: Aetna Commercial	$54.42
Rate for Payer: Aetna Medicare Advantage	$42.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.52
Rate for Payer: Cigna Commercial	$71.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48
Rate for Payer: UnitedHealthcare Community & State	$4.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

Know your out-of-pocket cost for care.

All Charges