Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL 4.5x34mm

Facility

$260.00

Service Code	HCPCS C1713
Hospital Charge Code	270668434
Hospital Revenue Code	278
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$98.80
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Community & State	$8.22
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

SCREW CORTICAL 4.5 X 38

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	270663311
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 4.5 X 38

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	270663311
Hospital Revenue Code	278
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

SCREW CORTICAL 4.5X75MM

Facility

$245.00

Hospital Charge Code	270668431
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 4.5X75MM

Facility

$245.00

Hospital Charge Code	270668431
Hospital Revenue Code	278
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

SCREW CORTICAL 4.5X80MM

Facility

$245.00

Hospital Charge Code	270668435
Hospital Revenue Code	278
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

SCREW CORTICAL 4.5X80MM

Facility

$245.00

Hospital Charge Code	270668435
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

SCREW CORTICAL 5.0MM X 32MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270687402
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CORTICAL 5.0MM X 32MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270687402
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

SCREW CORTICAL 5.0MMX36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695287
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

SCREW CORTICAL 5.0MMX36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695287
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CORTICAL 5.0X36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695827
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

SCREW CORTICAL 5.0X36MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695827
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SCREW CORTICAL 5.0 X 60MM

Facility

$717.00

Hospital Charge Code	270663322
Hospital Revenue Code	278
Min. Negotiated Rate	$107.55
Max. Negotiated Rate	$173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55

SCREW CORTICAL 5.0 X 60MM

Facility

$717.00

Hospital Charge Code	270663322
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$358.50
Rate for Payer: Aetna Commercial	$272.46
Rate for Payer: Aetna Medicare Advantage	$215.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.84
Rate for Payer: Cigna Commercial	$358.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.51
Rate for Payer: Qualcare PPO/HMO/WC	$107.55
Rate for Payer: UnitedHealthcare Community & State	$22.66
Rate for Payer: Wellpoint Medicaid Managed Care	$20.36

SCREW CORTICAL 55-85MM ALTA

Facility

$541.00

Hospital Charge Code	270335177
Hospital Revenue Code	278
Min. Negotiated Rate	$81.15
Max. Negotiated Rate	$130.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.92
Rate for Payer: Qualcare PPO/HMO/WC	$81.15

SCREW CORTICAL 55-85MM ALTA

Facility

$541.00

Hospital Charge Code	270335177
Hospital Revenue Code	278
Min. Negotiated Rate	$15.36
Max. Negotiated Rate	$270.50
Rate for Payer: Aetna Commercial	$205.58
Rate for Payer: Aetna Medicare Advantage	$162.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.96
Rate for Payer: Cigna Commercial	$270.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.92
Rate for Payer: Qualcare PPO/HMO/WC	$81.15
Rate for Payer: UnitedHealthcare Community & State	$17.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.36

SCREW CORTICAL 5X42MM

Facility

$1,650.00

Hospital Charge Code	270702709
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

SCREW CORTICAL 5X42MM

Facility

$1,650.00

Hospital Charge Code	270702709
Hospital Revenue Code	278
Min. Negotiated Rate	$46.86
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$52.14
Rate for Payer: Wellpoint Medicaid Managed Care	$46.86

SCREW CORTICAL 5X46MM

Facility

$1,650.00

Hospital Charge Code	270702710
Hospital Revenue Code	278
Min. Negotiated Rate	$46.86
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Community & State	$52.14
Rate for Payer: Wellpoint Medicaid Managed Care	$46.86

SCREW CORTICAL 5X46MM

Facility

$1,650.00

Hospital Charge Code	270702710
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

SCREW CORTICAL 5x60 14-405060

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270641745
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CORTICAL 5x60 14-405060

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270641745
Hospital Revenue Code	278
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$326.80
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00
Rate for Payer: UnitedHealthcare Community & State	$27.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.42

SCREW CORTICAL 7 X 55MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684985
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

SCREW CORTICAL 7 X 55MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684985
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

Know your out-of-pocket cost for care.

All Charges