Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TENODESIS PEEK

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691590
Hospital Revenue Code	278
Min. Negotiated Rate	$57.51
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$769.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75
Rate for Payer: UnitedHealthcare Community & State	$63.99
Rate for Payer: Wellpoint Medicaid Managed Care	$57.51

SCREW TENODESIS PEEK

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691590
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SCREW TENODESIS PEEK

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691580
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

SCREW TENODESIS PEEK

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691580
Hospital Revenue Code	278
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

SCREW TENODESIS W/DRIVER PK 5.

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679968
Hospital Revenue Code	278
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

SCREW TENODESIS W/DRIVER PK 5.

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679968
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

SCREW TFNA 105MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676514
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 105MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676514
Hospital Revenue Code	278
Min. Negotiated Rate	$89.07
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$99.11
Rate for Payer: Wellpoint Medicaid Managed Care	$89.07

SCREW TFNA 75MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270694884
Hospital Revenue Code	278
Min. Negotiated Rate	$533.89
Max. Negotiated Rate	$861.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: Qualcare PPO/HMO/WC	$533.89

SCREW TFNA 75MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270694884
Hospital Revenue Code	278
Min. Negotiated Rate	$101.08
Max. Negotiated Rate	$1,779.65
Rate for Payer: Aetna Commercial	$1,352.53
Rate for Payer: Aetna Medicare Advantage	$1,067.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$907.62
Rate for Payer: Cigna Commercial	$1,779.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: Qualcare PPO/HMO/WC	$533.89
Rate for Payer: UnitedHealthcare Community & State	$112.47
Rate for Payer: Wellpoint Medicaid Managed Care	$101.08

SCREW TFNA 80MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676286
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 80MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676286
Hospital Revenue Code	278
Min. Negotiated Rate	$89.07
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$99.11
Rate for Payer: Wellpoint Medicaid Managed Care	$89.07

SCREW TFNA 85MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676276
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 85MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676276
Hospital Revenue Code	278
Min. Negotiated Rate	$89.07
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$99.11
Rate for Payer: Wellpoint Medicaid Managed Care	$89.07

SCREW TFNA 90MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270675685
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 90MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270675685
Hospital Revenue Code	278
Min. Negotiated Rate	$89.07
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$1,191.81
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45
Rate for Payer: UnitedHealthcare Community & State	$99.11
Rate for Payer: Wellpoint Medicaid Managed Care	$89.07

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702805
Hospital Revenue Code	278
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$29.55
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702805
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702806
Hospital Revenue Code	278
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$29.55
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

SCREW THD 4.0 MM X 34 MM

Facility

$935.00

Hospital Charge Code	270702806
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 44 MM

Facility

$935.00

Hospital Charge Code	270702807
Hospital Revenue Code	278
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$29.55
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

SCREW THD 4.0 MM X 44 MM

Facility

$935.00

Hospital Charge Code	270702807
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 48 MM

Facility

$935.00

Hospital Charge Code	270702808
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

SCREW THD 4.0 MM X 48 MM

Facility

$935.00

Hospital Charge Code	270702808
Hospital Revenue Code	278
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Community & State	$29.55
Rate for Payer: Wellpoint Medicaid Managed Care	$26.55

SCREW THD 4.0 MM X 50 MM

Facility

$935.00

Hospital Charge Code	270702810
Hospital Revenue Code	278
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$226.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.27
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

Know your out-of-pocket cost for care.

All Charges