Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW INNER MNTR

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270663778
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SCREW INNER MNTR

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270663778
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW INNER MNTR H/H X-CONN

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270663777
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

SCREW INNER MNTR H/H X-CONN

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270663777
Hospital Revenue Code	278
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Community & State	$24.81
Rate for Payer: Wellpoint Medicaid Managed Care	$22.29

SCREW INNER OC

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270687896
Hospital Revenue Code	278
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$252.70
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$99.75
Rate for Payer: UnitedHealthcare Community & State	$21.01
Rate for Payer: Wellpoint Medicaid Managed Care	$18.89

SCREW INNER OC

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270687896
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW INTEGRAD LAPIPASTY 4.0 M

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697757
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

SCREW INTEGRAD LAPIPASTY 4.0 M

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697757
Hospital Revenue Code	278
Min. Negotiated Rate	$77.39
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$1,035.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: Qualcare PPO/HMO/WC	$408.75
Rate for Payer: UnitedHealthcare Community & State	$86.11
Rate for Payer: Wellpoint Medicaid Managed Care	$77.39

SCREW INTERENCE 10MM X30 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684909
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 INTERENCE 10MM X30 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684909
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 INTERENCE 10 X 30 MM

Facility

$1,519.25

Hospital Charge Code	270684908
Hospital Revenue Code	278
Min. Negotiated Rate	$227.89
Max. Negotiated Rate	$367.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.66
Rate for Payer: Qualcare PPO/HMO/WC	$227.89

SCREW INTERENCE 10 X 30 MM

Facility

$1,519.25

Hospital Charge Code	270684908
Hospital Revenue Code	278
Min. Negotiated Rate	$43.15
Max. Negotiated Rate	$759.62
Rate for Payer: Aetna Commercial	$577.32
Rate for Payer: Aetna Medicare Advantage	$455.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$387.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$387.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$387.41
Rate for Payer: Cigna Commercial	$759.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$367.66
Rate for Payer: Qualcare PPO/HMO/WC	$227.89
Rate for Payer: UnitedHealthcare Community & State	$48.01
Rate for Payer: Wellpoint Medicaid Managed Care	$43.15

SCREW INTERFERENCE 10x23MM

Facility

$1,250.00

Hospital Charge Code	270675571
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW INTERFERENCE 10x23MM

Facility

$1,250.00

Hospital Charge Code	270675571
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW INTERFERENCE 11X88MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655963
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

SCREW INTERFERENCE 11X88MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655963
Hospital Revenue Code	278
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

SCREW INTERFERENCE 8x23MM

Facility

$1,250.00

Hospital Charge Code	270675569
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW INTERFERENCE 8x23MM

Facility

$1,250.00

Hospital Charge Code	270675569
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW INTERFERENCE 9x23MM

Facility

$1,250.00

Hospital Charge Code	270675570
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW INTERFERENCE 9x23MM

Facility

$1,250.00

Hospital Charge Code	270675570
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW INTERFERENCE RD 10x28MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655961
Hospital Revenue Code	278
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

SCREW INTERFERENCE RD 10x28MM

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270655961
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

SCREW INTERFRAG 3.5x30MM

Facility

$1,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270679881
Hospital Revenue Code	278
Min. Negotiated Rate	$37.91
Max. Negotiated Rate	$667.50
Rate for Payer: Aetna Commercial	$507.30
Rate for Payer: Aetna Medicare Advantage	$400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.43
Rate for Payer: Cigna Commercial	$667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Community & State	$42.19
Rate for Payer: Wellpoint Medicaid Managed Care	$37.91

SCREW INTERFRAG 3.5x30MM

Facility

$1,335.00

Service Code	HCPCS C1713
Hospital Charge Code	270679881
Hospital Revenue Code	278
Min. Negotiated Rate	$200.25
Max. Negotiated Rate	$323.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.07
Rate for Payer: Qualcare PPO/HMO/WC	$200.25

SCREW INTERFX SD DL 3.5X14

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270698832
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

Know your out-of-pocket cost for care.

All Charges