Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG 525 STR DRV 5x40MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660156
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LCKG SLF-TAP T4 1.3x16M

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683578
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF-TAP T4 1.3x16M

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683578
Hospital Revenue Code	278
Min. Negotiated Rate	$13.43
Max. Negotiated Rate	$236.38
Rate for Payer: Aetna Commercial	$179.65
Rate for Payer: Aetna Medicare Advantage	$141.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.55
Rate for Payer: Cigna Commercial	$236.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: Wellpoint Medicaid Managed Care	$13.43

SCREW LCKG SLF-TAP T4 1.3x18

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683579
Hospital Revenue Code	278
Min. Negotiated Rate	$13.43
Max. Negotiated Rate	$236.38
Rate for Payer: Aetna Commercial	$179.65
Rate for Payer: Aetna Medicare Advantage	$141.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.55
Rate for Payer: Cigna Commercial	$236.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: Wellpoint Medicaid Managed Care	$13.43

SCREW LCKG SLF-TAP T4 1.3x18

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683579
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF TPNG

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270660646
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW LCKG SLF TPNG

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270660646
Hospital Revenue Code	278
Min. Negotiated Rate	$14.74
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$197.22
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Community & State	$16.40
Rate for Payer: Wellpoint Medicaid Managed Care	$14.74

SCREW LCKG S/TPNG 4.0x22MM

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270646169
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$148.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: Qualcare PPO/HMO/WC	$91.77

SCREW LCKG S/TPNG 4.0x22MM

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270646169
Hospital Revenue Code	278
Min. Negotiated Rate	$17.38
Max. Negotiated Rate	$305.90
Rate for Payer: Aetna Commercial	$232.48
Rate for Payer: Aetna Medicare Advantage	$183.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.01
Rate for Payer: Cigna Commercial	$305.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: Qualcare PPO/HMO/WC	$91.77
Rate for Payer: UnitedHealthcare Community & State	$19.33
Rate for Payer: Wellpoint Medicaid Managed Care	$17.38

SCREW LCKG S/TPPNG 5.0x10MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648922
Hospital Revenue Code	278
Min. Negotiated Rate	$25.63
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$342.87
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34
Rate for Payer: UnitedHealthcare Community & State	$28.51
Rate for Payer: Wellpoint Medicaid Managed Care	$25.63

SCREW LCKG S/TPPNG 5.0x10MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648922
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x12MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648923
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x12MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648923
Hospital Revenue Code	278
Min. Negotiated Rate	$25.63
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$342.87
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34
Rate for Payer: UnitedHealthcare Community & State	$28.51
Rate for Payer: Wellpoint Medicaid Managed Care	$25.63

SCREW LCKG S/TPPNG 5.0x8MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648921
Hospital Revenue Code	278
Min. Negotiated Rate	$25.63
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$342.87
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34
Rate for Payer: UnitedHealthcare Community & State	$28.51
Rate for Payer: Wellpoint Medicaid Managed Care	$25.63

SCREW LCKG S/TPPNG 5.0x8MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648921
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG T25 STR DRV 4x24MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270637803
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LCKG T25 STR DRV 4x24MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270637803
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

SCREW LCKG T25 STR DRV 4x26MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679776
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW LCKG T25 STR DRV 4x26MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679776
Hospital Revenue Code	278
Min. Negotiated Rate	$21.24
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$284.16
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17
Rate for Payer: UnitedHealthcare Community & State	$23.63
Rate for Payer: Wellpoint Medicaid Managed Care	$21.24

SCREW LCKG T25 STR DRV 4x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270637804
Hospital Revenue Code	278
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$30.07
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

SCREW LCKG T25 STR DRV 4x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270637804
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SCREW LCKG T25 STR DRV 4x30MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679775
Hospital Revenue Code	278
Min. Negotiated Rate	$21.24
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$284.16
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17
Rate for Payer: UnitedHealthcare Community & State	$23.63
Rate for Payer: Wellpoint Medicaid Managed Care	$21.24

SCREW LCKG T25 STR DRV 4x30MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270650155
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

SCREW LCKG T25 STR DRV 4x30MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270679775
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW LCKG T25 STR DRV 4x30MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270650155
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

Know your out-of-pocket cost for care.

All Charges