Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG T25 STR DRV 5x58MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671811
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 5x62MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675113
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 5x62MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675113
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 5x66MM

Facility

$965.85

Service Code	HCPCS C1713
Hospital Charge Code	270688214
Hospital Revenue Code	278
Min. Negotiated Rate	$144.88
Max. Negotiated Rate	$233.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.74
Rate for Payer: Qualcare PPO/HMO/WC	$144.88

SCREW LCKG T25 STR DRV 5x66MM

Facility

$965.85

Service Code	HCPCS C1713
Hospital Charge Code	270688214
Hospital Revenue Code	278
Min. Negotiated Rate	$27.43
Max. Negotiated Rate	$482.93
Rate for Payer: Aetna Commercial	$367.02
Rate for Payer: Aetna Medicare Advantage	$289.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.29
Rate for Payer: Cigna Commercial	$482.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.74
Rate for Payer: Qualcare PPO/HMO/WC	$144.88
Rate for Payer: UnitedHealthcare Community & State	$30.52
Rate for Payer: Wellpoint Medicaid Managed Care	$27.43

SCREW LCKG T25 STR DRV 5x72MM

Facility

$924.00

Hospital Charge Code	270677440
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 5x72MM

Facility

$924.00

Hospital Charge Code	270677440
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 5x85MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270680078
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 5x85MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270680078
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 LCKNG CAP KIT 4.5x46MM P

Facility

$547.85

Service Code	HCPCS C1713
Hospital Charge Code	270684300
Hospital Revenue Code	278
Min. Negotiated Rate	$15.56
Max. Negotiated Rate	$273.93
Rate for Payer: Aetna Commercial	$208.18
Rate for Payer: Aetna Medicare Advantage	$164.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.70
Rate for Payer: Cigna Commercial	$273.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.18
Rate for Payer: UnitedHealthcare Community & State	$17.31
Rate for Payer: Wellpoint Medicaid Managed Care	$15.56

SCREW LCKNG CAP KIT 4.5x46MM P

Facility

$547.85

Service Code	HCPCS C1713
Hospital Charge Code	270684300
Hospital Revenue Code	278
Min. Negotiated Rate	$82.18
Max. Negotiated Rate	$132.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.18

SCREW LCKNG SLF TAP 2.7x10MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648480
Hospital Revenue Code	278
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$150.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

SCREW LCKNG SLF TAP 2.7x10MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648480
Hospital Revenue Code	278
Min. Negotiated Rate	$17.72
Max. Negotiated Rate	$311.90
Rate for Payer: Aetna Commercial	$237.04
Rate for Payer: Aetna Medicare Advantage	$187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.07
Rate for Payer: Cigna Commercial	$311.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.57
Rate for Payer: UnitedHealthcare Community & State	$19.71
Rate for Payer: Wellpoint Medicaid Managed Care	$17.72

SCREW LCKNG SLF TAP 2.7x8MM

Facility

$605.65

Service Code	HCPCS C1713
Hospital Charge Code	270664150
Hospital Revenue Code	278
Min. Negotiated Rate	$90.85
Max. Negotiated Rate	$146.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.57
Rate for Payer: Qualcare PPO/HMO/WC	$90.85

SCREW LCKNG SLF TAP 2.7x8MM

Facility

$605.65

Service Code	HCPCS C1713
Hospital Charge Code	270664150
Hospital Revenue Code	278
Min. Negotiated Rate	$17.20
Max. Negotiated Rate	$302.82
Rate for Payer: Aetna Commercial	$230.15
Rate for Payer: Aetna Medicare Advantage	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.44
Rate for Payer: Cigna Commercial	$302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.57
Rate for Payer: Qualcare PPO/HMO/WC	$90.85
Rate for Payer: UnitedHealthcare Community & State	$19.14
Rate for Payer: Wellpoint Medicaid Managed Care	$17.20

SCREW LCKNG T25 4.0x26mm TI

Facility

$888.00

Hospital Charge Code	270662827
Hospital Revenue Code	278
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$337.44
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.20
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

SCREW LCKNG T25 4.0x26mm TI

Facility

$888.00

Hospital Charge Code	270662827
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$214.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

SCREW LCKNG T25 4.0x40mm TI

Facility

$888.00

Hospital Charge Code	270662825
Hospital Revenue Code	278
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$444.00
Rate for Payer: Aetna Commercial	$337.44
Rate for Payer: Aetna Medicare Advantage	$266.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.44
Rate for Payer: Cigna Commercial	$444.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.20
Rate for Payer: UnitedHealthcare Community & State	$28.06
Rate for Payer: Wellpoint Medicaid Managed Care	$25.22

SCREW LCKNG T25 4.0x40mm TI

Facility

$888.00

Hospital Charge Code	270662825
Hospital Revenue Code	278
Min. Negotiated Rate	$133.20
Max. Negotiated Rate	$214.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.90
Rate for Payer: Qualcare PPO/HMO/WC	$133.20

SCREW LCK SQR 2.7MMX 15MM

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270699270
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW LCK SQR 2.7MMX 15MM

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270699270
Hospital Revenue Code	278
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

SCREW LCK SQR 2.7MMX 20MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270699267
Hospital Revenue Code	278
Min. Negotiated Rate	$27.83
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$372.40
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Community & State	$30.97
Rate for Payer: Wellpoint Medicaid Managed Care	$27.83

SCREW LCK SQR 2.7MMX 20MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270699267
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

SCREW LCK SQU 2.7 MMX10 MM

Facility

$825.00

Hospital Charge Code	270702389
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW LCK SQU 2.7 MMX10 MM

Facility

$825.00

Hospital Charge Code	270702389
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

Know your out-of-pocket cost for care.

All Charges