Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW RND TAPERED INTF 8X28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675573
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 RSS 4.5X30 MM CAP

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689634
Hospital Revenue Code	278
Min. Negotiated Rate	$147.71
Max. Negotiated Rate	$238.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71

SCREW RSS 4.5X30 MM CAP

Facility

$984.75

Service Code	HCPCS C1713
Hospital Charge Code	270689634
Hospital Revenue Code	278
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$492.38
Rate for Payer: Aetna Commercial	$374.20
Rate for Payer: Aetna Medicare Advantage	$295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.11
Rate for Payer: Cigna Commercial	$492.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.31
Rate for Payer: Qualcare PPO/HMO/WC	$147.71
Rate for Payer: UnitedHealthcare Community & State	$31.12
Rate for Payer: Wellpoint Medicaid Managed Care	$27.97

SCREW RVRS GLENOID 6.5X25MM

Facility

$6,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270700530
Hospital Revenue Code	278
Min. Negotiated Rate	$171.68
Max. Negotiated Rate	$3,022.50
Rate for Payer: Aetna Commercial	$2,297.10
Rate for Payer: Aetna Medicare Advantage	$1,813.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,541.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,541.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,209.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,541.47
Rate for Payer: Cigna Commercial	$3,022.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.89
Rate for Payer: Qualcare PPO/HMO/WC	$906.75
Rate for Payer: UnitedHealthcare Community & State	$191.02
Rate for Payer: Wellpoint Medicaid Managed Care	$171.68

SCREW RVRS GLENOID 6.5X25MM

Facility

$6,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270700530
Hospital Revenue Code	278
Min. Negotiated Rate	$906.75
Max. Negotiated Rate	$1,462.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.89
Rate for Payer: Qualcare PPO/HMO/WC	$906.75

SCREWS 5.5 X 40 MM

Facility

$2,200.00

Hospital Charge Code	270702852
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

SCREWS 5.5 X 40 MM

Facility

$2,200.00

Hospital Charge Code	270702852
Hospital Revenue Code	278
Min. Negotiated Rate	$62.48
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$836.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00
Rate for Payer: UnitedHealthcare Community & State	$69.52
Rate for Payer: Wellpoint Medicaid Managed Care	$62.48

SCREW SAVANNAH T 6.5x35MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674911
Hospital Revenue Code	278
Min. Negotiated Rate	$343.64
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$382.36
Rate for Payer: Wellpoint Medicaid Managed Care	$343.64

SCREW SAVANNAH T 6.5x35MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674911
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

SCREW SAVANNAH T 6.5x45MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674912
Hospital Revenue Code	278
Min. Negotiated Rate	$343.64
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$382.36
Rate for Payer: Wellpoint Medicaid Managed Care	$343.64

SCREW SAVANNAH T 6.5x45MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674912
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

SCREW SAVANNAH T 7.5x45MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674913
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

SCREW SAVANNAH T 7.5x45MM

Facility

$12,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270674913
Hospital Revenue Code	278
Min. Negotiated Rate	$343.64
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$382.36
Rate for Payer: Wellpoint Medicaid Managed Care	$343.64

SCREW SCHANZ 3/4x80MM

Facility

$378.75

Service Code	HCPCS C1713
Hospital Charge Code	270601800
Hospital Revenue Code	278
Min. Negotiated Rate	$10.76
Max. Negotiated Rate	$189.38
Rate for Payer: Aetna Commercial	$143.93
Rate for Payer: Aetna Medicare Advantage	$113.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.58
Rate for Payer: Cigna Commercial	$189.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$56.81
Rate for Payer: UnitedHealthcare Community & State	$11.97
Rate for Payer: Wellpoint Medicaid Managed Care	$10.76

SCREW SCHANZ 3/4x80MM

Facility

$378.75

Service Code	HCPCS C1713
Hospital Charge Code	270601800
Hospital Revenue Code	278
Min. Negotiated Rate	$56.81
Max. Negotiated Rate	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$56.81

SCREW SCHANZ 4.0/60MM SPADE

Facility

$357.00

Hospital Charge Code	270656304
Hospital Revenue Code	278
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$178.50
Rate for Payer: Aetna Commercial	$135.66
Rate for Payer: Aetna Medicare Advantage	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.03
Rate for Payer: Cigna Commercial	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: Wellpoint Medicaid Managed Care	$10.14

SCREW SCHANZ 4.0/60MM SPADE

Facility

$357.00

Hospital Charge Code	270656304
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$86.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

SCREW SCHANZ 4.0MMX150 MMX40

Facility

$1,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270688024
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$762.50
Rate for Payer: Aetna Commercial	$579.50
Rate for Payer: Aetna Medicare Advantage	$457.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.88
Rate for Payer: Cigna Commercial	$762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.05
Rate for Payer: Qualcare PPO/HMO/WC	$228.75
Rate for Payer: UnitedHealthcare Community & State	$48.19
Rate for Payer: Wellpoint Medicaid Managed Care	$43.31

SCREW SCHANZ 4.0MMX150 MMX40

Facility

$1,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270688024
Hospital Revenue Code	278
Min. Negotiated Rate	$228.75
Max. Negotiated Rate	$369.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.05
Rate for Payer: Qualcare PPO/HMO/WC	$228.75

SCREW SCHANZ 4.0MM X 2.5MM 80M

Facility

$774.00

Hospital Charge Code	270660432
Hospital Revenue Code	278
Min. Negotiated Rate	$116.10
Max. Negotiated Rate	$187.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.31
Rate for Payer: Qualcare PPO/HMO/WC	$116.10

SCREW SCHANZ 4.0MM X 2.5MM 80M

Facility

$774.00

Hospital Charge Code	270660432
Hospital Revenue Code	278
Min. Negotiated Rate	$21.98
Max. Negotiated Rate	$387.00
Rate for Payer: Aetna Commercial	$294.12
Rate for Payer: Aetna Medicare Advantage	$232.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.37
Rate for Payer: Cigna Commercial	$387.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.31
Rate for Payer: Qualcare PPO/HMO/WC	$116.10
Rate for Payer: UnitedHealthcare Community & State	$24.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.98

SCREW SCHANZ 4.0x20x80mm

Facility

$797.20

Service Code	HCPCS C1713
Hospital Charge Code	270619747
Hospital Revenue Code	278
Min. Negotiated Rate	$119.58
Max. Negotiated Rate	$192.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: Qualcare PPO/HMO/WC	$119.58

SCREW SCHANZ 4.0x20x80mm

Facility

$797.20

Service Code	HCPCS C1713
Hospital Charge Code	270619747
Hospital Revenue Code	278
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$398.60
Rate for Payer: Aetna Commercial	$302.94
Rate for Payer: Aetna Medicare Advantage	$239.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.29
Rate for Payer: Cigna Commercial	$398.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: Qualcare PPO/HMO/WC	$119.58
Rate for Payer: UnitedHealthcare Community & State	$25.19
Rate for Payer: Wellpoint Medicaid Managed Care	$22.64

SCREW SCHANZ 4.0 X 3.0MM 100MM

Facility

$774.00

Hospital Charge Code	270660433
Hospital Revenue Code	278
Min. Negotiated Rate	$116.10
Max. Negotiated Rate	$187.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.31
Rate for Payer: Qualcare PPO/HMO/WC	$116.10

SCREW SCHANZ 4.0 X 3.0MM 100MM

Facility

$774.00

Hospital Charge Code	270660433
Hospital Revenue Code	278
Min. Negotiated Rate	$21.98
Max. Negotiated Rate	$387.00
Rate for Payer: Aetna Commercial	$294.12
Rate for Payer: Aetna Medicare Advantage	$232.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.37
Rate for Payer: Cigna Commercial	$387.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.31
Rate for Payer: Qualcare PPO/HMO/WC	$116.10
Rate for Payer: UnitedHealthcare Community & State	$24.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.98

Know your out-of-pocket cost for care.

All Charges