Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW OVERWATCH 7.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692996
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

SCREW OVERWATCH 7.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692996
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

SCREWOVERWATCHEXTENTAB6.5X45MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694705
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREWOVERWATCHEXTENTAB6.5X45MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694705
Hospital Revenue Code	278
Min. Negotiated Rate	$119.28
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,596.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00
Rate for Payer: UnitedHealthcare Community & State	$132.72
Rate for Payer: Wellpoint Medicaid Managed Care	$119.28

SCREW OVERWATCH EXT TAB 50MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694707
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW OVERWATCH EXT TAB 50MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694707
Hospital Revenue Code	278
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$17.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SCREWOVERWATCHMISEXTAB8.5X40MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695184
Hospital Revenue Code	278
Min. Negotiated Rate	$119.28
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,596.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00
Rate for Payer: UnitedHealthcare Community & State	$132.72
Rate for Payer: Wellpoint Medicaid Managed Care	$119.28

SCREWOVERWATCHMISEXTAB8.5X40MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695184
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW OW 7.5X40MM CANN EXT TAB

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693522
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

SCREW OW 7.5X40MM CANN EXT TAB

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693522
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 PACK

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681287
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW PACK

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681287
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW PALISADE SET

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692237
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW PALISADE SET

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692237
Hospital Revenue Code	278
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

SCREW PANTA PART. THD 5x75MM

Facility

$1,524.60

Hospital Charge Code	270666227
Hospital Revenue Code	278
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$368.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69

SCREW PANTA PART. THD 5x75MM

Facility

$1,524.60

Hospital Charge Code	270666227
Hospital Revenue Code	278
Min. Negotiated Rate	$43.30
Max. Negotiated Rate	$762.30
Rate for Payer: Aetna Commercial	$579.35
Rate for Payer: Aetna Medicare Advantage	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.77
Rate for Payer: Cigna Commercial	$762.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69
Rate for Payer: UnitedHealthcare Community & State	$48.18
Rate for Payer: Wellpoint Medicaid Managed Care	$43.30

SCREW PANTA PART. THD 5x80MM

Facility

$1,524.60

Hospital Charge Code	270666226
Hospital Revenue Code	278
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$368.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69

SCREW PANTA PART. THD 5x80MM

Facility

$1,524.60

Hospital Charge Code	270666226
Hospital Revenue Code	278
Min. Negotiated Rate	$43.30
Max. Negotiated Rate	$762.30
Rate for Payer: Aetna Commercial	$579.35
Rate for Payer: Aetna Medicare Advantage	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.77
Rate for Payer: Cigna Commercial	$762.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69
Rate for Payer: UnitedHealthcare Community & State	$48.18
Rate for Payer: Wellpoint Medicaid Managed Care	$43.30

SCREW PARTIALLY THREADED 70MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659861
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW PARTIALLY THREADED 70MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659861
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SCREW PARTIAL THREAD 4.5X40MM

Facility

$875.00

Hospital Charge Code	270668301
Hospital Revenue Code	278
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

SCREW PARTIAL THREAD 4.5X40MM

Facility

$875.00

Hospital Charge Code	270668301
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW PART THREADED 3.0X34

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270648823
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THREADED 3.0X34

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270648823
Hospital Revenue Code	278
Min. Negotiated Rate	$26.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Community & State	$29.39
Rate for Payer: Wellpoint Medicaid Managed Care	$26.41

SCREW PEDICLE 5.5x35MM

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680560
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

Know your out-of-pocket cost for care.

All Charges