Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$17.66
Max. Negotiated Rate	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.66

SCREW PELV CORT S/TAP 3.5x85MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270677980
Hospital Revenue Code	278
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$60.65
Rate for Payer: Aetna Commercial	$46.09
Rate for Payer: Aetna Medicare Advantage	$36.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.93
Rate for Payer: Cigna Commercial	$60.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: Qualcare PPO/HMO/WC	$18.20
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

SCREW PELV CORT S/TAP 3.5x85MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270677980
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: Qualcare PPO/HMO/WC	$18.20

SCREW PELVIC COTEX 3.5MM 80MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270678176
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: Qualcare PPO/HMO/WC	$18.20

SCREW PELVIC COTEX 3.5MM 80MM

Facility

$121.30

Service Code	HCPCS C1713
Hospital Charge Code	270678176
Hospital Revenue Code	278
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$60.65
Rate for Payer: Aetna Commercial	$46.09
Rate for Payer: Aetna Medicare Advantage	$36.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.93
Rate for Payer: Cigna Commercial	$60.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.35
Rate for Payer: Qualcare PPO/HMO/WC	$18.20
Rate for Payer: UnitedHealthcare Community & State	$3.83
Rate for Payer: Wellpoint Medicaid Managed Care	$3.44

SCREW PELVIC G2

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270681215
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SCREW PELVIC G2

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270681215
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684558
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270686371
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270686371
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684558
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684591
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SCREW PELVIC LONG

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684591
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PELVIC STANDARD

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684557
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

SCREW PELVIC STANDARD

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270684557
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SCREW PERI 3.5MMX16MM W/2.7

Facility

$185.00

Service Code	HCPCS C1713
Hospital Charge Code	270661509
Hospital Revenue Code	278
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

SCREW PERI 3.5MMX16MM W/2.7

Facility

$185.00

Service Code	HCPCS C1713
Hospital Charge Code	270661509
Hospital Revenue Code	278
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$44.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

SCREW PERI 3.5MMX22MM W/2.7

Facility

$185.00

Hospital Charge Code	270661510
Hospital Revenue Code	278
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$44.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

SCREW PERI 3.5MMX22MM W/2.7

Facility

$185.00

Hospital Charge Code	270661510
Hospital Revenue Code	278
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$70.30
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.77
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5.25

SCREW PERIA LOCK/CANN 4.5X28MM

Facility

$610.00

Hospital Charge Code	270639623
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 4.5X28MM

Facility

$610.00

Hospital Charge Code	270639623
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

SCREW PERIA LOCK/CANN 4.5X32MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270639624
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$227.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00

SCREW PERIA LOCK/CANN 4.5X32MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270639624
Hospital Revenue Code	278
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$470.00
Rate for Payer: Aetna Commercial	$357.20
Rate for Payer: Aetna Medicare Advantage	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.70
Rate for Payer: Cigna Commercial	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00
Rate for Payer: UnitedHealthcare Community & State	$29.70
Rate for Payer: Wellpoint Medicaid Managed Care	$26.70

SCREW PERIA LOCK/CANN 4.5X40MM

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270639201
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 4.5X40MM

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270639201
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

Know your out-of-pocket cost for care.

All Charges