Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING TI 4x42MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673952
Hospital Revenue Code	278
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$39.66
Rate for Payer: Wellpoint Medicaid Managed Care	$35.64

SCREW LOCKING TI 4x42MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673952
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x60MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674962
Hospital Revenue Code	278
Min. Negotiated Rate	$139.08
Max. Negotiated Rate	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: Qualcare PPO/HMO/WC	$139.08

SCREW LOCKING TI 4x60MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674962
Hospital Revenue Code	278
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$463.60
Rate for Payer: Aetna Commercial	$352.34
Rate for Payer: Aetna Medicare Advantage	$278.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.44
Rate for Payer: Cigna Commercial	$463.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: Qualcare PPO/HMO/WC	$139.08
Rate for Payer: UnitedHealthcare Community & State	$29.30
Rate for Payer: Wellpoint Medicaid Managed Care	$26.33

SCREW LOCKING TI 4x65MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674961
Hospital Revenue Code	278
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$463.60
Rate for Payer: Aetna Commercial	$352.34
Rate for Payer: Aetna Medicare Advantage	$278.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.44
Rate for Payer: Cigna Commercial	$463.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: Qualcare PPO/HMO/WC	$139.08
Rate for Payer: UnitedHealthcare Community & State	$29.30
Rate for Payer: Wellpoint Medicaid Managed Care	$26.33

SCREW LOCKING TI 4x65MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674961
Hospital Revenue Code	278
Min. Negotiated Rate	$139.08
Max. Negotiated Rate	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: Qualcare PPO/HMO/WC	$139.08

SCREW LOCKING TI 4x70MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674960
Hospital Revenue Code	278
Min. Negotiated Rate	$26.33
Max. Negotiated Rate	$463.60
Rate for Payer: Aetna Commercial	$352.34
Rate for Payer: Aetna Medicare Advantage	$278.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.44
Rate for Payer: Cigna Commercial	$463.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: Qualcare PPO/HMO/WC	$139.08
Rate for Payer: UnitedHealthcare Community & State	$29.30
Rate for Payer: Wellpoint Medicaid Managed Care	$26.33

SCREW LOCKING TI 4x70MM

Facility

$927.20

Service Code	HCPCS C1713
Hospital Charge Code	270674960
Hospital Revenue Code	278
Min. Negotiated Rate	$139.08
Max. Negotiated Rate	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.38
Rate for Payer: Qualcare PPO/HMO/WC	$139.08

SCREW LOCKING TI 4x80MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673950
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x80MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673950
Hospital Revenue Code	278
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$39.66
Rate for Payer: Wellpoint Medicaid Managed Care	$35.64

SCREW LOCKING TI 4x85MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673949
Hospital Revenue Code	278
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$39.66
Rate for Payer: Wellpoint Medicaid Managed Care	$35.64

SCREW LOCKING TI 4x85MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673949
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 4x90MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673948
Hospital Revenue Code	278
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$476.90
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Community & State	$39.66
Rate for Payer: Wellpoint Medicaid Managed Care	$35.64

SCREW LOCKING TI 4x90MM

Facility

$1,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270673948
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SCREW LOCKING TI 5.0x32MM

Facility

$945.00

Hospital Charge Code	270665915
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW LOCKING TI 5.0x32MM

Facility

$945.00

Hospital Charge Code	270665915
Hospital Revenue Code	278
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.84

SCREW LOCKING Ti 5.0x36mm

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270646025
Hospital Revenue Code	278
Min. Negotiated Rate	$146.00
Max. Negotiated Rate	$235.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.55
Rate for Payer: Qualcare PPO/HMO/WC	$146.00

SCREW LOCKING Ti 5.0x36mm

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270646025
Hospital Revenue Code	278
Min. Negotiated Rate	$27.64
Max. Negotiated Rate	$486.68
Rate for Payer: Aetna Commercial	$369.87
Rate for Payer: Aetna Medicare Advantage	$292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.20
Rate for Payer: Cigna Commercial	$486.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.55
Rate for Payer: Qualcare PPO/HMO/WC	$146.00
Rate for Payer: UnitedHealthcare Community & State	$30.76
Rate for Payer: Wellpoint Medicaid Managed Care	$27.64

SCREW LOCKING Ti 5.0x36mm

Facility

$766.30

Service Code	HCPCS C1713
Hospital Charge Code	270641673
Hospital Revenue Code	278
Min. Negotiated Rate	$21.76
Max. Negotiated Rate	$383.15
Rate for Payer: Aetna Commercial	$291.19
Rate for Payer: Aetna Medicare Advantage	$229.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.41
Rate for Payer: Cigna Commercial	$383.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.44
Rate for Payer: Qualcare PPO/HMO/WC	$114.94
Rate for Payer: UnitedHealthcare Community & State	$24.22
Rate for Payer: Wellpoint Medicaid Managed Care	$21.76

SCREW LOCKING Ti 5.0x36mm

Facility

$766.30

Service Code	HCPCS C1713
Hospital Charge Code	270641673
Hospital Revenue Code	278
Min. Negotiated Rate	$114.94
Max. Negotiated Rate	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.44
Rate for Payer: Qualcare PPO/HMO/WC	$114.94

SCREW LOCKING TI 5.0X38MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270664324
Hospital Revenue Code	278
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.84

SCREW LOCKING TI 5.0X38MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270664324
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW LOCKING Ti 5.0x40mm

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270633465
Hospital Revenue Code	278
Min. Negotiated Rate	$146.00
Max. Negotiated Rate	$235.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.55
Rate for Payer: Qualcare PPO/HMO/WC	$146.00

SCREW LOCKING Ti 5.0x40mm

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270633465
Hospital Revenue Code	278
Min. Negotiated Rate	$27.64
Max. Negotiated Rate	$486.68
Rate for Payer: Aetna Commercial	$369.87
Rate for Payer: Aetna Medicare Advantage	$292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.20
Rate for Payer: Cigna Commercial	$486.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.55
Rate for Payer: Qualcare PPO/HMO/WC	$146.00
Rate for Payer: UnitedHealthcare Community & State	$30.76
Rate for Payer: Wellpoint Medicaid Managed Care	$27.64

SCREW LOCKING TI 5.0x50MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270674375
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

Know your out-of-pocket cost for care.

All Charges