Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW HLCOMP 6.5

Facility

$1,468.35

Service Code	HCPCS C1713
Hospital Charge Code	270687865
Hospital Revenue Code	278
Min. Negotiated Rate	$220.25
Max. Negotiated Rate	$355.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.34
Rate for Payer: Qualcare PPO/HMO/WC	$220.25

SCREW HLCOMP 6.5

Facility

$1,483.35

Service Code	HCPCS C1713
Hospital Charge Code	270687866
Hospital Revenue Code	278
Min. Negotiated Rate	$222.50
Max. Negotiated Rate	$358.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.97
Rate for Payer: Qualcare PPO/HMO/WC	$222.50

SCREW HLCOMP 6.5

Facility

$1,483.35

Service Code	HCPCS C1713
Hospital Charge Code	270687866
Hospital Revenue Code	278
Min. Negotiated Rate	$42.13
Max. Negotiated Rate	$741.67
Rate for Payer: Aetna Commercial	$563.67
Rate for Payer: Aetna Medicare Advantage	$445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.25
Rate for Payer: Cigna Commercial	$741.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.97
Rate for Payer: Qualcare PPO/HMO/WC	$222.50
Rate for Payer: UnitedHealthcare Community & State	$46.87
Rate for Payer: Wellpoint Medicaid Managed Care	$42.13

SCREW HOLDING/DRIVER ASSY

Facility

$10,920.00

Hospital Charge Code	270686085
Hospital Revenue Code	272
Min. Negotiated Rate	$1,638.00
Max. Negotiated Rate	$1,638.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,638.00

SCREW HOLDING/DRIVER ASSY

Facility

$10,920.00

Hospital Charge Code	270686085
Hospital Revenue Code	272
Min. Negotiated Rate	$310.13
Max. Negotiated Rate	$5,460.00
Rate for Payer: Aetna Commercial	$4,149.60
Rate for Payer: Aetna Medicare Advantage	$3,276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,784.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,784.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,784.60
Rate for Payer: Cigna Commercial	$5,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.20
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,638.00
Rate for Payer: UnitedHealthcare Commercial	$2,184.00
Rate for Payer: UnitedHealthcare Community & State	$345.07
Rate for Payer: Wellpoint Medicaid Managed Care	$310.13

SCREW HUMERAL TAPER SIZE 25 OR

Facility

$2,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270679727
Hospital Revenue Code	278
Min. Negotiated Rate	$75.97
Max. Negotiated Rate	$1,337.50
Rate for Payer: Aetna Commercial	$1,016.50
Rate for Payer: Aetna Medicare Advantage	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.12
Rate for Payer: Cigna Commercial	$1,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: Qualcare PPO/HMO/WC	$401.25
Rate for Payer: UnitedHealthcare Community & State	$84.53
Rate for Payer: Wellpoint Medicaid Managed Care	$75.97

SCREW HUMERAL TAPER SIZE 25 OR

Facility

$2,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270679727
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$647.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

SCREW, IDTI ALIF SA,LAT 5.0X25

Facility

$2,845.00

Hospital Charge Code	270703003
Hospital Revenue Code	278
Min. Negotiated Rate	$80.80
Max. Negotiated Rate	$1,422.50
Rate for Payer: Aetna Commercial	$1,081.10
Rate for Payer: Aetna Medicare Advantage	$853.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.48
Rate for Payer: Cigna Commercial	$1,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.49
Rate for Payer: Qualcare PPO/HMO/WC	$426.75
Rate for Payer: UnitedHealthcare Community & State	$89.90
Rate for Payer: Wellpoint Medicaid Managed Care	$80.80

SCREW, IDTI ALIF SA,LAT 5.0X25

Facility

$2,845.00

Hospital Charge Code	270703003
Hospital Revenue Code	278
Min. Negotiated Rate	$426.75
Max. Negotiated Rate	$688.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.49
Rate for Payer: Qualcare PPO/HMO/WC	$426.75

SCREW IF VENTED BC 9MMX20 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688545
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW IF VENTED BC 9MMX20 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688545
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

SCREW INCORE 3.5X24MM TI

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270688354
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$820.00
Rate for Payer: Aetna Commercial	$623.20
Rate for Payer: Aetna Medicare Advantage	$492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.20
Rate for Payer: Cigna Commercial	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00
Rate for Payer: UnitedHealthcare Community & State	$51.82
Rate for Payer: Wellpoint Medicaid Managed Care	$46.58

SCREW INCORE 3.5X24MM TI

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270688354
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

SCREW INCORE 3.5X32MM IT

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687067
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW INCORE 3.5X32MM IT

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270687067
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

SCREW INCORE 3.5X38MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688352
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

SCREW INCORE 3.5X38MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688352
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW INCORE 3.5X54MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688353
Hospital Revenue Code	278
Min. Negotiated Rate	$39.19
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Community & State	$43.61
Rate for Payer: Wellpoint Medicaid Managed Care	$39.19

SCREW INCORE 3.5X54MM TI

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688353
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW INCORE LAPIDUS 5.9MMX 28

Facility

$24,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270688763
Hospital Revenue Code	278
Min. Negotiated Rate	$3,607.50
Max. Negotiated Rate	$5,820.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,820.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,607.50

SCREW INCORE LAPIDUS 5.9MMX 28

Facility

$24,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270688763
Hospital Revenue Code	278
Min. Negotiated Rate	$683.02
Max. Negotiated Rate	$12,025.00
Rate for Payer: Aetna Commercial	$9,139.00
Rate for Payer: Aetna Medicare Advantage	$7,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,132.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,132.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,132.75
Rate for Payer: Cigna Commercial	$12,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,820.10
Rate for Payer: Qualcare PPO/HMO/WC	$3,607.50
Rate for Payer: UnitedHealthcare Community & State	$759.98
Rate for Payer: Wellpoint Medicaid Managed Care	$683.02

SCREW INFINITY OCP 3.5X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699634
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

SCREW INFINITY OCP 3.5X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699634
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 INFINITY OCP 4.0X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699633
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 INFINITY OCP 4.0X12MM

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699633
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