Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LP LOCKING 5X44MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695444
Hospital Revenue Code	278
Min. Negotiated Rate	$42.33
Max. Negotiated Rate	$745.25
Rate for Payer: Aetna Commercial	$566.39
Rate for Payer: Aetna Medicare Advantage	$447.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.08
Rate for Payer: Cigna Commercial	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: Qualcare PPO/HMO/WC	$223.57
Rate for Payer: UnitedHealthcare Community & State	$47.10
Rate for Payer: Wellpoint Medicaid Managed Care	$42.33

SCREW LP LOCKING 5X50MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695445
Hospital Revenue Code	278
Min. Negotiated Rate	$42.33
Max. Negotiated Rate	$745.25
Rate for Payer: Aetna Commercial	$566.39
Rate for Payer: Aetna Medicare Advantage	$447.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.08
Rate for Payer: Cigna Commercial	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: Qualcare PPO/HMO/WC	$223.57
Rate for Payer: UnitedHealthcare Community & State	$47.10
Rate for Payer: Wellpoint Medicaid Managed Care	$42.33

SCREW LP LOCKING 5X50MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695445
Hospital Revenue Code	278
Min. Negotiated Rate	$223.57
Max. Negotiated Rate	$360.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: Qualcare PPO/HMO/WC	$223.57

SCREW LP LOCKING 5X78MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695446
Hospital Revenue Code	278
Min. Negotiated Rate	$42.33
Max. Negotiated Rate	$745.25
Rate for Payer: Aetna Commercial	$566.39
Rate for Payer: Aetna Medicare Advantage	$447.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.08
Rate for Payer: Cigna Commercial	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: Qualcare PPO/HMO/WC	$223.57
Rate for Payer: UnitedHealthcare Community & State	$47.10
Rate for Payer: Wellpoint Medicaid Managed Care	$42.33

SCREW LP LOCKING 5X78MM XL25

Facility

$1,490.50

Service Code	HCPCS C1713
Hospital Charge Code	270695446
Hospital Revenue Code	278
Min. Negotiated Rate	$223.57
Max. Negotiated Rate	$360.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.70
Rate for Payer: Qualcare PPO/HMO/WC	$223.57

SCREW LP NON LCK 2.7 X 13 MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270702079
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

SCREW LP NON LCK 2.7 X 13 MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270702079
Hospital Revenue Code	278
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$226.10
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$16.90

SCREW LP-PRO 5.5X 55MM

Facility

$4,100.00

Hospital Charge Code	270703177
Hospital Revenue Code	278
Min. Negotiated Rate	$116.44
Max. Negotiated Rate	$2,050.00
Rate for Payer: Aetna Commercial	$1,558.00
Rate for Payer: Aetna Medicare Advantage	$1,230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,045.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,045.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$820.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,045.50
Rate for Payer: Cigna Commercial	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$992.20
Rate for Payer: Qualcare PPO/HMO/WC	$615.00
Rate for Payer: UnitedHealthcare Community & State	$129.56
Rate for Payer: Wellpoint Medicaid Managed Care	$116.44

SCREW LP-PRO 5.5X 55MM

Facility

$4,100.00

Hospital Charge Code	270703177
Hospital Revenue Code	278
Min. Negotiated Rate	$615.00
Max. Negotiated Rate	$992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$992.20
Rate for Payer: Qualcare PPO/HMO/WC	$615.00

SCREW LP PTD THD TI 6X55MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697347
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

SCREW LP PTD THD TI 6X55MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697347
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SCREW LP TI 4.0MM X 38 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270685936
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW LP TI 4.0MM X 38 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270685936
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4.0X16MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697468
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW LP TI 4.0X16MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697468
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4X14MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270696334
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW LP TI 4X14MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270696334
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI CORTICAL 3.0X46MM

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270699066
Hospital Revenue Code	278
Min. Negotiated Rate	$16.98
Max. Negotiated Rate	$299.00
Rate for Payer: Aetna Commercial	$227.24
Rate for Payer: Aetna Medicare Advantage	$179.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.49
Rate for Payer: Cigna Commercial	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: Qualcare PPO/HMO/WC	$89.70
Rate for Payer: UnitedHealthcare Community & State	$18.90
Rate for Payer: Wellpoint Medicaid Managed Care	$16.98

SCREW LP TI CORTICAL 3.0X46MM

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270699066
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: Qualcare PPO/HMO/WC	$89.70

SCREW LP TI CORT MTP 3.0X12MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696251
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW LP TI CORT MTP 3.0X12MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696251
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693498
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693498
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW LP TI CORT MTP 3.0X18MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693499
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW LP TI CORT MTP 3.0X18MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693499
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

Know your out-of-pocket cost for care.

All Charges