Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING TI 5.0x50MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270674375
Hospital Revenue Code	278
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$361.65
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75
Rate for Payer: UnitedHealthcare Community & State	$30.07
Rate for Payer: Wellpoint Medicaid Managed Care	$27.03

SCREW LOCKING TI 5.0x64mm

Facility

$924.00

Hospital Charge Code	270675114
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LOCKING TI 5.0x64mm

Facility

$924.00

Hospital Charge Code	270675114
Hospital Revenue Code	278
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$29.20
Rate for Payer: Wellpoint Medicaid Managed Care	$26.24

SCREW LOCKING TI 5.0x70mm

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270675115
Hospital Revenue Code	278
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$30.98
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

SCREW LOCKING TI 5.0x70mm

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270675115
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LOCKING TI 5.0x74MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270676340
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LOCKING TI 5.0x74MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671810
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LOCKING TI 5.0x74MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671810
Hospital Revenue Code	278
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$29.20
Rate for Payer: Wellpoint Medicaid Managed Care	$26.24

SCREW LOCKING TI 5.0x74MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270676340
Hospital Revenue Code	278
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Community & State	$29.20
Rate for Payer: Wellpoint Medicaid Managed Care	$26.24

SCREW LOCKING TI 5.0X86MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699424
Hospital Revenue Code	278
Min. Negotiated Rate	$77.53
Max. Negotiated Rate	$1,365.00
Rate for Payer: Aetna Commercial	$1,037.40
Rate for Payer: Aetna Medicare Advantage	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.15
Rate for Payer: Cigna Commercial	$1,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: Qualcare PPO/HMO/WC	$409.50
Rate for Payer: UnitedHealthcare Community & State	$86.27
Rate for Payer: Wellpoint Medicaid Managed Care	$77.53

SCREW LOCKING TI 5.0X86MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699424
Hospital Revenue Code	278
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

SCREW LOCKING TI 5x24mm

Facility

$984.20

Hospital Charge Code	270673779
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW LOCKING TI 5x24mm

Facility

$984.20

Hospital Charge Code	270673779
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$374.00
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63
Rate for Payer: UnitedHealthcare Community & State	$31.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

SCREW LOCKING TI 5X26MM

Facility

$870.00

Service Code	HCPCS C1713
Hospital Charge Code	270669735
Hospital Revenue Code	278
Min. Negotiated Rate	$130.50
Max. Negotiated Rate	$210.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.54
Rate for Payer: Qualcare PPO/HMO/WC	$130.50

SCREW LOCKING TI 5X26MM

Facility

$870.00

Service Code	HCPCS C1713
Hospital Charge Code	270669735
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$435.00
Rate for Payer: Aetna Commercial	$330.60
Rate for Payer: Aetna Medicare Advantage	$261.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.85
Rate for Payer: Cigna Commercial	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.54
Rate for Payer: Qualcare PPO/HMO/WC	$130.50
Rate for Payer: UnitedHealthcare Community & State	$27.49
Rate for Payer: Wellpoint Medicaid Managed Care	$24.71

SCREW LOCKING TI 5x28mm

Facility

$984.20

Hospital Charge Code	270673768
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$374.00
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63
Rate for Payer: UnitedHealthcare Community & State	$31.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

SCREW LOCKING TI 5x28mm

Facility

$984.20

Hospital Charge Code	270673768
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW LOCKING TI 5x32mm

Facility

$984.20

Hospital Charge Code	270673778
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW LOCKING TI 5x32mm

Facility

$984.20

Hospital Charge Code	270673778
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$374.00
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63
Rate for Payer: UnitedHealthcare Community & State	$31.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

SCREW LOCKING TI 5x38mm

Facility

$984.20

Hospital Charge Code	270673771
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$374.00
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63
Rate for Payer: UnitedHealthcare Community & State	$31.10
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

SCREW LOCKING TI 5x38mm

Facility

$984.20

Hospital Charge Code	270673771
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW LOCKING TI 5X40MM

Facility

$870.00

Service Code	HCPCS C1713
Hospital Charge Code	270669736
Hospital Revenue Code	278
Min. Negotiated Rate	$130.50
Max. Negotiated Rate	$210.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.54
Rate for Payer: Qualcare PPO/HMO/WC	$130.50

SCREW LOCKING TI 5X40MM

Facility

$870.00

Service Code	HCPCS C1713
Hospital Charge Code	270669736
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$435.00
Rate for Payer: Aetna Commercial	$330.60
Rate for Payer: Aetna Medicare Advantage	$261.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.85
Rate for Payer: Cigna Commercial	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.54
Rate for Payer: Qualcare PPO/HMO/WC	$130.50
Rate for Payer: UnitedHealthcare Community & State	$27.49
Rate for Payer: Wellpoint Medicaid Managed Care	$24.71

SCREW LOCKING TI 5x44MM

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270652424
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 5x44MM

Facility

$973.35

Service Code	HCPCS C1713
Hospital Charge Code	270652424
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

Know your out-of-pocket cost for care.

All Charges