Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI PEDICLE POLY 6.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694184
Hospital Revenue Code	278
Min. Negotiated Rate	$191.42
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$212.98
Rate for Payer: Wellpoint Medicaid Managed Care	$191.42

SCREW TI PEDICLE POLY 6.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694184
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI PEDICLE POLY 8.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694812
Hospital Revenue Code	278
Min. Negotiated Rate	$191.42
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$212.98
Rate for Payer: Wellpoint Medicaid Managed Care	$191.42

SCREW TI PEDICLE POLY 8.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI POLYAX 8.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI POLYAX 8.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695705
Hospital Revenue Code	278
Min. Negotiated Rate	$191.42
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,561.20
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00
Rate for Payer: UnitedHealthcare Community & State	$212.98
Rate for Payer: Wellpoint Medicaid Managed Care	$191.42

SCREW TI SD MAXTORQUE 4X45MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700602
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW TI SD MAXTORQUE 4X45MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700602
Hospital Revenue Code	278
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$404.70
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75
Rate for Payer: UnitedHealthcare Community & State	$33.65
Rate for Payer: Wellpoint Medicaid Managed Care	$30.25

SCREW TI SD VA 4.0X14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697204
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 TI SD VA 4.0X14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697204
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 TI SELFTAP 4.5MMX14MM

Facility

$1,465.00

Service Code	HCPCS C1713
Hospital Charge Code	270693705
Hospital Revenue Code	278
Min. Negotiated Rate	$219.75
Max. Negotiated Rate	$354.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.53
Rate for Payer: Qualcare PPO/HMO/WC	$219.75

SCREW TI SELFTAP 4.5MMX14MM

Facility

$1,465.00

Service Code	HCPCS C1713
Hospital Charge Code	270693705
Hospital Revenue Code	278
Min. Negotiated Rate	$41.61
Max. Negotiated Rate	$732.50
Rate for Payer: Aetna Commercial	$556.70
Rate for Payer: Aetna Medicare Advantage	$439.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.57
Rate for Payer: Cigna Commercial	$732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.53
Rate for Payer: Qualcare PPO/HMO/WC	$219.75
Rate for Payer: UnitedHealthcare Community & State	$46.29
Rate for Payer: Wellpoint Medicaid Managed Care	$41.61

SCREW TI SNAP OFF 2.75X16MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699707
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

SCREW TI SNAP OFF 2.75X16MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699707
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TI SNAP OFF 2.75X18MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699706
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

SCREW TI SNAP OFF 2.75X18MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699706
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TITANIUM 2.0X 13MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270684052
Hospital Revenue Code	278
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$344.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

SCREW TITANIUM 2.0X 13MM

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270684052
Hospital Revenue Code	278
Min. Negotiated Rate	$40.47
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$541.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.85
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Community & State	$45.03
Rate for Payer: Wellpoint Medicaid Managed Care	$40.47

SCREW TIT LOK 3.5MM X 34M

Facility

$750.02

Service Code	HCPCS C1713
Hospital Charge Code	270687869
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW TIT LOK 3.5MM X 34M

Facility

$750.02

Service Code	HCPCS C1713
Hospital Charge Code	270687869
Hospital Revenue Code	278
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$375.01
Rate for Payer: Aetna Commercial	$285.01
Rate for Payer: Aetna Medicare Advantage	$225.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.26
Rate for Payer: Cigna Commercial	$375.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$23.70
Rate for Payer: Wellpoint Medicaid Managed Care	$21.30

SCREW TI VAL 3.0X22MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692861
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 TI VAL 3.0X22MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692861
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 TM CORT ST 6.5X50MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270697049
Hospital Revenue Code	278
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

SCREW TM CORT ST 6.5X50MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270697049
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW TNFA-ADVANCE 85 MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270698687
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

Know your out-of-pocket cost for care.

All Charges