Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW EXTTAB CAN POLY 6.5X40MM

Facility

$7,562.50

Service Code	HCPCS C1713
Hospital Charge Code	270699534
Hospital Revenue Code	278
Min. Negotiated Rate	$214.78
Max. Negotiated Rate	$3,781.25
Rate for Payer: Aetna Commercial	$2,873.75
Rate for Payer: Aetna Medicare Advantage	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,928.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,928.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,928.44
Rate for Payer: Cigna Commercial	$3,781.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.38
Rate for Payer: UnitedHealthcare Community & State	$238.97
Rate for Payer: Wellpoint Medicaid Managed Care	$214.78

SCREW EXT TAB T20 7.5X40MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW EXT TAB T20 7.5X40MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698046
Hospital Revenue Code	278
Min. Negotiated Rate	$198.09
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$220.41
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

SCREW EXT TAB T20 7.5X45MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698047
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW EXT TAB T20 7.5X45MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698047
Hospital Revenue Code	278
Min. Negotiated Rate	$198.09
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,650.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Community & State	$220.41
Rate for Payer: Wellpoint Medicaid Managed Care	$198.09

SCREW FA 4.0 MM X L16MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688699
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW FA 4.0 MM X L16MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688699
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

SCREW FACET 6.0X10MM

Facility

$44,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696784
Hospital Revenue Code	278
Min. Negotiated Rate	$6,727.50
Max. Negotiated Rate	$10,853.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,853.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,727.50

SCREW FACET 6.0X10MM

Facility

$44,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696784
Hospital Revenue Code	278
Min. Negotiated Rate	$1,273.74
Max. Negotiated Rate	$22,425.00
Rate for Payer: Aetna Commercial	$17,043.00
Rate for Payer: Aetna Medicare Advantage	$13,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,436.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,436.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,436.75
Rate for Payer: Cigna Commercial	$22,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,853.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,727.50
Rate for Payer: UnitedHealthcare Community & State	$1,417.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1,273.74

SCREW FACET CANN 5X30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703619
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

SCREW FACET CANN 5X30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703619
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SCREW FACET FIXX FT 4.5X25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693619
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

SCREW FACET FIXX FT 4.5X25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693619
Hospital Revenue Code	278
Min. Negotiated Rate	$141.29
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$157.21
Rate for Payer: Wellpoint Medicaid Managed Care	$141.29

SCREW FACET FIXX FT 4.5X30MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693620
Hospital Revenue Code	278
Min. Negotiated Rate	$141.29
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$157.21
Rate for Payer: Wellpoint Medicaid Managed Care	$141.29

SCREW FACET FIXX FT 4.5X30MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693620
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

SCREW FEMORAL 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270676878
Hospital Revenue Code	278
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

SCREW FEMORAL 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270676878
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW FEMORAL AUG POST SZ1 5MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680663
Hospital Revenue Code	278
Min. Negotiated Rate	$102.35
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$113.89
Rate for Payer: Wellpoint Medicaid Managed Care	$102.35

SCREW FEMORAL AUG POST SZ1 5MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680663
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ1 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680664
Hospital Revenue Code	278
Min. Negotiated Rate	$102.35
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$113.89
Rate for Payer: Wellpoint Medicaid Managed Care	$102.35

SCREW FEMORAL AUG SZ1 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680664
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ3 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676963
Hospital Revenue Code	278
Min. Negotiated Rate	$102.35
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$113.89
Rate for Payer: Wellpoint Medicaid Managed Care	$102.35

SCREW FEMORAL AUG SZ3 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676963
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ4 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676558
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ4 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676558
Hospital Revenue Code	278
Min. Negotiated Rate	$102.35
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,369.52
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60
Rate for Payer: UnitedHealthcare Community & State	$113.89
Rate for Payer: Wellpoint Medicaid Managed Care	$102.35

Know your out-of-pocket cost for care.

All Charges