Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW POLY TAB EXT 6.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692625
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 POST PLUG

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270686980
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$435.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

SCREW POST PLUG

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270686980
Hospital Revenue Code	278
Min. Negotiated Rate	$51.12
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$684.00
Rate for Payer: Aetna Medicare Advantage	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.00
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.60
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Community & State	$56.88
Rate for Payer: Wellpoint Medicaid Managed Care	$51.12

SCREW PP LKG ST T6 SD 5.0X14MM

Facility

$3,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270700476
Hospital Revenue Code	278
Min. Negotiated Rate	$96.13
Max. Negotiated Rate	$1,692.50
Rate for Payer: Aetna Commercial	$1,286.30
Rate for Payer: Aetna Medicare Advantage	$1,015.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$863.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$863.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$863.17
Rate for Payer: Cigna Commercial	$1,692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.17
Rate for Payer: Qualcare PPO/HMO/WC	$507.75
Rate for Payer: UnitedHealthcare Community & State	$106.97
Rate for Payer: Wellpoint Medicaid Managed Care	$96.13

SCREW PP LKG ST T6 SD 5.0X14MM

Facility

$3,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270700476
Hospital Revenue Code	278
Min. Negotiated Rate	$507.75
Max. Negotiated Rate	$819.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$677.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$819.17
Rate for Payer: Qualcare PPO/HMO/WC	$507.75

SCREW PROFILE 8x25MM

Facility

$1,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270673366
Hospital Revenue Code	278
Min. Negotiated Rate	$41.46
Max. Negotiated Rate	$730.00
Rate for Payer: Aetna Commercial	$554.80
Rate for Payer: Aetna Medicare Advantage	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$372.30
Rate for Payer: Cigna Commercial	$730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.32
Rate for Payer: Qualcare PPO/HMO/WC	$219.00
Rate for Payer: UnitedHealthcare Community & State	$46.14
Rate for Payer: Wellpoint Medicaid Managed Care	$41.46

SCREW PROFILE 8x25MM

Facility

$1,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270673366
Hospital Revenue Code	278
Min. Negotiated Rate	$219.00
Max. Negotiated Rate	$353.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.32
Rate for Payer: Qualcare PPO/HMO/WC	$219.00

SCREW PT CANCELLOUS 4X30MM

Facility

$1,452.30

Service Code	HCPCS C1713
Hospital Charge Code	270705010
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$726.15
Rate for Payer: Aetna Commercial	$551.87
Rate for Payer: Aetna Medicare Advantage	$435.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$370.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$370.34
Rate for Payer: Cigna Commercial	$726.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.46
Rate for Payer: Qualcare PPO/HMO/WC	$217.84
Rate for Payer: UnitedHealthcare Community & State	$45.89
Rate for Payer: Wellpoint Medicaid Managed Care	$41.25

SCREW PT CANCELLOUS 4X30MM

Facility

$1,452.30

Service Code	HCPCS C1713
Hospital Charge Code	270705010
Hospital Revenue Code	278
Min. Negotiated Rate	$217.84
Max. Negotiated Rate	$351.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.46
Rate for Payer: Qualcare PPO/HMO/WC	$217.84

SCREW PTLY THRD TI 4.5X45MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693761
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 PTLY THRD TI 4.5X45MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693761
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 PT THR C PANTA2 5.0X65MM

Facility

$4,895.00

Service Code	HCPCS C1713
Hospital Charge Code	270699960
Hospital Revenue Code	278
Min. Negotiated Rate	$734.25
Max. Negotiated Rate	$1,184.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$979.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,184.59
Rate for Payer: Qualcare PPO/HMO/WC	$734.25

SCREW PT THR C PANTA2 5.0X65MM

Facility

$4,895.00

Service Code	HCPCS C1713
Hospital Charge Code	270699960
Hospital Revenue Code	278
Min. Negotiated Rate	$139.02
Max. Negotiated Rate	$2,447.50
Rate for Payer: Aetna Commercial	$1,860.10
Rate for Payer: Aetna Medicare Advantage	$1,468.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,248.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,248.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$979.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,248.22
Rate for Payer: Cigna Commercial	$2,447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,184.59
Rate for Payer: Qualcare PPO/HMO/WC	$734.25
Rate for Payer: UnitedHealthcare Community & State	$154.68
Rate for Payer: Wellpoint Medicaid Managed Care	$139.02

SCREW PT THREAD 4.5 X 55 MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270669797
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 PT THREAD 4.5 X 55 MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270669797
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 P VAL OPTILINK SD 5X14MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699687
Hospital Revenue Code	278
Min. Negotiated Rate	$113.32
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,516.20
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50
Rate for Payer: UnitedHealthcare Community & State	$126.08
Rate for Payer: Wellpoint Medicaid Managed Care	$113.32

SCREW P VAL OPTILINK SD 5X14MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699687
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

SCREW P VAL OPTILINK SD 5X16MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699688
Hospital Revenue Code	278
Min. Negotiated Rate	$113.32
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,516.20
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50
Rate for Payer: UnitedHealthcare Community & State	$126.08
Rate for Payer: Wellpoint Medicaid Managed Care	$113.32

SCREW P VAL OPTILINK SD 5X16MM

Facility

$3,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270699688
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

SCREW PYRENEES 2 LV MONO 44MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270691702
Hospital Revenue Code	278
Min. Negotiated Rate	$185.17
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$2,477.60
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00
Rate for Payer: UnitedHealthcare Community & State	$206.03
Rate for Payer: Wellpoint Medicaid Managed Care	$185.17

SCREW PYRENEES 2 LV MONO 44MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270691702
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

SCREW PYRENEES SLF STRT 4X12MM

Facility

$1,565.00

Hospital Charge Code	270670333
Hospital Revenue Code	278
Min. Negotiated Rate	$44.45
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$49.45
Rate for Payer: Wellpoint Medicaid Managed Care	$44.45

SCREW PYRENEES SLF STRT 4X12MM

Facility

$1,565.00

Hospital Charge Code	270670333
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

SCREW PYRENEES SLF STRT 4X14MM

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270670335
Hospital Revenue Code	278
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

SCREW PYRENEES SLF STRT 4X14MM

Facility

$1,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270670335
Hospital Revenue Code	278
Min. Negotiated Rate	$44.45
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.73
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Community & State	$49.45
Rate for Payer: Wellpoint Medicaid Managed Care	$44.45

Know your out-of-pocket cost for care.

All Charges