Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW COMP RVS CNTRL 6.5X20MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270671257
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW CONCENTR GLENOSPH 36x2MM

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270671582
Hospital Revenue Code	278
Min. Negotiated Rate	$355.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$4,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Community & State	$395.00
Rate for Payer: Wellpoint Medicaid Managed Care	$355.00

SCREW CONCENTR GLENOSPH 36x2MM

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270671582
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

SCREW CONICAL EXTRACTION 2.5MM

Facility

$273.00

Hospital Charge Code	270654497
Hospital Revenue Code	278
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$66.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.07
Rate for Payer: Qualcare PPO/HMO/WC	$40.95

SCREW CONICAL EXTRACTION 2.5MM

Facility

$273.00

Hospital Charge Code	270654497
Hospital Revenue Code	278
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$136.50
Rate for Payer: Aetna Commercial	$103.74
Rate for Payer: Aetna Medicare Advantage	$81.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.61
Rate for Payer: Cigna Commercial	$136.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.07
Rate for Payer: Qualcare PPO/HMO/WC	$40.95
Rate for Payer: UnitedHealthcare Community & State	$8.63
Rate for Payer: Wellpoint Medicaid Managed Care	$7.75

SCREW CONNECTING SDRVE LOCKING

Facility

$969.80

Service Code	HCPCS C1713
Hospital Charge Code	270693775
Hospital Revenue Code	278
Min. Negotiated Rate	$27.54
Max. Negotiated Rate	$484.90
Rate for Payer: Aetna Commercial	$368.52
Rate for Payer: Aetna Medicare Advantage	$290.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.30
Rate for Payer: Cigna Commercial	$484.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.69
Rate for Payer: Qualcare PPO/HMO/WC	$145.47
Rate for Payer: UnitedHealthcare Community & State	$30.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.54

SCREW CONNECTING SDRVE LOCKING

Facility

$969.80

Service Code	HCPCS C1713
Hospital Charge Code	270693775
Hospital Revenue Code	278
Min. Negotiated Rate	$145.47
Max. Negotiated Rate	$234.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.69
Rate for Payer: Qualcare PPO/HMO/WC	$145.47

SCREW CORITAL 3.5 MM X 22 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270684010
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW CORITAL 3.5 MM X 22 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270684010
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW CORLOCK STARDRIVE 3.5x24

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660900
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

SCREW CORLOCK STARDRIVE 3.5x24

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660900
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCREW CORLOCK STARDRIVE 3.5x28

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668476
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

SCREW CORLOCK STARDRIVE 3.5x28

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270668476
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCREW CORLOCK STARDRIVE 3.5x34

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660897
Hospital Revenue Code	278
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$35.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27

SCREW CORLOCK STARDRIVE 3.5x34

Facility

$148.50

Service Code	HCPCS C1713
Hospital Charge Code	270660897
Hospital Revenue Code	278
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$74.25
Rate for Payer: Aetna Commercial	$56.43
Rate for Payer: Aetna Medicare Advantage	$44.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.87
Rate for Payer: Cigna Commercial	$74.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.94
Rate for Payer: Qualcare PPO/HMO/WC	$22.27
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.22

SCREW COROENT SP INTRLK 4X15MM

Facility

$2,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270693752
Hospital Revenue Code	278
Min. Negotiated Rate	$78.81
Max. Negotiated Rate	$1,387.50
Rate for Payer: Aetna Commercial	$1,054.50
Rate for Payer: Aetna Medicare Advantage	$832.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$707.62
Rate for Payer: Cigna Commercial	$1,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25
Rate for Payer: UnitedHealthcare Community & State	$87.69
Rate for Payer: Wellpoint Medicaid Managed Care	$78.81

SCREW COROENT SP INTRLK 4X15MM

Facility

$2,775.00

Service Code	HCPCS C1713
Hospital Charge Code	270693752
Hospital Revenue Code	278
Min. Negotiated Rate	$416.25
Max. Negotiated Rate	$671.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.55
Rate for Payer: Qualcare PPO/HMO/WC	$416.25

SCREW COROENT XLF VAR 5.5X40MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270697555
Hospital Revenue Code	278
Min. Negotiated Rate	$162.87
Max. Negotiated Rate	$2,867.50
Rate for Payer: Aetna Commercial	$2,179.30
Rate for Payer: Aetna Medicare Advantage	$1,720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,462.42
Rate for Payer: Cigna Commercial	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: Qualcare PPO/HMO/WC	$860.25
Rate for Payer: UnitedHealthcare Community & State	$181.23
Rate for Payer: Wellpoint Medicaid Managed Care	$162.87

SCREW COROENT XLF VAR 5.5X40MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270697555
Hospital Revenue Code	278
Min. Negotiated Rate	$860.25
Max. Negotiated Rate	$1,387.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: Qualcare PPO/HMO/WC	$860.25

SCREW COROENT XLFVAR 5.5X45MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270695491
Hospital Revenue Code	278
Min. Negotiated Rate	$162.87
Max. Negotiated Rate	$2,867.50
Rate for Payer: Aetna Commercial	$2,179.30
Rate for Payer: Aetna Medicare Advantage	$1,720.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,462.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,462.42
Rate for Payer: Cigna Commercial	$2,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: Qualcare PPO/HMO/WC	$860.25
Rate for Payer: UnitedHealthcare Community & State	$181.23
Rate for Payer: Wellpoint Medicaid Managed Care	$162.87

SCREW COROENT XLFVAR 5.5X45MM

Facility

$5,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270695491
Hospital Revenue Code	278
Min. Negotiated Rate	$860.25
Max. Negotiated Rate	$1,387.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,387.87
Rate for Payer: Qualcare PPO/HMO/WC	$860.25

SCREW CORT 2.3X14MM

Facility

$525.00

Hospital Charge Code	270668128
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

SCREW CORT 2.3X14MM

Facility

$525.00

Hospital Charge Code	270668128
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW CORT 3.5x44mm SELFTAP

Facility

$90.40

Service Code	HCPCS C1713
Hospital Charge Code	270644881
Hospital Revenue Code	278
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$45.20
Rate for Payer: Aetna Commercial	$34.35
Rate for Payer: Aetna Medicare Advantage	$27.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.05
Rate for Payer: Cigna Commercial	$45.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.88
Rate for Payer: Qualcare PPO/HMO/WC	$13.56
Rate for Payer: UnitedHealthcare Community & State	$2.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

SCREW CORT 3.5x44mm SELFTAP

Facility

$90.40

Service Code	HCPCS C1713
Hospital Charge Code	270644881
Hospital Revenue Code	278
Min. Negotiated Rate	$13.56
Max. Negotiated Rate	$21.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.88
Rate for Payer: Qualcare PPO/HMO/WC	$13.56

Know your out-of-pocket cost for care.

All Charges