Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING CANN 5.0x90mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270628188
Hospital Revenue Code	278
Min. Negotiated Rate	$23.69
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$26.36
Rate for Payer: Wellpoint Medicaid Managed Care	$23.69

SCREW LOCKING CANN 7.3MM 100MM

Facility

$1,264.30

Service Code	HCPCS C1713
Hospital Charge Code	270689706
Hospital Revenue Code	278
Min. Negotiated Rate	$189.65
Max. Negotiated Rate	$305.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.96
Rate for Payer: Qualcare PPO/HMO/WC	$189.65

SCREW LOCKING CANN 7.3MM 100MM

Facility

$1,264.30

Service Code	HCPCS C1713
Hospital Charge Code	270689706
Hospital Revenue Code	278
Min. Negotiated Rate	$35.91
Max. Negotiated Rate	$632.15
Rate for Payer: Aetna Commercial	$480.43
Rate for Payer: Aetna Medicare Advantage	$379.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.40
Rate for Payer: Cigna Commercial	$632.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.96
Rate for Payer: Qualcare PPO/HMO/WC	$189.65
Rate for Payer: UnitedHealthcare Community & State	$39.95
Rate for Payer: Wellpoint Medicaid Managed Care	$35.91

SCREW LOCKING CANN 7.3MM 105MM

Facility

$1,264.30

Service Code	HCPCS C1713
Hospital Charge Code	270689707
Hospital Revenue Code	278
Min. Negotiated Rate	$189.65
Max. Negotiated Rate	$305.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.96
Rate for Payer: Qualcare PPO/HMO/WC	$189.65

SCREW LOCKING CANN 7.3MM 105MM

Facility

$1,264.30

Service Code	HCPCS C1713
Hospital Charge Code	270689707
Hospital Revenue Code	278
Min. Negotiated Rate	$35.91
Max. Negotiated Rate	$632.15
Rate for Payer: Aetna Commercial	$480.43
Rate for Payer: Aetna Medicare Advantage	$379.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.40
Rate for Payer: Cigna Commercial	$632.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.96
Rate for Payer: Qualcare PPO/HMO/WC	$189.65
Rate for Payer: UnitedHealthcare Community & State	$39.95
Rate for Payer: Wellpoint Medicaid Managed Care	$35.91

SCREW LOCKING CANN 7.3 MM 20 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689702
Hospital Revenue Code	278
Min. Negotiated Rate	$186.12
Max. Negotiated Rate	$300.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12

SCREW LOCKING CANN 7.3 MM 20 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689702
Hospital Revenue Code	278
Min. Negotiated Rate	$35.24
Max. Negotiated Rate	$620.40
Rate for Payer: Aetna Commercial	$471.50
Rate for Payer: Aetna Medicare Advantage	$372.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.40
Rate for Payer: Cigna Commercial	$620.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12
Rate for Payer: UnitedHealthcare Community & State	$39.21
Rate for Payer: Wellpoint Medicaid Managed Care	$35.24

SCREW LOCKING CANN 7.3 MM 25 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689703
Hospital Revenue Code	278
Min. Negotiated Rate	$186.12
Max. Negotiated Rate	$300.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12

SCREW LOCKING CANN 7.3 MM 25 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689703
Hospital Revenue Code	278
Min. Negotiated Rate	$35.24
Max. Negotiated Rate	$620.40
Rate for Payer: Aetna Commercial	$471.50
Rate for Payer: Aetna Medicare Advantage	$372.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.40
Rate for Payer: Cigna Commercial	$620.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12
Rate for Payer: UnitedHealthcare Community & State	$39.21
Rate for Payer: Wellpoint Medicaid Managed Care	$35.24

SCREW LOCKING CANN 7.3 MM 30 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689704
Hospital Revenue Code	278
Min. Negotiated Rate	$35.24
Max. Negotiated Rate	$620.40
Rate for Payer: Aetna Commercial	$471.50
Rate for Payer: Aetna Medicare Advantage	$372.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.40
Rate for Payer: Cigna Commercial	$620.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12
Rate for Payer: UnitedHealthcare Community & State	$39.21
Rate for Payer: Wellpoint Medicaid Managed Care	$35.24

SCREW LOCKING CANN 7.3 MM 30 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689704
Hospital Revenue Code	278
Min. Negotiated Rate	$186.12
Max. Negotiated Rate	$300.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12

SCREW LOCKING CANN 7.3 MM 65 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689705
Hospital Revenue Code	278
Min. Negotiated Rate	$35.24
Max. Negotiated Rate	$620.40
Rate for Payer: Aetna Commercial	$471.50
Rate for Payer: Aetna Medicare Advantage	$372.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.40
Rate for Payer: Cigna Commercial	$620.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12
Rate for Payer: UnitedHealthcare Community & State	$39.21
Rate for Payer: Wellpoint Medicaid Managed Care	$35.24

SCREW LOCKING CANN 7.3 MM 65 M

Facility

$1,240.80

Service Code	HCPCS C1713
Hospital Charge Code	270689705
Hospital Revenue Code	278
Min. Negotiated Rate	$186.12
Max. Negotiated Rate	$300.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.12

SCREW LOCKING CANNUL 5.0MMX55

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689700
Hospital Revenue Code	278
Min. Negotiated Rate	$23.69
Max. Negotiated Rate	$417.12
Rate for Payer: Aetna Commercial	$317.01
Rate for Payer: Aetna Medicare Advantage	$250.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.73
Rate for Payer: Cigna Commercial	$417.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$26.36
Rate for Payer: Wellpoint Medicaid Managed Care	$23.69

SCREW LOCKING CANNUL 5.0MMX55

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689700
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW LOCKING CANNUL 5.0MMX60

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689701
Hospital Revenue Code	278
Min. Negotiated Rate	$23.69
Max. Negotiated Rate	$417.12
Rate for Payer: Aetna Commercial	$317.01
Rate for Payer: Aetna Medicare Advantage	$250.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.73
Rate for Payer: Cigna Commercial	$417.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$26.36
Rate for Payer: Wellpoint Medicaid Managed Care	$23.69

SCREW LOCKING CANNUL 5.0MMX60

Facility

$834.25

Service Code	HCPCS C1713
Hospital Charge Code	270689701
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.89
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW LOCKING CANNULATED 40

Facility

$1,203.00

Hospital Charge Code	270661929
Hospital Revenue Code	278
Min. Negotiated Rate	$34.17
Max. Negotiated Rate	$601.50
Rate for Payer: Aetna Commercial	$457.14
Rate for Payer: Aetna Medicare Advantage	$360.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.76
Rate for Payer: Cigna Commercial	$601.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: Qualcare PPO/HMO/WC	$180.45
Rate for Payer: UnitedHealthcare Community & State	$38.01
Rate for Payer: Wellpoint Medicaid Managed Care	$34.17

SCREW LOCKING CANNULATED 40

Facility

$1,203.00

Hospital Charge Code	270661929
Hospital Revenue Code	278
Min. Negotiated Rate	$180.45
Max. Negotiated Rate	$291.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.13
Rate for Payer: Qualcare PPO/HMO/WC	$180.45

SCREW LOCKING CANN VA 5x60MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663324
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$30.73

SCREW LOCKING CANN VA 5x60MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663324
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW LOCKING CANN VA 5x70MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663325
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW LOCKING CANN VA 5x70MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270663325
Hospital Revenue Code	278
Min. Negotiated Rate	$30.73
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$411.20
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31
Rate for Payer: UnitedHealthcare Community & State	$34.19
Rate for Payer: Wellpoint Medicaid Managed Care	$30.73

SCREW LOCKING CANN VA 5x85MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270663327
Hospital Revenue Code	278
Min. Negotiated Rate	$28.97
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$32.23
Rate for Payer: Wellpoint Medicaid Managed Care	$28.97

SCREW LOCKING CANN VA 5x85MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270663327
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

Know your out-of-pocket cost for care.

All Charges