Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI INCORE 3.5 X 54MM

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688019
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW Ti LAG 010.5x75mm

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270671132
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$1,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

SCREW Ti LAG 010.5x75mm

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270671132
Hospital Revenue Code	278
Min. Negotiated Rate	$125.81
Max. Negotiated Rate	$2,215.00
Rate for Payer: Aetna Commercial	$1,683.40
Rate for Payer: Aetna Medicare Advantage	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.65
Rate for Payer: Cigna Commercial	$2,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50
Rate for Payer: UnitedHealthcare Community & State	$139.99
Rate for Payer: Wellpoint Medicaid Managed Care	$125.81

SCREW TI LKG LP 3.5X12MM

Facility

$812.50

Service Code	HCPCS C1713
Hospital Charge Code	270688318
Hospital Revenue Code	278
Min. Negotiated Rate	$23.07
Max. Negotiated Rate	$406.25
Rate for Payer: Aetna Commercial	$308.75
Rate for Payer: Aetna Medicare Advantage	$243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.19
Rate for Payer: Cigna Commercial	$406.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.62
Rate for Payer: Qualcare PPO/HMO/WC	$121.88
Rate for Payer: UnitedHealthcare Community & State	$25.68
Rate for Payer: Wellpoint Medicaid Managed Care	$23.07

SCREW TI LKG LP 3.5X12MM

Facility

$812.50

Service Code	HCPCS C1713
Hospital Charge Code	270688318
Hospital Revenue Code	278
Min. Negotiated Rate	$121.88
Max. Negotiated Rate	$196.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.62
Rate for Payer: Qualcare PPO/HMO/WC	$121.88

SCREW TI LOCKING 5X50MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270645391
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TI LOCKING 5X50MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270645391
Hospital Revenue Code	278
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.84

SCREW TI LOCKING 5X56MM

Facility

$945.00

Hospital Charge Code	270670733
Hospital Revenue Code	278
Min. Negotiated Rate	$26.84
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$359.10
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Community & State	$29.86
Rate for Payer: Wellpoint Medicaid Managed Care	$26.84

SCREW TI LOCKING 5X56MM

Facility

$945.00

Hospital Charge Code	270670733
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TILOCK SET

Facility

$804.75

Service Code	HCPCS C1713
Hospital Charge Code	270699239
Hospital Revenue Code	278
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$402.38
Rate for Payer: Aetna Commercial	$305.81
Rate for Payer: Aetna Medicare Advantage	$241.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.21
Rate for Payer: Cigna Commercial	$402.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.71
Rate for Payer: UnitedHealthcare Community & State	$25.43
Rate for Payer: Wellpoint Medicaid Managed Care	$22.85

SCREW TILOCK SET

Facility

$804.75

Service Code	HCPCS C1713
Hospital Charge Code	270699239
Hospital Revenue Code	278
Min. Negotiated Rate	$120.71
Max. Negotiated Rate	$194.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.71

SCREW TILOC WT25 STR DR 5X76MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270680163
Hospital Revenue Code	278
Min. Negotiated Rate	$21.24
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$284.16
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17
Rate for Payer: UnitedHealthcare Community & State	$23.63
Rate for Payer: Wellpoint Medicaid Managed Care	$21.24

SCREW TILOC WT25 STR DR 5X76MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270680163
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW TI LOW PROFILE 4X24MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270677408
Hospital Revenue Code	278
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Community & State	$9.48
Rate for Payer: Wellpoint Medicaid Managed Care	$8.52

SCREW TI LOW PROFILE 4X24MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270677408
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW TI MATRIXNEURO SD 3MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270697090
Hospital Revenue Code	278
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$262.20
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50
Rate for Payer: UnitedHealthcare Community & State	$21.80
Rate for Payer: Wellpoint Medicaid Managed Care	$19.60

SCREW TI MATRIXNEURO SD 3MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270697090
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$166.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

SCREW TI MOD CANN 8.5X50MM

Facility

$7,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695297
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.65
Max. Negotiated Rate	$1,875.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.65

SCREW TI MOD CANN 8.5X50MM

Facility

$7,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695297
Hospital Revenue Code	278
Min. Negotiated Rate	$220.13
Max. Negotiated Rate	$3,875.50
Rate for Payer: Aetna Commercial	$2,945.38
Rate for Payer: Aetna Medicare Advantage	$2,325.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.51
Rate for Payer: Cigna Commercial	$3,875.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.65
Rate for Payer: UnitedHealthcare Community & State	$244.93
Rate for Payer: Wellpoint Medicaid Managed Care	$220.13

SCREW TI MOD CANN 9.5X50MM

Facility

$5,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695298
Hospital Revenue Code	278
Min. Negotiated Rate	$163.33
Max. Negotiated Rate	$2,875.50
Rate for Payer: Aetna Commercial	$2,185.38
Rate for Payer: Aetna Medicare Advantage	$1,725.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.51
Rate for Payer: Cigna Commercial	$2,875.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.74
Rate for Payer: Qualcare PPO/HMO/WC	$862.65
Rate for Payer: UnitedHealthcare Community & State	$181.73
Rate for Payer: Wellpoint Medicaid Managed Care	$163.33

SCREW TI MOD CANN 9.5X50MM

Facility

$5,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695298
Hospital Revenue Code	278
Min. Negotiated Rate	$862.65
Max. Negotiated Rate	$1,391.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.74
Rate for Payer: Qualcare PPO/HMO/WC	$862.65

SCREW TI MOD MIS CANN 7.5X40MM

Facility

$6,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270695962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,048.50
Max. Negotiated Rate	$1,691.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.50

SCREW TI MOD MIS CANN 7.5X40MM

Facility

$6,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270695962
Hospital Revenue Code	278
Min. Negotiated Rate	$198.52
Max. Negotiated Rate	$3,495.00
Rate for Payer: Aetna Commercial	$2,656.20
Rate for Payer: Aetna Medicare Advantage	$2,097.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,782.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,782.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,782.45
Rate for Payer: Cigna Commercial	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.50
Rate for Payer: UnitedHealthcare Community & State	$220.88
Rate for Payer: Wellpoint Medicaid Managed Care	$198.52

SCREW TI MODULAR GRN 6.5X50MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270699662
Hospital Revenue Code	278
Min. Negotiated Rate	$195.96
Max. Negotiated Rate	$3,450.00
Rate for Payer: Aetna Commercial	$2,622.00
Rate for Payer: Aetna Medicare Advantage	$2,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,759.50
Rate for Payer: Cigna Commercial	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00
Rate for Payer: UnitedHealthcare Community & State	$218.04
Rate for Payer: Wellpoint Medicaid Managed Care	$195.96

SCREW TI MODULAR GRN 6.5X50MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270699662
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,669.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00

Know your out-of-pocket cost for care.

All Charges