Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW DARCO 6.5 X 55

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687131
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

SCREW DARCO 70 X 6.5

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687141
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

SCREW DARCO 70 X 6.5

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687141
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

SCREW DARCO HEADED 4.0x36MM

Facility

$1,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270676414
Hospital Revenue Code	278
Min. Negotiated Rate	$36.92
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Community & State	$41.08
Rate for Payer: Wellpoint Medicaid Managed Care	$36.92

SCREW DARCO HEADED 4.0x36MM

Facility

$1,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270676414
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$314.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

SCREW DARTFIRE COMP 4.0MMX38MM

Facility

$1,290.00

Service Code	HCPCS C1713
Hospital Charge Code	270701092
Hospital Revenue Code	278
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$312.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

SCREW DARTFIRE COMP 4.0MMX38MM

Facility

$1,290.00

Service Code	HCPCS C1713
Hospital Charge Code	270701092
Hospital Revenue Code	278
Min. Negotiated Rate	$36.64
Max. Negotiated Rate	$645.00
Rate for Payer: Aetna Commercial	$490.20
Rate for Payer: Aetna Medicare Advantage	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.95
Rate for Payer: Cigna Commercial	$645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Community & State	$40.76
Rate for Payer: Wellpoint Medicaid Managed Care	$36.64

SCREW DARTFIRE COMP 4.0MMX46MM

Facility

$1,290.00

Service Code	HCPCS C1713
Hospital Charge Code	270701093
Hospital Revenue Code	278
Min. Negotiated Rate	$193.50
Max. Negotiated Rate	$312.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.50

SCREW DARTFIRE COMP 4.0MMX46MM

Facility

$1,290.00

Service Code	HCPCS C1713
Hospital Charge Code	270701093
Hospital Revenue Code	278
Min. Negotiated Rate	$36.64
Max. Negotiated Rate	$645.00
Rate for Payer: Aetna Commercial	$490.20
Rate for Payer: Aetna Medicare Advantage	$387.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.95
Rate for Payer: Cigna Commercial	$645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.18
Rate for Payer: Qualcare PPO/HMO/WC	$193.50
Rate for Payer: UnitedHealthcare Community & State	$40.76
Rate for Payer: Wellpoint Medicaid Managed Care	$36.64

SCREW DART-FIRE TI 4.0X44MM

Facility

$2,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270699445
Hospital Revenue Code	278
Min. Negotiated Rate	$73.27
Max. Negotiated Rate	$1,290.00
Rate for Payer: Aetna Commercial	$980.40
Rate for Payer: Aetna Medicare Advantage	$774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.90
Rate for Payer: Cigna Commercial	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.36
Rate for Payer: Qualcare PPO/HMO/WC	$387.00
Rate for Payer: UnitedHealthcare Community & State	$81.53
Rate for Payer: Wellpoint Medicaid Managed Care	$73.27

SCREW DART-FIRE TI 4.0X44MM

Facility

$2,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270699445
Hospital Revenue Code	278
Min. Negotiated Rate	$387.00
Max. Negotiated Rate	$624.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.36
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

SCREW DEPTH GAUGE 1.5MM 2.0MM

Facility

$2,067.20

Service Code	HCPCS C1713
Hospital Charge Code	270655069
Hospital Revenue Code	278
Min. Negotiated Rate	$58.71
Max. Negotiated Rate	$1,033.60
Rate for Payer: Aetna Commercial	$785.54
Rate for Payer: Aetna Medicare Advantage	$620.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$527.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$527.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$527.14
Rate for Payer: Cigna Commercial	$1,033.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.26
Rate for Payer: Qualcare PPO/HMO/WC	$310.08
Rate for Payer: UnitedHealthcare Community & State	$65.32
Rate for Payer: Wellpoint Medicaid Managed Care	$58.71

SCREW DEPTH GAUGE 1.5MM 2.0MM

Facility

$2,067.20

Service Code	HCPCS C1713
Hospital Charge Code	270655069
Hospital Revenue Code	278
Min. Negotiated Rate	$310.08
Max. Negotiated Rate	$500.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$413.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$500.26
Rate for Payer: Qualcare PPO/HMO/WC	$310.08

SCREW DF HEAD COMP PT 3.5X24MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700382
Hospital Revenue Code	278
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$527.80
Rate for Payer: Aetna Commercial	$401.13
Rate for Payer: Aetna Medicare Advantage	$316.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.18
Rate for Payer: Cigna Commercial	$527.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: Qualcare PPO/HMO/WC	$158.34
Rate for Payer: UnitedHealthcare Community & State	$33.36
Rate for Payer: Wellpoint Medicaid Managed Care	$29.98

SCREW DF HEAD COMP PT 3.5X24MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700382
Hospital Revenue Code	278
Min. Negotiated Rate	$158.34
Max. Negotiated Rate	$255.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: Qualcare PPO/HMO/WC	$158.34

SCREW DF HEAD COMP PT 3.5X28MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700383
Hospital Revenue Code	278
Min. Negotiated Rate	$158.34
Max. Negotiated Rate	$255.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: Qualcare PPO/HMO/WC	$158.34

SCREW DF HEAD COMP PT 3.5X28MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700383
Hospital Revenue Code	278
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$527.80
Rate for Payer: Aetna Commercial	$401.13
Rate for Payer: Aetna Medicare Advantage	$316.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.18
Rate for Payer: Cigna Commercial	$527.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: Qualcare PPO/HMO/WC	$158.34
Rate for Payer: UnitedHealthcare Community & State	$33.36
Rate for Payer: Wellpoint Medicaid Managed Care	$29.98

SCREW DF HEAD COMP PT 3.5X30MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700381
Hospital Revenue Code	278
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$527.80
Rate for Payer: Aetna Commercial	$401.13
Rate for Payer: Aetna Medicare Advantage	$316.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.18
Rate for Payer: Cigna Commercial	$527.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: Qualcare PPO/HMO/WC	$158.34
Rate for Payer: UnitedHealthcare Community & State	$33.36
Rate for Payer: Wellpoint Medicaid Managed Care	$29.98

SCREW DF HEAD COMP PT 3.5X30MM

Facility

$1,055.60

Service Code	HCPCS C1713
Hospital Charge Code	270700381
Hospital Revenue Code	278
Min. Negotiated Rate	$158.34
Max. Negotiated Rate	$255.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.46
Rate for Payer: Qualcare PPO/HMO/WC	$158.34

SCREW DF HEAD COMP PT 3X20MM

Facility

$1,020.60

Service Code	HCPCS C1713
Hospital Charge Code	270700380
Hospital Revenue Code	278
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$510.30
Rate for Payer: Aetna Commercial	$387.83
Rate for Payer: Aetna Medicare Advantage	$306.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.25
Rate for Payer: Cigna Commercial	$510.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.09
Rate for Payer: UnitedHealthcare Community & State	$32.25
Rate for Payer: Wellpoint Medicaid Managed Care	$28.99

SCREW DF HEAD COMP PT 3X20MM

Facility

$1,020.60

Service Code	HCPCS C1713
Hospital Charge Code	270700380
Hospital Revenue Code	278
Min. Negotiated Rate	$153.09
Max. Negotiated Rate	$246.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.99
Rate for Payer: Qualcare PPO/HMO/WC	$153.09

SCREW DHS/DCS 90mm

Facility

$1,611.00

Hospital Charge Code	270671817
Hospital Revenue Code	278
Min. Negotiated Rate	$241.65
Max. Negotiated Rate	$389.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.86
Rate for Payer: Qualcare PPO/HMO/WC	$241.65

SCREW DHS/DCS 90mm

Facility

$1,611.00

Hospital Charge Code	270671817
Hospital Revenue Code	278
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$805.50
Rate for Payer: Aetna Commercial	$612.18
Rate for Payer: Aetna Medicare Advantage	$483.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.81
Rate for Payer: Cigna Commercial	$805.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.86
Rate for Payer: Qualcare PPO/HMO/WC	$241.65
Rate for Payer: UnitedHealthcare Community & State	$50.91
Rate for Payer: Wellpoint Medicaid Managed Care	$45.75

SCREW DOME MPACT 15MM

Facility

$16,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270684245
Hospital Revenue Code	278
Min. Negotiated Rate	$2,452.50
Max. Negotiated Rate	$3,956.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50

SCREW DOME MPACT 15MM

Facility

$16,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270684245
Hospital Revenue Code	278
Min. Negotiated Rate	$464.34
Max. Negotiated Rate	$8,175.00
Rate for Payer: Aetna Commercial	$6,213.00
Rate for Payer: Aetna Medicare Advantage	$4,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,169.25
Rate for Payer: Cigna Commercial	$8,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50
Rate for Payer: UnitedHealthcare Community & State	$516.66
Rate for Payer: Wellpoint Medicaid Managed Care	$464.34

Know your out-of-pocket cost for care.

All Charges