Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW HEADLESS CANN 2.4x16MM

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270673751
Hospital Revenue Code	278
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

SCREW HEADLESS CANN 5.5X 52 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690340
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SCREW HEADLESS CANN 5.5X 52 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690340
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SCREW HEADLESS CANN 6.5X65MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688167
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SCREW HEADLESS CANN 6.5X65MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688167
Hospital Revenue Code	278
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

SCREW HEADLESS COM 6.5 X 110MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686756
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SCREW HEADLESS COM 6.5 X 110MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686756
Hospital Revenue Code	278
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688170
Hospital Revenue Code	278
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688171
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688171
Hospital Revenue Code	278
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688170
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SCREW HEADLESS COMP 4.5/6.5

Facility

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	270685925
Hospital Revenue Code	278
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$231.00
Rate for Payer: Aetna Commercial	$175.56
Rate for Payer: Aetna Medicare Advantage	$138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.81
Rate for Payer: Cigna Commercial	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.80
Rate for Payer: Qualcare PPO/HMO/WC	$69.30
Rate for Payer: UnitedHealthcare Community & State	$14.60
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

SCREW HEADLESS COMP 4.5/6.5

Facility

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	270685925
Hospital Revenue Code	278
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$111.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.80
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

SCREW HEADLESS COMPRESSION 2.4

Facility

$1,410.00

Hospital Charge Code	270660883
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW HEADLESS COMPRESSION 2.4

Facility

$1,410.00

Hospital Charge Code	270660883
Hospital Revenue Code	278
Min. Negotiated Rate	$40.04
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$535.80
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50
Rate for Payer: UnitedHealthcare Community & State	$44.56
Rate for Payer: Wellpoint Medicaid Managed Care	$40.04

SCREW HEADLESSCOMP ST 6.5X40MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270694533
Hospital Revenue Code	278
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

SCREW HEADLESSCOMP ST 6.5X40MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270694533
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SCREW HEADLESS MNI 4.0 X 40 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690345
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SCREW HEADLESS MNI 4.0 X 40 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690345
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SCREW HEADLESSS 2.5X14 TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688012
Hospital Revenue Code	278
Min. Negotiated Rate	$84.49
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$94.01
Rate for Payer: Wellpoint Medicaid Managed Care	$84.49

SCREW HEADLESSS 2.5X14 TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688012
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SCREW HEADLESSS 2.5 X 16TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688014
Hospital Revenue Code	278
Min. Negotiated Rate	$84.49
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$94.01
Rate for Payer: Wellpoint Medicaid Managed Care	$84.49

SCREW HEADLESSS 2.5 X 16TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688014
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SCREW HEAD PEDICLE EXT POLY G2

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270694930
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW HEAD PEDICLE EXT POLY G2

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270694930
Hospital Revenue Code	278
Min. Negotiated Rate	$152.65
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$2,042.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
Rate for Payer: UnitedHealthcare Community & State	$169.85
Rate for Payer: Wellpoint Medicaid Managed Care	$152.65

Know your out-of-pocket cost for care.

All Charges