Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW OPTILINK 5.0MM X 60 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691473
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK 5.0MM X 65 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691477
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW OPTILINK 5.0MM X 65 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691477
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK 5.0MM X 70 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691478
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK 5.0MM X 70 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691478
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW OPTILINK 5.0MM X 75 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691479
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK 5.0MM X 75 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691479
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW OPTILINK 5.0MM X 80 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691480
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW OPTILINK 5.0MM X 80 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691480
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK 5.0MM X 85 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691481
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW OPTILINK 5.0MM X 85 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691481
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK 5.0MM X 90 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691482
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW OPTILINK 5.0MM X 90 MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691482
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK ST SD 5.0X28MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691214
Hospital Revenue Code	278
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$453.93
Rate for Payer: Aetna Commercial	$344.98
Rate for Payer: Aetna Medicare Advantage	$272.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.50
Rate for Payer: Cigna Commercial	$453.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18
Rate for Payer: UnitedHealthcare Community & State	$28.69
Rate for Payer: Wellpoint Medicaid Managed Care	$25.78

SCREW OPTILINK ST SD 5.0X28MM

Facility

$907.85

Service Code	HCPCS C1713
Hospital Charge Code	270691214
Hospital Revenue Code	278
Min. Negotiated Rate	$136.18
Max. Negotiated Rate	$219.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.70
Rate for Payer: Qualcare PPO/HMO/WC	$136.18

SCREW ORTHOLOC 3.5X36MM

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270700815
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

SCREW ORTHOLOC 3.5X36MM

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270700815
Hospital Revenue Code	278
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$203.30
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: Qualcare PPO/HMO/WC	$80.25
Rate for Payer: UnitedHealthcare Community & State	$16.91
Rate for Payer: Wellpoint Medicaid Managed Care	$15.19

SCREW ORTHOLOC 3DI 2.7X10MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700378
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW ORTHOLOC 3DI 2.7X10MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700378
Hospital Revenue Code	278
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$399.23
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59
Rate for Payer: UnitedHealthcare Community & State	$33.20
Rate for Payer: Wellpoint Medicaid Managed Care	$29.84

SCREW ORTHOLOC 3DI 3.5X10MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270700814
Hospital Revenue Code	278
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$33.18
Rate for Payer: Wellpoint Medicaid Managed Care	$29.82

SCREW ORTHOLOC 3DI 3.5X10MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270700814
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW ORTHOLOC NONLKG 3.5X50MM

Facility

$1,365.00

Service Code	HCPCS C1713
Hospital Charge Code	270700641
Hospital Revenue Code	278
Min. Negotiated Rate	$38.77
Max. Negotiated Rate	$682.50
Rate for Payer: Aetna Commercial	$518.70
Rate for Payer: Aetna Medicare Advantage	$409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.07
Rate for Payer: Cigna Commercial	$682.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: Qualcare PPO/HMO/WC	$204.75
Rate for Payer: UnitedHealthcare Community & State	$43.13
Rate for Payer: Wellpoint Medicaid Managed Care	$38.77

SCREW ORTHOLOC NONLKG 3.5X50MM

Facility

$1,365.00

Service Code	HCPCS C1713
Hospital Charge Code	270700641
Hospital Revenue Code	278
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$330.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.33
Rate for Payer: Qualcare PPO/HMO/WC	$204.75

SCREW OVERWATCH 7.5MMX50 MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692997
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,995.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Community & State	$165.90
Rate for Payer: Wellpoint Medicaid Managed Care	$149.10

SCREW OVERWATCH 7.5MMX50 MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692997
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

Know your out-of-pocket cost for care.

All Charges