Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW STRM NL LP 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693506
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW ST T25STDR TI LOCK 5MM

Facility

$895.05

Service Code	HCPCS C1713
Hospital Charge Code	270693694
Hospital Revenue Code	278
Min. Negotiated Rate	$25.42
Max. Negotiated Rate	$447.52
Rate for Payer: Aetna Commercial	$340.12
Rate for Payer: Aetna Medicare Advantage	$268.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.24
Rate for Payer: Cigna Commercial	$447.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.60
Rate for Payer: Qualcare PPO/HMO/WC	$134.26
Rate for Payer: UnitedHealthcare Community & State	$28.28
Rate for Payer: Wellpoint Medicaid Managed Care	$25.42

SCREW ST T25STDR TI LOCK 5MM

Facility

$895.05

Service Code	HCPCS C1713
Hospital Charge Code	270693694
Hospital Revenue Code	278
Min. Negotiated Rate	$134.26
Max. Negotiated Rate	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.60
Rate for Payer: Qualcare PPO/HMO/WC	$134.26

SCREW ST VAR 4.5X12MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695653
Hospital Revenue Code	278
Min. Negotiated Rate	$136.32
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Community & State	$151.68
Rate for Payer: Wellpoint Medicaid Managed Care	$136.32

SCREW ST VAR 4.5X12MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695653
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

SCREW SYMPHONY 3.5X18MM

Facility

$8,911.70

Service Code	HCPCS C1713
Hospital Charge Code	270694480
Hospital Revenue Code	278
Min. Negotiated Rate	$1,336.76
Max. Negotiated Rate	$2,156.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,782.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,156.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.76

SCREW SYMPHONY 3.5X18MM

Facility

$8,911.70

Service Code	HCPCS C1713
Hospital Charge Code	270694480
Hospital Revenue Code	278
Min. Negotiated Rate	$253.09
Max. Negotiated Rate	$4,455.85
Rate for Payer: Aetna Commercial	$3,386.45
Rate for Payer: Aetna Medicare Advantage	$2,673.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,782.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,272.48
Rate for Payer: Cigna Commercial	$4,455.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,156.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.76
Rate for Payer: UnitedHealthcare Community & State	$281.61
Rate for Payer: Wellpoint Medicaid Managed Care	$253.09

SCREW SYMPHONY OCT SET TALL

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693351
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 SYMPHONY OCT SET TALL

Facility

$1,045.50

Service Code	HCPCS C1713
Hospital Charge Code	270693351
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 SYN CANC PT THD 4.0/26MM

Facility

$71.25

Service Code	HCPCS C1713
Hospital Charge Code	270604271
Hospital Revenue Code	278
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$17.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

SCREW SYN CANC PT THD 4.0/26MM

Facility

$71.25

Service Code	HCPCS C1713
Hospital Charge Code	270604271
Hospital Revenue Code	278
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Community & State	$2.25
Rate for Payer: Wellpoint Medicaid Managed Care	$2.02

SCREW SYN CANC TL 16 7.3 105MM

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605034
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

SCREW SYN CANC TL 16 7.3 105MM

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270605034
Hospital Revenue Code	278
Min. Negotiated Rate	$31.15
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$34.66
Rate for Payer: Wellpoint Medicaid Managed Care	$31.15

SCREW SYN CORT 3.5 30MM 204.30

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604212
Hospital Revenue Code	278
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Community & State	$2.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

SCREW SYN CORT 3.5 30MM 204.30

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604212
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 40MM 204.40

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604217
Hospital Revenue Code	278
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Community & State	$2.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

SCREW SYN CORT 3.5 40MM 204.40

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604217
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 45MM 204.45

Facility

$75.00

Service Code	HCPCS C1713
Hospital Charge Code	270604218
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

SCREW SYN CORT 3.5 45MM 204.45

Facility

$75.00

Service Code	HCPCS C1713
Hospital Charge Code	270604218
Hospital Revenue Code	278
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

SCREW SYNFIX EVO FINE 20MM

Facility

$4,097.70

Service Code	HCPCS C1713
Hospital Charge Code	270698985
Hospital Revenue Code	278
Min. Negotiated Rate	$116.37
Max. Negotiated Rate	$2,048.85
Rate for Payer: Aetna Commercial	$1,557.13
Rate for Payer: Aetna Medicare Advantage	$1,229.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$819.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.91
Rate for Payer: Cigna Commercial	$2,048.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$991.64
Rate for Payer: Qualcare PPO/HMO/WC	$614.65
Rate for Payer: UnitedHealthcare Community & State	$129.49
Rate for Payer: Wellpoint Medicaid Managed Care	$116.37

SCREW SYNFIX EVO FINE 20MM

Facility

$4,097.70

Service Code	HCPCS C1713
Hospital Charge Code	270698985
Hospital Revenue Code	278
Min. Negotiated Rate	$614.65
Max. Negotiated Rate	$991.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$819.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$991.64
Rate for Payer: Qualcare PPO/HMO/WC	$614.65

SCREW SYN LOCKING 497-78

Facility

$211.25

Service Code	HCPCS C1713
Hospital Charge Code	270609418
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$51.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

SCREW SYN LOCKING 497-78

Facility

$211.25

Service Code	HCPCS C1713
Hospital Charge Code	270609418
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$80.28
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Community & State	$6.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6.00

SCREW SYN SCHZ 6/190MM 294.68

Facility

$424.00

Service Code	HCPCS C1713
Hospital Charge Code	270615261
Hospital Revenue Code	278
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$212.00
Rate for Payer: Aetna Commercial	$161.12
Rate for Payer: Aetna Medicare Advantage	$127.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.12
Rate for Payer: Cigna Commercial	$212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.61
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
Rate for Payer: UnitedHealthcare Community & State	$13.40
Rate for Payer: Wellpoint Medicaid Managed Care	$12.04

SCREW SYN SCHZ 6/190MM 294.68

Facility

$424.00

Service Code	HCPCS C1713
Hospital Charge Code	270615261
Hospital Revenue Code	278
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$102.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.61
Rate for Payer: Qualcare PPO/HMO/WC	$63.60

Know your out-of-pocket cost for care.

All Charges