Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LAG Z NAIL 10.5 X 90

Facility

$2,810.00

Hospital Charge Code	270666935
Hospital Revenue Code	278
Min. Negotiated Rate	$421.50
Max. Negotiated Rate	$680.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.02
Rate for Payer: Qualcare PPO/HMO/WC	$421.50

SCREW LAG Z NAIL 10.5 X 90

Facility

$2,810.00

Hospital Charge Code	270666935
Hospital Revenue Code	278
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$1,405.00
Rate for Payer: Aetna Commercial	$1,067.80
Rate for Payer: Aetna Medicare Advantage	$843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$716.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$716.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$716.55
Rate for Payer: Cigna Commercial	$1,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.02
Rate for Payer: Qualcare PPO/HMO/WC	$421.50
Rate for Payer: UnitedHealthcare Community & State	$88.80
Rate for Payer: Wellpoint Medicaid Managed Care	$79.80

SCREW LAPIP 2.0 MM SNAP OFF

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270695086
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 LAPIP 2.0 MM SNAP OFF

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270695086
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 LAPIPLASTY 4.0 FT32/36MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699776
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

SCREW LAPIPLASTY 4.0 FT32/36MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699776
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW LAPIPLASTY FT4.0 38/42MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699902
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

SCREW LAPIPLASTY FT4.0 38/42MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699902
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW LAPIPLASTY HDLSS 2.5MM

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700186
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 LAPIPLASTY HDLSS 2.5MM

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700186
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 LATERNAL 5X30MM

Facility

$2,800.00

Hospital Charge Code	270703552
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW LATERNAL 5X30MM

Facility

$2,800.00

Hospital Charge Code	270703552
Hospital Revenue Code	278
Min. Negotiated Rate	$79.52
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$1,064.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Community & State	$88.48
Rate for Payer: Wellpoint Medicaid Managed Care	$79.52

SCREW LCK 4.2 X 18

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	270701483
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

SCREW LCK 4.2 X 18

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	270701483
Hospital Revenue Code	278
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$261.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$21.73
Rate for Payer: Wellpoint Medicaid Managed Care	$19.52

SCREW LCK CAP KIT 4.5X18MM WHT

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668556
Hospital Revenue Code	278
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

SCREW LCK CAP KIT 4.5X18MM WHT

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668556
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW LCK CAP KIT 4.5X26MM ORG

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668551
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$145.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCK CAP KIT 4.5X26MM ORG

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668551
Hospital Revenue Code	278
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$228.61
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24
Rate for Payer: UnitedHealthcare Community & State	$19.01
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

SCREW LCK CAP KIT 4.5X30MM BLU

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668554
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$145.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCK CAP KIT 4.5X30MM BLU

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668554
Hospital Revenue Code	278
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$228.61
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24
Rate for Payer: UnitedHealthcare Community & State	$19.01
Rate for Payer: Wellpoint Medicaid Managed Care	$17.09

SCREW LCKG 2.0 X 12

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688181
Hospital Revenue Code	278
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$194.64
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83
Rate for Payer: UnitedHealthcare Community & State	$16.19
Rate for Payer: Wellpoint Medicaid Managed Care	$14.55

SCREW LCKG 2.0 X 12

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688181
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$123.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 2.0 X 14

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688182
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$123.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 2.0 X 14

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688182
Hospital Revenue Code	278
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$194.64
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83
Rate for Payer: UnitedHealthcare Community & State	$16.19
Rate for Payer: Wellpoint Medicaid Managed Care	$14.55

SCREW LCKG 525 STR DRV 5x40MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660156
Hospital Revenue Code	278
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$30.98
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

Know your out-of-pocket cost for care.

All Charges