Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORT SELF TAP 2.7x24MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270672959
Hospital Revenue Code	278
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Community & State	$6.95
Rate for Payer: Wellpoint Medicaid Managed Care	$6.25

SCREW CORT SELF TAP 2.7x24MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270672959
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW CORT TI 3.5X46MM

Facility

$252.50

Service Code	HCPCS C1713
Hospital Charge Code	270699451
Hospital Revenue Code	278
Min. Negotiated Rate	$37.88
Max. Negotiated Rate	$61.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.10
Rate for Payer: Qualcare PPO/HMO/WC	$37.88

SCREW CORT TI 3.5X46MM

Facility

$252.50

Service Code	HCPCS C1713
Hospital Charge Code	270699451
Hospital Revenue Code	278
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$126.25
Rate for Payer: Aetna Commercial	$95.95
Rate for Payer: Aetna Medicare Advantage	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.39
Rate for Payer: Cigna Commercial	$126.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.10
Rate for Payer: Qualcare PPO/HMO/WC	$37.88
Rate for Payer: UnitedHealthcare Community & State	$7.98
Rate for Payer: Wellpoint Medicaid Managed Care	$7.17

SCREW CORT TI 4.5x36mm

Facility

$171.00

Hospital Charge Code	270673764
Hospital Revenue Code	278
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.86

SCREW CORT TI 4.5x36mm

Facility

$171.00

Hospital Charge Code	270673764
Hospital Revenue Code	278
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$41.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

SCREW CORT TI 4.5x65mm

Facility

$171.00

Hospital Charge Code	270673765
Hospital Revenue Code	278
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.86

SCREW CORT TI 4.5x65mm

Facility

$171.00

Hospital Charge Code	270673765
Hospital Revenue Code	278
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$41.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.38
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

SCREW CORT TI 5x38 14405038

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270643296
Hospital Revenue Code	278
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

SCREW CORT TI 5x38 14405038

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270643296
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW CORT TI-DOB

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270705501
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCREW CORT TI-DOB

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270705501
Hospital Revenue Code	278
Min. Negotiated Rate	$76.68
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Community & State	$85.32
Rate for Payer: Wellpoint Medicaid Managed Care	$76.68

SCREW CORTX 2.4 SLFTP T8SD12MM

Facility

$246.90

Service Code	HCPCS C1713
Hospital Charge Code	270659970
Hospital Revenue Code	278
Min. Negotiated Rate	$37.03
Max. Negotiated Rate	$59.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.03

SCREW CORTX 2.4 SLFTP T8SD12MM

Facility

$246.90

Service Code	HCPCS C1713
Hospital Charge Code	270659970
Hospital Revenue Code	278
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$123.45
Rate for Payer: Aetna Commercial	$93.82
Rate for Payer: Aetna Medicare Advantage	$74.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.96
Rate for Payer: Cigna Commercial	$123.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.03
Rate for Payer: UnitedHealthcare Community & State	$7.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7.01

SCREW CORT Z NAIL 5.0 X 30

Facility

$750.00

Hospital Charge Code	270658847
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SCREW CORT Z NAIL 5.0 X 30

Facility

$750.00

Hospital Charge Code	270658847
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW COUNTER SINK 1.5- 2.0MM

Facility

$624.20

Hospital Charge Code	270663617
Hospital Revenue Code	278
Min. Negotiated Rate	$93.63
Max. Negotiated Rate	$151.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.06
Rate for Payer: Qualcare PPO/HMO/WC	$93.63

SCREW COUNTER SINK 1.5- 2.0MM

Facility

$624.20

Hospital Charge Code	270663617
Hospital Revenue Code	278
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$312.10
Rate for Payer: Aetna Commercial	$237.20
Rate for Payer: Aetna Medicare Advantage	$187.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.17
Rate for Payer: Cigna Commercial	$312.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.06
Rate for Payer: Qualcare PPO/HMO/WC	$93.63
Rate for Payer: UnitedHealthcare Community & State	$19.72
Rate for Payer: Wellpoint Medicaid Managed Care	$17.73

SCREW CREO 6.5X30MM MODULAR

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693569
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

SCREW CREO 6.5X30MM MODULAR

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693569
Hospital Revenue Code	278
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

SCREW CREO AMP 5.5MM POLYAX TU

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693439
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

SCREW CREO AMP 5.5MM POLYAX TU

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693439
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

SCREW CREO AMP 6.5X35MM

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693570
Hospital Revenue Code	278
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

SCREW CREO AMP 6.5X35MM

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693570
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

SCREW CREO AMP 6.5X40MM

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693435
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

Know your out-of-pocket cost for care.

All Charges