Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SOLID PEDICLE 7.5x40MM

Facility

$9,280.00

Hospital Charge Code	270671181
Hospital Revenue Code	278
Min. Negotiated Rate	$263.55
Max. Negotiated Rate	$4,640.00
Rate for Payer: Aetna Commercial	$3,526.40
Rate for Payer: Aetna Medicare Advantage	$2,784.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,366.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,366.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,366.40
Rate for Payer: Cigna Commercial	$4,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,245.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,392.00
Rate for Payer: UnitedHealthcare Community & State	$293.25
Rate for Payer: Wellpoint Medicaid Managed Care	$263.55

SCREW SOLID PEDICLE 7.5x40MM

Facility

$9,280.00

Hospital Charge Code	270671181
Hospital Revenue Code	278
Min. Negotiated Rate	$1,392.00
Max. Negotiated Rate	$2,245.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,856.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,245.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,392.00

SCREW SOLID PEDICLE 7.5x50MM

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270671180
Hospital Revenue Code	278
Min. Negotiated Rate	$252.76
Max. Negotiated Rate	$4,450.00
Rate for Payer: Aetna Commercial	$3,382.00
Rate for Payer: Aetna Medicare Advantage	$2,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,269.50
Rate for Payer: Cigna Commercial	$4,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00
Rate for Payer: UnitedHealthcare Community & State	$281.24
Rate for Payer: Wellpoint Medicaid Managed Care	$252.76

SCREW SOLID PEDICLE 7.5x50MM

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270671180
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.00
Max. Negotiated Rate	$2,153.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00

SCREW SOLID PEDICLE 7.5x55MM

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270671179
Hospital Revenue Code	278
Min. Negotiated Rate	$1,335.00
Max. Negotiated Rate	$2,153.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00

SCREW SOLID PEDICLE 7.5x55MM

Facility

$8,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270671179
Hospital Revenue Code	278
Min. Negotiated Rate	$252.76
Max. Negotiated Rate	$4,450.00
Rate for Payer: Aetna Commercial	$3,382.00
Rate for Payer: Aetna Medicare Advantage	$2,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,269.50
Rate for Payer: Cigna Commercial	$4,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,153.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,335.00
Rate for Payer: UnitedHealthcare Community & State	$281.24
Rate for Payer: Wellpoint Medicaid Managed Care	$252.76

SCREW SOLSTICE POLYAX 3.5X12MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699305
Hospital Revenue Code	278
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

SCREW SOLSTICE POLYAX 3.5X12MM

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699305
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

SCREW SPINAL 30MM TULIPHDCREO

Facility

$5,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693234
Hospital Revenue Code	278
Min. Negotiated Rate	$162.59
Max. Negotiated Rate	$2,862.50
Rate for Payer: Aetna Commercial	$2,175.50
Rate for Payer: Aetna Medicare Advantage	$1,717.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,459.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,459.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,459.88
Rate for Payer: Cigna Commercial	$2,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.45
Rate for Payer: Qualcare PPO/HMO/WC	$858.75
Rate for Payer: UnitedHealthcare Community & State	$180.91
Rate for Payer: Wellpoint Medicaid Managed Care	$162.59

SCREW SPINAL 30MM TULIPHDCREO

Facility

$5,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270693234
Hospital Revenue Code	278
Min. Negotiated Rate	$858.75
Max. Negotiated Rate	$1,385.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.45
Rate for Payer: Qualcare PPO/HMO/WC	$858.75

SCREW SPINAL SDVA 4.0X18MM

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697547
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

SCREW SPINAL SDVA 4.0X18MM

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697547
Hospital Revenue Code	278
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$474.00
Rate for Payer: Wellpoint Medicaid Managed Care	$426.00

SCREW SPINAL SDVA 4X16MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697150
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

SCREW SPINAL SDVA 4X16MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697150
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

SCREW SPINAL STD TI 5.5X25MM7D

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696609
Hospital Revenue Code	278
Min. Negotiated Rate	$283.29
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$315.21
Rate for Payer: Wellpoint Medicaid Managed Care	$283.29

SCREW SPINAL STD TI 5.5X25MM7D

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696609
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

SCREW SPINAL STFA GRUVE 4X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698921
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 SPINAL STFA GRUVE 4X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698921
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 SPINAL TI ALLOY DTRAX

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692494
Hospital Revenue Code	278
Min. Negotiated Rate	$198.80
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$221.20
Rate for Payer: Wellpoint Medicaid Managed Care	$198.80

SCREW SPINAL TI ALLOY DTRAX

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692494
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SCREW SPINAL VAR SD 3.5X12MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694922
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 SPINAL VAR SD 3.5X12MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694922
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 SPIN DIAM 2MM LG 12MM

Facility

$1,477.45

Hospital Charge Code	270660951
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$357.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPIN DIAM 2MM LG 12MM

Facility

$1,477.45

Hospital Charge Code	270660951
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$738.73
Rate for Payer: Aetna Commercial	$561.43
Rate for Payer: Aetna Medicare Advantage	$443.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.75
Rate for Payer: Cigna Commercial	$738.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62
Rate for Payer: UnitedHealthcare Community & State	$46.69
Rate for Payer: Wellpoint Medicaid Managed Care	$41.96

SCREW SPIN DIAM 2MM LG 14MM

Facility

$1,477.45

Hospital Charge Code	270660950
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$738.73
Rate for Payer: Aetna Commercial	$561.43
Rate for Payer: Aetna Medicare Advantage	$443.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.75
Rate for Payer: Cigna Commercial	$738.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62
Rate for Payer: UnitedHealthcare Community & State	$46.69
Rate for Payer: Wellpoint Medicaid Managed Care	$41.96

Know your out-of-pocket cost for care.

All Charges