Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LKG PT T2 SHAFT 5X35MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699231
Hospital Revenue Code	278
Min. Negotiated Rate	$70.43
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$78.37
Rate for Payer: Wellpoint Medicaid Managed Care	$70.43

SCREW LKG R3CON 3.5X12MM

Facility

$841.50

Service Code	HCPCS C1713
Hospital Charge Code	270700176
Hospital Revenue Code	278
Min. Negotiated Rate	$126.22
Max. Negotiated Rate	$203.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.64
Rate for Payer: Qualcare PPO/HMO/WC	$126.22

SCREW LKG R3CON 3.5X12MM

Facility

$841.50

Service Code	HCPCS C1713
Hospital Charge Code	270700176
Hospital Revenue Code	278
Min. Negotiated Rate	$23.90
Max. Negotiated Rate	$420.75
Rate for Payer: Aetna Commercial	$319.77
Rate for Payer: Aetna Medicare Advantage	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.58
Rate for Payer: Cigna Commercial	$420.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.64
Rate for Payer: Qualcare PPO/HMO/WC	$126.22
Rate for Payer: UnitedHealthcare Community & State	$26.59
Rate for Payer: Wellpoint Medicaid Managed Care	$23.90

SCREW LKG ST 2.7x14MM

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270648481
Hospital Revenue Code	278
Min. Negotiated Rate	$49.98
Max. Negotiated Rate	$880.00
Rate for Payer: Aetna Commercial	$668.80
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.92
Rate for Payer: Qualcare PPO/HMO/WC	$264.00
Rate for Payer: UnitedHealthcare Community & State	$55.62
Rate for Payer: Wellpoint Medicaid Managed Care	$49.98

SCREW LKG ST 2.7x14MM

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270648481
Hospital Revenue Code	278
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$425.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.92
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

SCREW LKG T2 ALPHA 5.0X47.5MM

Facility

$1,570.55

Service Code	HCPCS C1713
Hospital Charge Code	270697351
Hospital Revenue Code	278
Min. Negotiated Rate	$44.60
Max. Negotiated Rate	$785.27
Rate for Payer: Aetna Commercial	$596.81
Rate for Payer: Aetna Medicare Advantage	$471.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.49
Rate for Payer: Cigna Commercial	$785.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.07
Rate for Payer: Qualcare PPO/HMO/WC	$235.58
Rate for Payer: UnitedHealthcare Community & State	$49.63
Rate for Payer: Wellpoint Medicaid Managed Care	$44.60

SCREW LKG T2 ALPHA 5.0X47.5MM

Facility

$1,570.55

Service Code	HCPCS C1713
Hospital Charge Code	270697351
Hospital Revenue Code	278
Min. Negotiated Rate	$235.58
Max. Negotiated Rate	$380.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.07
Rate for Payer: Qualcare PPO/HMO/WC	$235.58

SCREW LKG T2 ALPHA 5X27.5MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699234
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW LKG T2 ALPHA 5X27.5MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699234
Hospital Revenue Code	278
Min. Negotiated Rate	$70.43
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$78.37
Rate for Payer: Wellpoint Medicaid Managed Care	$70.43

SCREW LKG T2 ALPHA 5X37.5MM

Facility

$1,530.15

Service Code	HCPCS C1713
Hospital Charge Code	270700386
Hospital Revenue Code	278
Min. Negotiated Rate	$229.52
Max. Negotiated Rate	$370.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.30
Rate for Payer: Qualcare PPO/HMO/WC	$229.52

SCREW LKG T2 ALPHA 5X37.5MM

Facility

$1,530.15

Service Code	HCPCS C1713
Hospital Charge Code	270700386
Hospital Revenue Code	278
Min. Negotiated Rate	$43.46
Max. Negotiated Rate	$765.08
Rate for Payer: Aetna Commercial	$581.46
Rate for Payer: Aetna Medicare Advantage	$459.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.19
Rate for Payer: Cigna Commercial	$765.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.30
Rate for Payer: Qualcare PPO/HMO/WC	$229.52
Rate for Payer: UnitedHealthcare Community & State	$48.35
Rate for Payer: Wellpoint Medicaid Managed Care	$43.46

SCREW LKG T2 ALPHA 5X40MM

Facility

$1,530.15

Service Code	HCPCS C1713
Hospital Charge Code	270700451
Hospital Revenue Code	278
Min. Negotiated Rate	$43.46
Max. Negotiated Rate	$765.08
Rate for Payer: Aetna Commercial	$581.46
Rate for Payer: Aetna Medicare Advantage	$459.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.19
Rate for Payer: Cigna Commercial	$765.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.30
Rate for Payer: Qualcare PPO/HMO/WC	$229.52
Rate for Payer: UnitedHealthcare Community & State	$48.35
Rate for Payer: Wellpoint Medicaid Managed Care	$43.46

SCREW LKG T2 ALPHA 5X40MM

Facility

$1,530.15

Service Code	HCPCS C1713
Hospital Charge Code	270700451
Hospital Revenue Code	278
Min. Negotiated Rate	$229.52
Max. Negotiated Rate	$370.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.30
Rate for Payer: Qualcare PPO/HMO/WC	$229.52

SCREW LKG T2 ALPHA 5X42.5MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699235
Hospital Revenue Code	278
Min. Negotiated Rate	$70.43
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$78.37
Rate for Payer: Wellpoint Medicaid Managed Care	$70.43

SCREW LKG T2 ALPHA 5X42.5MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699235
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW LKG T2 ALPHA 5X45.0MM

Facility

$1,530.15

Service Code	HCPCS C1713
Hospital Charge Code	270700387
Hospital Revenue Code	278
Min. Negotiated Rate	$43.46
Max. Negotiated Rate	$765.08
Rate for Payer: Aetna Commercial	$581.46
Rate for Payer: Aetna Medicare Advantage	$459.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.19
Rate for Payer: Cigna Commercial	$765.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.30
Rate for Payer: Qualcare PPO/HMO/WC	$229.52
Rate for Payer: UnitedHealthcare Community & State	$48.35
Rate for Payer: Wellpoint Medicaid Managed Care	$43.46

SCREW LKG T2 ALPHA 5X45.0MM

Facility

$1,530.15

Service Code	HCPCS C1713
Hospital Charge Code	270700387
Hospital Revenue Code	278
Min. Negotiated Rate	$229.52
Max. Negotiated Rate	$370.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.30
Rate for Payer: Qualcare PPO/HMO/WC	$229.52

SCREW LKG T2 ALPHA 5X47.5MM

Facility

$4,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270698910
Hospital Revenue Code	278
Min. Negotiated Rate	$119.99
Max. Negotiated Rate	$2,112.50
Rate for Payer: Aetna Commercial	$1,605.50
Rate for Payer: Aetna Medicare Advantage	$1,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.38
Rate for Payer: Cigna Commercial	$2,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.45
Rate for Payer: Qualcare PPO/HMO/WC	$633.75
Rate for Payer: UnitedHealthcare Community & State	$133.51
Rate for Payer: Wellpoint Medicaid Managed Care	$119.99

SCREW LKG T2 ALPHA 5X47.5MM

Facility

$4,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270698910
Hospital Revenue Code	278
Min. Negotiated Rate	$633.75
Max. Negotiated Rate	$1,022.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.45
Rate for Payer: Qualcare PPO/HMO/WC	$633.75

SCREW LKG T2 ALPHA 5X65MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699236
Hospital Revenue Code	278
Min. Negotiated Rate	$70.43
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$942.40
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$78.37
Rate for Payer: Wellpoint Medicaid Managed Care	$70.43

SCREW LKG T2 ALPHA 5X65MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699236
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW LKG T6 2.0X10MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700509
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW LKG T6 2.0X10MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700509
Hospital Revenue Code	278
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$276.34
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08
Rate for Payer: UnitedHealthcare Community & State	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$20.65

SCREW LKG T6 2.0X12MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700508
Hospital Revenue Code	278
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$472.07
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34
Rate for Payer: UnitedHealthcare Community & State	$39.26
Rate for Payer: Wellpoint Medicaid Managed Care	$35.28

SCREW LKG T6 2.0X12MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700508
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

Know your out-of-pocket cost for care.

All Charges