Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SET 15100

Facility

$618.75

Service Code	HCPCS C1713
Hospital Charge Code	270698056
Hospital Revenue Code	278
Min. Negotiated Rate	$92.81
Max. Negotiated Rate	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.74
Rate for Payer: Qualcare PPO/HMO/WC	$92.81

SCREW SET FIREBIRD

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270692300
Hospital Revenue Code	278
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

SCREW SET FIREBIRD

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270692300
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

SCREW SET MARINER 41-1010

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693229
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SCREW SET MARINER 41-1010

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693229
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW SET OVERWATCH

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270692589
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW SET OVERWATCH

Facility

$675.00

Service Code	HCPCS C1713
Hospital Charge Code	270692589
Hospital Revenue Code	278
Min. Negotiated Rate	$19.17
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.17

SCREW SET PEDICLE

Facility

$1,750.00

Hospital Charge Code	270680079
Hospital Revenue Code	272
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) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

SCREW SET PEDICLE

Facility

$1,750.00

Hospital Charge Code	270680079
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

SCREW SET SAVANNAH-T

Facility

$2,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270656140
Hospital Revenue Code	278
Min. Negotiated Rate	$67.59
Max. Negotiated Rate	$1,190.00
Rate for Payer: Aetna Commercial	$904.40
Rate for Payer: Aetna Medicare Advantage	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.90
Rate for Payer: Cigna Commercial	$1,190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: Qualcare PPO/HMO/WC	$357.00
Rate for Payer: UnitedHealthcare Community & State	$75.21
Rate for Payer: Wellpoint Medicaid Managed Care	$67.59

SCREW SET SAVANNAH-T

Facility

$2,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270656140
Hospital Revenue Code	278
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$575.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$476.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.96
Rate for Payer: Qualcare PPO/HMO/WC	$357.00

SCREW SET SPINE 4.75MM TI CAP

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270696281
Hospital Revenue Code	278
Min. Negotiated Rate	$51.83
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$693.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$273.75
Rate for Payer: UnitedHealthcare Community & State	$57.67
Rate for Payer: Wellpoint Medicaid Managed Care	$51.83

SCREW SET SPINE 4.75MM TI CAP

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270696281
Hospital Revenue Code	278
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$441.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

SCREW SET SYMPHONY

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693341
Hospital Revenue Code	278
Min. Negotiated Rate	$156.82
Max. Negotiated Rate	$253.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.82

SCREW SET SYMPHONY

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693341
Hospital Revenue Code	278
Min. Negotiated Rate	$29.69
Max. Negotiated Rate	$522.75
Rate for Payer: Aetna Commercial	$397.29
Rate for Payer: Aetna Medicare Advantage	$313.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.60
Rate for Payer: Cigna Commercial	$522.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.82
Rate for Payer: UnitedHealthcare Community & State	$33.04
Rate for Payer: Wellpoint Medicaid Managed Care	$29.69

SCREW SET T25 5.5/6.0 TULIP

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693913
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW SET T25 5.5/6.0 TULIP

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693913
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW SET T25 LOCKING CAP

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692672
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW SET T25 LOCKING CAP

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692672
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW SET TALL SYMPHONY

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693340
Hospital Revenue Code	278
Min. Negotiated Rate	$156.82
Max. Negotiated Rate	$253.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.82

SCREW SET TALL SYMPHONY

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693340
Hospital Revenue Code	278
Min. Negotiated Rate	$29.69
Max. Negotiated Rate	$522.75
Rate for Payer: Aetna Commercial	$397.29
Rate for Payer: Aetna Medicare Advantage	$313.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.60
Rate for Payer: Cigna Commercial	$522.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.82
Rate for Payer: UnitedHealthcare Community & State	$33.04
Rate for Payer: Wellpoint Medicaid Managed Care	$29.69

SCREW SET THUNDERBOLT 5.5MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695216
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

SCREW SET THUNDERBOLT 5.5MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695216
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW SET VOYAGER MAS 5.5X60MM

Facility

$1,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270699079
Hospital Revenue Code	278
Min. Negotiated Rate	$42.46
Max. Negotiated Rate	$747.50
Rate for Payer: Aetna Commercial	$568.10
Rate for Payer: Aetna Medicare Advantage	$448.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.23
Rate for Payer: Cigna Commercial	$747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25
Rate for Payer: UnitedHealthcare Community & State	$47.24
Rate for Payer: Wellpoint Medicaid Managed Care	$42.46

SCREW SET VOYAGER MAS 5.5X60MM

Facility

$1,495.00

Service Code	HCPCS C1713
Hospital Charge Code	270699079
Hospital Revenue Code	278
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$361.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.79
Rate for Payer: Qualcare PPO/HMO/WC	$224.25

Know your out-of-pocket cost for care.

All Charges