Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PEEK 7X20MM PEEK NON VEN

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691000
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

SCREW PEEK 7X20MM PEEK NON VEN

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691000
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK IF NON VENT 8X20MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693723
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

SCREW PEEK IF NON VENT 8X20MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693723
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK INTER 4.5X15MM STRL

Facility

$2,461.25

Hospital Charge Code	270701720
Hospital Revenue Code	278
Min. Negotiated Rate	$369.19
Max. Negotiated Rate	$595.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$492.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$595.62
Rate for Payer: Qualcare PPO/HMO/WC	$369.19

SCREW PEEK INTER 4.5X15MM STRL

Facility

$2,461.25

Hospital Charge Code	270701720
Hospital Revenue Code	278
Min. Negotiated Rate	$69.90
Max. Negotiated Rate	$1,230.62
Rate for Payer: Aetna Commercial	$935.27
Rate for Payer: Aetna Medicare Advantage	$738.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$627.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$627.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$492.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$627.62
Rate for Payer: Cigna Commercial	$1,230.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$595.62
Rate for Payer: Qualcare PPO/HMO/WC	$369.19
Rate for Payer: UnitedHealthcare Community & State	$77.78
Rate for Payer: Wellpoint Medicaid Managed Care	$69.90

SCREW PEEK INTER 7.0X23.MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675568
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW PEEK INTER 7.0X23.MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675568
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

SCREW PEEK TENO VENT

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270691579
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

SCREW PEEK TENO VENT

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270691579
Hospital Revenue Code	278
Min. Negotiated Rate	$44.73
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$598.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25
Rate for Payer: UnitedHealthcare Community & State	$49.77
Rate for Payer: Wellpoint Medicaid Managed Care	$44.73

SCREW PEG 2.5x20MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648152
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

SCREW PEG 2.5x20MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648152
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x22MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648153
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x22MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648153
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

SCREW PEG 2.5x26MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648155
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

SCREW PEG 2.5x26MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648155
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x30MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270671104
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x30MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270671104
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

SCREW PEG NON LOCKING 2.5x14mm

Facility

$585.00

Hospital Charge Code	270671836
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

SCREW PEG NON LOCKING 2.5x14mm

Facility

$585.00

Hospital Charge Code	270671836
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5X26MM

Facility

$585.00

Hospital Charge Code	270671105
Hospital Revenue Code	278
Min. Negotiated Rate	$16.61
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$222.30
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Community & State	$18.49
Rate for Payer: Wellpoint Medicaid Managed Care	$16.61

SCREW PEG NON LOCKING 2.5X26MM

Facility

$585.00

Hospital Charge Code	270671105
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PELV CORTEX ST 3.5X75MM

Facility

$151.05

Service Code	HCPCS C1713
Hospital Charge Code	270696623
Hospital Revenue Code	278
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$75.53
Rate for Payer: Aetna Commercial	$57.40
Rate for Payer: Aetna Medicare Advantage	$45.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.52
Rate for Payer: Cigna Commercial	$75.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.55
Rate for Payer: Qualcare PPO/HMO/WC	$22.66
Rate for Payer: UnitedHealthcare Community & State	$4.77
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

SCREW PELV CORTEX ST 3.5X75MM

Facility

$151.05

Service Code	HCPCS C1713
Hospital Charge Code	270696623
Hospital Revenue Code	278
Min. Negotiated Rate	$22.66
Max. Negotiated Rate	$36.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.55
Rate for Payer: Qualcare PPO/HMO/WC	$22.66

SCREW PELV CORT S/TAP 3.5x70MM

Facility

$117.75

Service Code	HCPCS C1713
Hospital Charge Code	270665809
Hospital Revenue Code	278
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$58.88
Rate for Payer: Aetna Commercial	$44.74
Rate for Payer: Aetna Medicare Advantage	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.03
Rate for Payer: Cigna Commercial	$58.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.66
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

Know your out-of-pocket cost for care.

All Charges