Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TAP 3.5MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699636
Hospital Revenue Code	272
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SCREW TAP 4.0MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699635
Hospital Revenue Code	272
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$367.50
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SCREW TAP 4.0MM

Facility

$2,450.00

Service Code	HCPCS A4649
Hospital Charge Code	270699635
Hospital Revenue Code	272
Min. Negotiated Rate	$69.58
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$931.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$637.00
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.50
Rate for Payer: UnitedHealthcare Commercial	$490.00
Rate for Payer: UnitedHealthcare Community & State	$77.42
Rate for Payer: Wellpoint Medicaid Managed Care	$69.58

SCREW TAP. 4.5MM

Facility

$16,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270683896
Hospital Revenue Code	278
Min. Negotiated Rate	$482.23
Max. Negotiated Rate	$8,490.00
Rate for Payer: Aetna Commercial	$6,452.40
Rate for Payer: Aetna Medicare Advantage	$5,094.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,329.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,329.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,329.90
Rate for Payer: Cigna Commercial	$8,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,109.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,547.00
Rate for Payer: UnitedHealthcare Community & State	$536.57
Rate for Payer: Wellpoint Medicaid Managed Care	$482.23

SCREW TAP. 4.5MM

Facility

$16,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270683896
Hospital Revenue Code	278
Min. Negotiated Rate	$2,547.00
Max. Negotiated Rate	$4,109.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,109.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,547.00

SCREW TAP 4 X 16 MM

Facility

$1,000.00

Hospital Charge Code	270695121
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 TAP 4 X 16 MM

Facility

$1,000.00

Hospital Charge Code	270695121
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 TAP SELF 16MM

Facility

$1,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270689204
Hospital Revenue Code	278
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$629.38
Rate for Payer: Aetna Commercial	$478.32
Rate for Payer: Aetna Medicare Advantage	$377.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.98
Rate for Payer: Cigna Commercial	$629.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.62
Rate for Payer: Qualcare PPO/HMO/WC	$188.81
Rate for Payer: UnitedHealthcare Community & State	$39.78
Rate for Payer: Wellpoint Medicaid Managed Care	$35.75

SCREW TAP SELF 16MM

Facility

$1,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270689204
Hospital Revenue Code	278
Min. Negotiated Rate	$188.81
Max. Negotiated Rate	$304.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.62
Rate for Payer: Qualcare PPO/HMO/WC	$188.81

SCREW TAP VARIABLE 4.5X12MM

Facility

$875.00

Hospital Charge Code	270703044
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 TAP VARIABLE 4.5X12MM

Facility

$875.00

Hospital Charge Code	270703044
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 TBOLT POLY 5.5X40MM

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696794
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

SCREW TBOLT POLY 5.5X40MM

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696794
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

SCREW TENO 5.5x8MM

Facility

$2,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270676705
Hospital Revenue Code	278
Min. Negotiated Rate	$57.94
Max. Negotiated Rate	$1,020.00
Rate for Payer: Aetna Commercial	$775.20
Rate for Payer: Aetna Medicare Advantage	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$520.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$520.20
Rate for Payer: Cigna Commercial	$1,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.68
Rate for Payer: Qualcare PPO/HMO/WC	$306.00
Rate for Payer: UnitedHealthcare Community & State	$64.46
Rate for Payer: Wellpoint Medicaid Managed Care	$57.94

SCREW TENO 5.5x8MM

Facility

$2,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270676705
Hospital Revenue Code	278
Min. Negotiated Rate	$306.00
Max. Negotiated Rate	$493.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$493.68
Rate for Payer: Qualcare PPO/HMO/WC	$306.00

SCREW TENODESIS 4 X10

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270685594
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 4 X10

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270685594
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SCREW TENODESIS 4X10 MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270687615
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SCREW TENODESIS 4X10 MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270687615
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 5.5x15MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270675073
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 5.5x15MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270675073
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

SCREW TENODESIS 6.25 X15 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688245
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW TENODESIS 6.25 X15 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688245
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

SCREW TENODESIS DISP 2.5 X 6

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691591
Hospital Revenue Code	278
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

SCREW TENODESIS DISP 2.5 X 6

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691591
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

Know your out-of-pocket cost for care.

All Charges