Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING SLF TAP 5x30MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637875
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING SLF TAP 5x30MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637875
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x34MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637874
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x34MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637874
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING SLF TAP 5x36MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641549
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING SLF TAP 5x36MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641549
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x38MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637793
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING SLF TAP 5x38MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637793
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x40MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637876
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING SLF TAP 5x40MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270637876
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x44MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641548
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING SLF TAP 5x44MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641548
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x46MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641545
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

SCREW LOCKING SLF TAP 5x46MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270641545
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

SCREW LOCKING S/TAP 2.0x13MM

Facility

$474.00

Hospital Charge Code	270676297
Hospital Revenue Code	278
Min. Negotiated Rate	$13.46
Max. Negotiated Rate	$237.00
Rate for Payer: Aetna Commercial	$180.12
Rate for Payer: Aetna Medicare Advantage	$142.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.87
Rate for Payer: Cigna Commercial	$237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.71
Rate for Payer: Qualcare PPO/HMO/WC	$71.10
Rate for Payer: UnitedHealthcare Community & State	$14.98
Rate for Payer: Wellpoint Medicaid Managed Care	$13.46

SCREW LOCKING S/TAP 2.0x13MM

Facility

$474.00

Hospital Charge Code	270676297
Hospital Revenue Code	278
Min. Negotiated Rate	$71.10
Max. Negotiated Rate	$114.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.71
Rate for Payer: Qualcare PPO/HMO/WC	$71.10

SCREW LOCKING S/TAP 3.0x14 mm

Facility

$487.50

Hospital Charge Code	270671852
Hospital Revenue Code	278
Min. Negotiated Rate	$73.12
Max. Negotiated Rate	$117.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$73.12

SCREW LOCKING S/TAP 3.0x14 mm

Facility

$487.50

Hospital Charge Code	270671852
Hospital Revenue Code	278
Min. Negotiated Rate	$13.85
Max. Negotiated Rate	$243.75
Rate for Payer: Aetna Commercial	$185.25
Rate for Payer: Aetna Medicare Advantage	$146.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.31
Rate for Payer: Cigna Commercial	$243.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$73.12
Rate for Payer: UnitedHealthcare Community & State	$15.40
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

SCREW LOCKING S/TAP 3.0x16mm

Facility

$487.50

Hospital Charge Code	270671854
Hospital Revenue Code	278
Min. Negotiated Rate	$13.85
Max. Negotiated Rate	$243.75
Rate for Payer: Aetna Commercial	$185.25
Rate for Payer: Aetna Medicare Advantage	$146.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.31
Rate for Payer: Cigna Commercial	$243.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$73.12
Rate for Payer: UnitedHealthcare Community & State	$15.40
Rate for Payer: Wellpoint Medicaid Managed Care	$13.85

SCREW LOCKING S/TAP 3.0x16mm

Facility

$487.50

Hospital Charge Code	270671854
Hospital Revenue Code	278
Min. Negotiated Rate	$73.12
Max. Negotiated Rate	$117.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$73.12

SCREW LOCKING S/TAP 3.0x18mm

Facility

$655.00

Hospital Charge Code	270671855
Hospital Revenue Code	278
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$248.90
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Community & State	$20.70
Rate for Payer: Wellpoint Medicaid Managed Care	$18.60

SCREW LOCKING S/TAP 3.0x18mm

Facility

$655.00

Hospital Charge Code	270671855
Hospital Revenue Code	278
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$158.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

SCREW LOCKING S/TAP 3.5x 16mm

Facility

$877.50

Service Code	HCPCS C1713
Hospital Charge Code	270648604
Hospital Revenue Code	278
Min. Negotiated Rate	$131.62
Max. Negotiated Rate	$212.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.35
Rate for Payer: Qualcare PPO/HMO/WC	$131.62

SCREW LOCKING S/TAP 3.5x 16mm

Facility

$877.50

Service Code	HCPCS C1713
Hospital Charge Code	270648604
Hospital Revenue Code	278
Min. Negotiated Rate	$24.92
Max. Negotiated Rate	$438.75
Rate for Payer: Aetna Commercial	$333.45
Rate for Payer: Aetna Medicare Advantage	$263.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.76
Rate for Payer: Cigna Commercial	$438.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.35
Rate for Payer: Qualcare PPO/HMO/WC	$131.62
Rate for Payer: UnitedHealthcare Community & State	$27.73
Rate for Payer: Wellpoint Medicaid Managed Care	$24.92

SCREW LOCKING STAR 3.5x52MM

Facility

$519.00

Hospital Charge Code	270657131
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

Know your out-of-pocket cost for care.

All Charges