Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG T25 STR DRV 4x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270647423
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 4x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270647423
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 4x34MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270659942
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 4x34MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270659942
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 4x44MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270647421
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 4x44MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270647421
Hospital Revenue Code	278
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$29.20
Rate for Payer: Wellpoint Medicaid Managed Care	$26.24

SCREW LCKG T25 STR DRV 4x48MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270647422
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 4x48MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270647422
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 4x52MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270680672
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 4x52MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270680672
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 5x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270661555
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 5x28MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270661555
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 5x30MM

Facility

$726.00

Service Code	HCPCS C1713
Hospital Charge Code	270646673
Hospital Revenue Code	278
Min. Negotiated Rate	$108.90
Max. Negotiated Rate	$175.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.69
Rate for Payer: Qualcare PPO/HMO/WC	$108.90

SCREW LCKG T25 STR DRV 5x30MM

Facility

$726.00

Service Code	HCPCS C1713
Hospital Charge Code	270646673
Hospital Revenue Code	278
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$363.00
Rate for Payer: Aetna Commercial	$275.88
Rate for Payer: Aetna Medicare Advantage	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.13
Rate for Payer: Cigna Commercial	$363.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.69
Rate for Payer: Qualcare PPO/HMO/WC	$108.90
Rate for Payer: UnitedHealthcare Community & State	$22.94
Rate for Payer: Wellpoint Medicaid Managed Care	$20.62

SCREW LCKG T25 STR DRV 5x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270646671
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 5x32MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270646671
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 5x36MM

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646672
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

SCREW LCKG T25 STR DRV 5x36MM

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646672
Hospital Revenue Code	278
Min. Negotiated Rate	$94.43
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$1,263.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75
Rate for Payer: UnitedHealthcare Community & State	$105.07
Rate for Payer: Wellpoint Medicaid Managed Care	$94.43

SCREW LCKG T25 STR DRV 5x38MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660153
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 5x38MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660153
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 5x42MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270645685
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 5x42MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270645685
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 5X48MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270676404
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 5X48MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270676404
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 5x58MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671811
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

Know your out-of-pocket cost for care.

All Charges