Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SHEATH 7.3 X 55MM

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270687083
Hospital Revenue Code	278
Min. Negotiated Rate	$76.54
Max. Negotiated Rate	$1,347.50
Rate for Payer: Aetna Commercial	$1,024.10
Rate for Payer: Aetna Medicare Advantage	$808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$687.23
Rate for Payer: Cigna Commercial	$1,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25
Rate for Payer: UnitedHealthcare Community & State	$85.16
Rate for Payer: Wellpoint Medicaid Managed Care	$76.54

SCREW SHEATH 7.3 X 55MM

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270687083
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$652.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

SCREW SHORT 2.5 X 17MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701200
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW SHORT 2.5 X 17MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701200
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$365.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38
Rate for Payer: UnitedHealthcare Community & State	$30.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27.34

SCREW SHORT THD 4x24MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674312
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x24MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674312
Hospital Revenue Code	278
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Community & State	$35.87
Rate for Payer: Wellpoint Medicaid Managed Care	$32.23

SCREW SHORT THD 4x28MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674311
Hospital Revenue Code	278
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Community & State	$35.87
Rate for Payer: Wellpoint Medicaid Managed Care	$32.23

SCREW SHORT THD 4x28MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674311
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x32MM

Facility

$1,135.00

Hospital Charge Code	270656797
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x32MM

Facility

$1,135.00

Hospital Charge Code	270656797
Hospital Revenue Code	278
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Community & State	$35.87
Rate for Payer: Wellpoint Medicaid Managed Care	$32.23

SCREW SHORT THREAD 6.2 X 56 MM

Facility

$3,231.25

Service Code	HCPCS C1713
Hospital Charge Code	270701365
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$1,615.62
Rate for Payer: Aetna Commercial	$1,227.88
Rate for Payer: Aetna Medicare Advantage	$969.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.97
Rate for Payer: Cigna Commercial	$1,615.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: Qualcare PPO/HMO/WC	$484.69
Rate for Payer: UnitedHealthcare Community & State	$102.11
Rate for Payer: Wellpoint Medicaid Managed Care	$91.77

SCREW SHORT THREAD 6.2 X 56 MM

Facility

$3,231.25

Service Code	HCPCS C1713
Hospital Charge Code	270701365
Hospital Revenue Code	278
Min. Negotiated Rate	$484.69
Max. Negotiated Rate	$781.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: Qualcare PPO/HMO/WC	$484.69

SCREW SI 14MM

Facility

$600.00

Hospital Charge Code	270703568
Hospital Revenue Code	278
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

SCREW SI 14MM

Facility

$600.00

Hospital Charge Code	270703568
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW SI 5.5 POLYAX 7X45MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698986
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

SCREW SI 5.5 POLYAX 7X45MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698986
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

SCREW SIDE RAIL 1 1/2 IN

Facility

$41.30

Hospital Charge Code	270679662
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$20.65
Rate for Payer: Aetna Commercial	$15.69
Rate for Payer: Aetna Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.53
Rate for Payer: Cigna Commercial	$20.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$8.26
Rate for Payer: Qualcare PPO/HMO/WC	$6.20
Rate for Payer: UnitedHealthcare Commercial	$8.26
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

SCREW SIDE RAIL 1 1/2 IN

Facility

$41.30

Hospital Charge Code	270679662
Hospital Revenue Code	272
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.20

SCREW SIMPACT 14.5X35MM

Facility

$13,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270696487
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$3,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

SCREW SIMPACT 14.5X35MM

Facility

$13,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270696487
Hospital Revenue Code	278
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$6,500.00
Rate for Payer: Aetna Commercial	$4,940.00
Rate for Payer: Aetna Medicare Advantage	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,315.00
Rate for Payer: Cigna Commercial	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00
Rate for Payer: UnitedHealthcare Community & State	$410.80
Rate for Payer: Wellpoint Medicaid Managed Care	$369.20

SCREW SIMPACT 14.5X45MM

Facility

$13,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697137
Hospital Revenue Code	278
Min. Negotiated Rate	$369.20
Max. Negotiated Rate	$6,500.00
Rate for Payer: Aetna Commercial	$4,940.00
Rate for Payer: Aetna Medicare Advantage	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,315.00
Rate for Payer: Cigna Commercial	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00
Rate for Payer: UnitedHealthcare Community & State	$410.80
Rate for Payer: Wellpoint Medicaid Managed Care	$369.20

SCREW SIMPACT 14.5X45MM

Facility

$13,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697137
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$3,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

SCREW SIROS-O SI DT 9.5X40MM

Facility

$17,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699523
Hospital Revenue Code	278
Min. Negotiated Rate	$504.10
Max. Negotiated Rate	$8,875.00
Rate for Payer: Aetna Commercial	$6,745.00
Rate for Payer: Aetna Medicare Advantage	$5,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,526.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,526.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,526.25
Rate for Payer: Cigna Commercial	$8,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,295.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,662.50
Rate for Payer: UnitedHealthcare Community & State	$560.90
Rate for Payer: Wellpoint Medicaid Managed Care	$504.10

SCREW SIROS-O SI DT 9.5X40MM

Facility

$17,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699523
Hospital Revenue Code	278
Min. Negotiated Rate	$2,662.50
Max. Negotiated Rate	$4,295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,295.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,662.50

SCREW SKY VARIABLE SD 14 MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270668467
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

Know your out-of-pocket cost for care.

All Charges