Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCK 3.5 X 16MM 40-35616

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660372
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW LOCK 3.5 X 16MM 40-35616

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660372
Hospital Revenue Code	278
Min. Negotiated Rate	$33.51
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$448.40
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00
Rate for Payer: UnitedHealthcare Community & State	$37.29
Rate for Payer: Wellpoint Medicaid Managed Care	$33.51

SCREW LOCK 3.5 X 18MM 40-35618

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660371
Hospital Revenue Code	278
Min. Negotiated Rate	$33.51
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$448.40
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00
Rate for Payer: UnitedHealthcare Community & State	$37.29
Rate for Payer: Wellpoint Medicaid Managed Care	$33.51

SCREW LOCK 3.5 X 18MM 40-35618

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660371
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW LOCK 3.5X26MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669707
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$331.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X26MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669707
Hospital Revenue Code	278
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Community & State	$43.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38.91

SCREW LOCK 3.5X50MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669706
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$331.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X50MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669706
Hospital Revenue Code	278
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Community & State	$43.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38.91

SCREW LOCK 3.5X70MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669705
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$331.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X70MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669705
Hospital Revenue Code	278
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Community & State	$43.29
Rate for Payer: Wellpoint Medicaid Managed Care	$38.91

SCREW LOCK 4.5x14mm 27814

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270648676
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

SCREW LOCK 4.5x14mm 27814

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270648676
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW LOCK 5.5MM OPEN TULIP

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691604
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$93.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

SCREW LOCK 5.5MM OPEN TULIP

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691604
Hospital Revenue Code	278
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$146.30
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.93

SCREW LOCK FASTP 2.7MM HIGHP

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693223
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 LOCK FASTP 2.7MM HIGHP

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693223
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 LOCK FOR IM 5MM32MMXL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692415
Hospital Revenue Code	278
Min. Negotiated Rate	$133.25
Max. Negotiated Rate	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.97
Rate for Payer: Qualcare PPO/HMO/WC	$133.25

SCREW LOCK FOR IM 5MM32MMXL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692415
Hospital Revenue Code	278
Min. Negotiated Rate	$25.23
Max. Negotiated Rate	$444.15
Rate for Payer: Aetna Commercial	$337.55
Rate for Payer: Aetna Medicare Advantage	$266.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.52
Rate for Payer: Cigna Commercial	$444.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.97
Rate for Payer: Qualcare PPO/HMO/WC	$133.25
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: Wellpoint Medicaid Managed Care	$25.23

SCREW LOCK FULL THRD 5x42.5mm

Facility

$949.45

Hospital Charge Code	270673212
Hospital Revenue Code	278
Min. Negotiated Rate	$142.42
Max. Negotiated Rate	$229.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.77
Rate for Payer: Qualcare PPO/HMO/WC	$142.42

SCREW LOCK FULL THRD 5x42.5mm

Facility

$949.45

Hospital Charge Code	270673212
Hospital Revenue Code	278
Min. Negotiated Rate	$26.96
Max. Negotiated Rate	$474.73
Rate for Payer: Aetna Commercial	$360.79
Rate for Payer: Aetna Medicare Advantage	$284.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.11
Rate for Payer: Cigna Commercial	$474.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.77
Rate for Payer: Qualcare PPO/HMO/WC	$142.42
Rate for Payer: UnitedHealthcare Community & State	$30.00
Rate for Payer: Wellpoint Medicaid Managed Care	$26.96

SCREW LOCKG LO PRO 2.4MMX16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270668415
Hospital Revenue Code	278
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Community & State	$17.38
Rate for Payer: Wellpoint Medicaid Managed Care	$15.62

SCREW LOCKG LO PRO 2.4MMX16MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270668415
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW LOCK HEXALOBE 3.5X10MM

Facility

$710.00

Service Code	HCPCS C1713
Hospital Charge Code	270668127
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$171.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.82
Rate for Payer: Qualcare PPO/HMO/WC	$106.50

SCREW LOCK HEXALOBE 3.5X10MM

Facility

$710.00

Service Code	HCPCS C1713
Hospital Charge Code	270668127
Hospital Revenue Code	278
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$355.00
Rate for Payer: Aetna Commercial	$269.80
Rate for Payer: Aetna Medicare Advantage	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.05
Rate for Payer: Cigna Commercial	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.82
Rate for Payer: Qualcare PPO/HMO/WC	$106.50
Rate for Payer: UnitedHealthcare Community & State	$22.44
Rate for Payer: Wellpoint Medicaid Managed Care	$20.16

SCREW LOCKING 10 MM X 2.4 MM

Facility

$1,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270683984
Hospital Revenue Code	278
Min. Negotiated Rate	$162.75
Max. Negotiated Rate	$262.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.57
Rate for Payer: Qualcare PPO/HMO/WC	$162.75

Know your out-of-pocket cost for care.

All Charges