Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SELF TAPPING 4 X 16MM VA

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692109
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

SCREW SELF TAPPING 4 X 16MM VA

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692109
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

SCREW SELF TAPPING 6x30MM

Facility

$1,413.00

Service Code	HCPCS C1713
Hospital Charge Code	270672588
Hospital Revenue Code	278
Min. Negotiated Rate	$40.13
Max. Negotiated Rate	$706.50
Rate for Payer: Aetna Commercial	$536.94
Rate for Payer: Aetna Medicare Advantage	$423.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$360.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$360.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$360.31
Rate for Payer: Cigna Commercial	$706.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.95
Rate for Payer: Qualcare PPO/HMO/WC	$211.95
Rate for Payer: UnitedHealthcare Community & State	$44.65
Rate for Payer: Wellpoint Medicaid Managed Care	$40.13

SCREW SELF TAPPING 6x30MM

Facility

$1,413.00

Service Code	HCPCS C1713
Hospital Charge Code	270672588
Hospital Revenue Code	278
Min. Negotiated Rate	$211.95
Max. Negotiated Rate	$341.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.95
Rate for Payer: Qualcare PPO/HMO/WC	$211.95

SCREW SELF TAPPING 6x35MM

Facility

$1,413.00

Service Code	HCPCS C1713
Hospital Charge Code	270672589
Hospital Revenue Code	278
Min. Negotiated Rate	$211.95
Max. Negotiated Rate	$341.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.95
Rate for Payer: Qualcare PPO/HMO/WC	$211.95

SCREW SELF TAPPING 6x35MM

Facility

$1,413.00

Service Code	HCPCS C1713
Hospital Charge Code	270672589
Hospital Revenue Code	278
Min. Negotiated Rate	$40.13
Max. Negotiated Rate	$706.50
Rate for Payer: Aetna Commercial	$536.94
Rate for Payer: Aetna Medicare Advantage	$423.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$360.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$360.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$360.31
Rate for Payer: Cigna Commercial	$706.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.95
Rate for Payer: Qualcare PPO/HMO/WC	$211.95
Rate for Payer: UnitedHealthcare Community & State	$44.65
Rate for Payer: Wellpoint Medicaid Managed Care	$40.13

SCREW SELF TAP VAR 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694264
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW SELF TAP VAR 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694264
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

SCREW SELF TAP VARIAB 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694462
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW SELF TAP VARIAB 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694462
Hospital Revenue Code	278
Min. Negotiated Rate	$28.40
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Community & State	$31.60
Rate for Payer: Wellpoint Medicaid Managed Care	$28.40

SCREW SELF VARIABLE 4.5MMX14MM

Facility

$875.00

Hospital Charge Code	270703045
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 SELF VARIABLE 4.5MMX14MM

Facility

$875.00

Hospital Charge Code	270703045
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 SET

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270688522
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270661266
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW SET

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270688522
Hospital Revenue Code	278
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

SCREW SET

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270685220
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$820.00
Rate for Payer: Aetna Commercial	$623.20
Rate for Payer: Aetna Medicare Advantage	$492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.20
Rate for Payer: Cigna Commercial	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00
Rate for Payer: UnitedHealthcare Community & State	$51.82
Rate for Payer: Wellpoint Medicaid Managed Care	$46.58

SCREW SET

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270685220
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270661266
Hospital Revenue Code	278
Min. Negotiated Rate	$82.36
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$1,102.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00
Rate for Payer: UnitedHealthcare Community & State	$91.64
Rate for Payer: Wellpoint Medicaid Managed Care	$82.36

SCREW SET

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270688707
Hospital Revenue Code	278
Min. Negotiated Rate	$22.29
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$298.30
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Community & State	$24.81
Rate for Payer: Wellpoint Medicaid Managed Care	$22.29

SCREW SET

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270688707
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

SCREW SET

Facility

$725.00

Hospital Charge Code	270694028
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW SET

Facility

$725.00

Hospital Charge Code	270694028
Hospital Revenue Code	278
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

SCREW SET

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688420
Hospital Revenue Code	278
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

SCREW SET

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688420
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW SET 15100

Facility

$618.75

Service Code	HCPCS C1713
Hospital Charge Code	270698056
Hospital Revenue Code	278
Min. Negotiated Rate	$17.57
Max. Negotiated Rate	$309.38
Rate for Payer: Aetna Commercial	$235.12
Rate for Payer: Aetna Medicare Advantage	$185.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.78
Rate for Payer: Cigna Commercial	$309.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.74
Rate for Payer: Qualcare PPO/HMO/WC	$92.81
Rate for Payer: UnitedHealthcare Community & State	$19.55
Rate for Payer: Wellpoint Medicaid Managed Care	$17.57

Know your out-of-pocket cost for care.

All Charges