Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING FULLY THD 5X65MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270669248
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

SCREW LOCKING FULLY THD 5X65MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270669248
Hospital Revenue Code	278
Min. Negotiated Rate	$39.76
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$44.24
Rate for Payer: Wellpoint Medicaid Managed Care	$39.76

SCREW LOCKING FULLY THD 5x80MM

Facility

$1,970.00

Service Code	HCPCS C1713
Hospital Charge Code	270672000
Hospital Revenue Code	278
Min. Negotiated Rate	$55.95
Max. Negotiated Rate	$985.00
Rate for Payer: Aetna Commercial	$748.60
Rate for Payer: Aetna Medicare Advantage	$591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$502.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$502.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$502.35
Rate for Payer: Cigna Commercial	$985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.74
Rate for Payer: Qualcare PPO/HMO/WC	$295.50
Rate for Payer: UnitedHealthcare Community & State	$62.25
Rate for Payer: Wellpoint Medicaid Managed Care	$55.95

SCREW LOCKING FULLY THD 5x80MM

Facility

$1,970.00

Service Code	HCPCS C1713
Hospital Charge Code	270672000
Hospital Revenue Code	278
Min. Negotiated Rate	$295.50
Max. Negotiated Rate	$476.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.74
Rate for Payer: Qualcare PPO/HMO/WC	$295.50

SCREW LOCKING FULLY THD 5x90MM

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270674282
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$355.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: Qualcare PPO/HMO/WC	$220.50

SCREW LOCKING FULLY THD 5x90MM

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270674282
Hospital Revenue Code	278
Min. Negotiated Rate	$41.75
Max. Negotiated Rate	$735.00
Rate for Payer: Aetna Commercial	$558.60
Rate for Payer: Aetna Medicare Advantage	$441.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.85
Rate for Payer: Cigna Commercial	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: Qualcare PPO/HMO/WC	$220.50
Rate for Payer: UnitedHealthcare Community & State	$46.45
Rate for Payer: Wellpoint Medicaid Managed Care	$41.75

SCREW LOCKING FULLY THREADED

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270661245
Hospital Revenue Code	278
Min. Negotiated Rate	$27.82
Max. Negotiated Rate	$489.73
Rate for Payer: Aetna Commercial	$372.19
Rate for Payer: Aetna Medicare Advantage	$293.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.76
Rate for Payer: Cigna Commercial	$489.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: Qualcare PPO/HMO/WC	$146.92
Rate for Payer: UnitedHealthcare Community & State	$30.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW LOCKING FULLY THREADED

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270661245
Hospital Revenue Code	278
Min. Negotiated Rate	$146.92
Max. Negotiated Rate	$237.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: Qualcare PPO/HMO/WC	$146.92

SCREW LOCKING FULLY THREADED 5

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270656558
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

SCREW LOCKING FULLY THREADED 5

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270656558
Hospital Revenue Code	278
Min. Negotiated Rate	$39.76
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$44.24
Rate for Payer: Wellpoint Medicaid Managed Care	$39.76

SCREW LOCKING FUL THD 5X37.5MM

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270648352
Hospital Revenue Code	278
Min. Negotiated Rate	$27.82
Max. Negotiated Rate	$489.73
Rate for Payer: Aetna Commercial	$372.19
Rate for Payer: Aetna Medicare Advantage	$293.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.76
Rate for Payer: Cigna Commercial	$489.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: Qualcare PPO/HMO/WC	$146.92
Rate for Payer: UnitedHealthcare Community & State	$30.95
Rate for Payer: Wellpoint Medicaid Managed Care	$27.82

SCREW LOCKING FUL THD 5X37.5MM

Facility

$979.45

Service Code	HCPCS C1713
Hospital Charge Code	270648352
Hospital Revenue Code	278
Min. Negotiated Rate	$146.92
Max. Negotiated Rate	$237.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.03
Rate for Payer: Qualcare PPO/HMO/WC	$146.92

SCREW LOCKING GLENOSPHERE

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668555
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW LOCKING GLENOSPHERE

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270668555
Hospital Revenue Code	278
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

SCREW LOCKING HEX 3.5x20MM

Facility

$1,120.00

Hospital Charge Code	270656792
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

SCREW LOCKING HEX 3.5x20MM

Facility

$1,120.00

Hospital Charge Code	270656792
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING HEX 3.5x24MM

Facility

$1,120.00

Hospital Charge Code	270656793
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

SCREW LOCKING HEX 3.5x24MM

Facility

$1,120.00

Hospital Charge Code	270656793
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING LG HD 2.7x16MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270680849
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING LG HD 2.7x16MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270680849
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

SCREW LOCKING LG HD 2.7x18MM

Facility

$1,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270662456
Hospital Revenue Code	278
Min. Negotiated Rate	$34.36
Max. Negotiated Rate	$605.00
Rate for Payer: Aetna Commercial	$459.80
Rate for Payer: Aetna Medicare Advantage	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.55
Rate for Payer: Cigna Commercial	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.82
Rate for Payer: Qualcare PPO/HMO/WC	$181.50
Rate for Payer: UnitedHealthcare Community & State	$38.24
Rate for Payer: Wellpoint Medicaid Managed Care	$34.36

SCREW LOCKING LG HD 2.7x18MM

Facility

$1,210.00

Service Code	HCPCS C1713
Hospital Charge Code	270662456
Hospital Revenue Code	278
Min. Negotiated Rate	$181.50
Max. Negotiated Rate	$292.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.82
Rate for Payer: Qualcare PPO/HMO/WC	$181.50

SCREW LOCKING LG HD 2.7x20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270662457
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

SCREW LOCKING LG HD 2.7x20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270662457
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW LOCKING LG HD 2.7x22MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270683759
Hospital Revenue Code	278
Min. Negotiated Rate	$31.81
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$425.60
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Community & State	$35.39
Rate for Payer: Wellpoint Medicaid Managed Care	$31.81

Know your out-of-pocket cost for care.

All Charges