Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SCHANZ SLF DRILL 5x200MM

Facility

$891.00

Service Code	HCPCS C1713
Hospital Charge Code	270675470
Hospital Revenue Code	278
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

SCREW SCHANZ SLF DRILL 5x200MM

Facility

$891.00

Service Code	HCPCS C1713
Hospital Charge Code	270675470
Hospital Revenue Code	278
Min. Negotiated Rate	$25.30
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$338.58
Rate for Payer: Aetna Medicare Advantage	$267.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.21
Rate for Payer: Cigna Commercial	$445.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: Qualcare PPO/HMO/WC	$133.65
Rate for Payer: UnitedHealthcare Community & State	$28.16
Rate for Payer: Wellpoint Medicaid Managed Care	$25.30

SCREW SCHANZ WITH ADP 4.0MM

Facility

$786.00

Service Code	HCPCS C1713
Hospital Charge Code	270661253
Hospital Revenue Code	278
Min. Negotiated Rate	$22.32
Max. Negotiated Rate	$393.00
Rate for Payer: Aetna Commercial	$298.68
Rate for Payer: Aetna Medicare Advantage	$235.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.43
Rate for Payer: Cigna Commercial	$393.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.21
Rate for Payer: Qualcare PPO/HMO/WC	$117.90
Rate for Payer: UnitedHealthcare Community & State	$24.84
Rate for Payer: Wellpoint Medicaid Managed Care	$22.32

SCREW SCHANZ WITH ADP 4.0MM

Facility

$786.00

Service Code	HCPCS C1713
Hospital Charge Code	270661253
Hospital Revenue Code	278
Min. Negotiated Rate	$117.90
Max. Negotiated Rate	$190.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.21
Rate for Payer: Qualcare PPO/HMO/WC	$117.90

SCREW S.D. 16MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270668254
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW S.D. 16MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270668254
Hospital Revenue Code	278
Min. Negotiated Rate	$39.05
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$43.45
Rate for Payer: Wellpoint Medicaid Managed Care	$39.05

SCREW SD 16MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705064
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

SCREW SD 16MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705064
Hospital Revenue Code	278
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$277.40
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50
Rate for Payer: UnitedHealthcare Community & State	$23.07
Rate for Payer: Wellpoint Medicaid Managed Care	$20.73

SCREW SD 3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699101
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW SD 3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699101
Hospital Revenue Code	278
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$399.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Community & State	$33.18
Rate for Payer: Wellpoint Medicaid Managed Care	$29.82

SCREW SD DAKOTA 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696091
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

SCREW SD DAKOTA 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697665
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

SCREW SD DAKOTA ACDF 4X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697751
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA ACDF 4X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697751
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Community & State	$213.30
Rate for Payer: Wellpoint Medicaid Managed Care	$191.70

SCREW SD FIXED 4.0X14MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270695867
Hospital Revenue Code	278
Min. Negotiated Rate	$59.64
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$798.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00
Rate for Payer: UnitedHealthcare Community & State	$66.36
Rate for Payer: Wellpoint Medicaid Managed Care	$59.64

SCREW SD FIXED 4.0X14MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270695867
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

SCREW S/DRILL DIAMOND 4x12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270657667
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 S/DRILL DIAMOND 4x12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270657667
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 S/DRLL DIAMOND 4.25x12MM

Facility

$1,250.00

Hospital Charge Code	270676924
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 S/DRLL DIAMOND 4.25x12MM

Facility

$1,250.00

Hospital Charge Code	270676924
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 SDS 16MM

Facility

$1,209.05

Service Code	HCPCS C1713
Hospital Charge Code	270692348
Hospital Revenue Code	278
Min. Negotiated Rate	$34.34
Max. Negotiated Rate	$604.52
Rate for Payer: Aetna Commercial	$459.44
Rate for Payer: Aetna Medicare Advantage	$362.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.31
Rate for Payer: Cigna Commercial	$604.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.59
Rate for Payer: Qualcare PPO/HMO/WC	$181.36
Rate for Payer: UnitedHealthcare Community & State	$38.21
Rate for Payer: Wellpoint Medicaid Managed Care	$34.34

SCREW SDS 16MM

Facility

$1,209.05

Service Code	HCPCS C1713
Hospital Charge Code	270692348
Hospital Revenue Code	278
Min. Negotiated Rate	$181.36
Max. Negotiated Rate	$292.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.59
Rate for Payer: Qualcare PPO/HMO/WC	$181.36

SCREW SD SCARLET AC-T 3.5X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697643
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

Know your out-of-pocket cost for care.

All Charges