Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VERIDTE 12MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270686287
Hospital Revenue Code	278
Min. Negotiated Rate	$39.05
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Community & State	$43.45
Rate for Payer: Wellpoint Medicaid Managed Care	$39.05

SCREW VERIDTE 12MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270686286
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW VERSAFITCUP 30MM

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270683284
Hospital Revenue Code	278
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

SCREW VERSAFITCUP 30MM

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270683284
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SCREW VIPER CORT PED TI 7X45MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693868
Hospital Revenue Code	278
Min. Negotiated Rate	$234.30
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$260.70
Rate for Payer: Wellpoint Medicaid Managed Care	$234.30

SCREW VIPER CORT PED TI 7X45MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693868
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

SCREW VIPER CORT PED TI 7X50MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693869
Hospital Revenue Code	278
Min. Negotiated Rate	$234.30
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$260.70
Rate for Payer: Wellpoint Medicaid Managed Care	$234.30

SCREW VIPER CORT PED TI 7X50MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693869
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

SCREW VOYAGER 5.5 MAS 5.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699435
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW VOYAGER 5.5 MAS 5.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699435
Hospital Revenue Code	278
Min. Negotiated Rate	$189.43
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$210.77
Rate for Payer: Wellpoint Medicaid Managed Care	$189.43

SCREW VOYAGER 5.5 MAS 6.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699432
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW VOYAGER 5.5 MAS 6.5X50MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699432
Hospital Revenue Code	278
Min. Negotiated Rate	$189.43
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$210.77
Rate for Payer: Wellpoint Medicaid Managed Care	$189.43

SCREW VOYAGER 5.5X40MM

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697029
Hospital Revenue Code	278
Min. Negotiated Rate	$411.80
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$5,510.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00
Rate for Payer: UnitedHealthcare Community & State	$458.20
Rate for Payer: Wellpoint Medicaid Managed Care	$411.80

SCREW VOYAGER 5.5X40MM

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697029
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

SCREW VOYAGER MAS 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699078
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

SCREW VOYAGER MAS 6.5X45MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270699078
Hospital Revenue Code	278
Min. Negotiated Rate	$189.43
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,534.60
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50
Rate for Payer: UnitedHealthcare Community & State	$210.77
Rate for Payer: Wellpoint Medicaid Managed Care	$189.43

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689421
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689422
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$471.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689421
Hospital Revenue Code	278
Min. Negotiated Rate	$55.38
Max. Negotiated Rate	$975.00
Rate for Payer: Aetna Commercial	$741.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50
Rate for Payer: UnitedHealthcare Community & State	$61.62
Rate for Payer: Wellpoint Medicaid Managed Care	$55.38

SCREW VPC 3.4 X 28 MM

Facility

$1,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270689422
Hospital Revenue Code	278
Min. Negotiated Rate	$55.38
Max. Negotiated Rate	$975.00
Rate for Payer: Aetna Commercial	$741.00
Rate for Payer: Aetna Medicare Advantage	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$497.25
Rate for Payer: Cigna Commercial	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.90
Rate for Payer: Qualcare PPO/HMO/WC	$292.50
Rate for Payer: UnitedHealthcare Community & State	$61.62
Rate for Payer: Wellpoint Medicaid Managed Care	$55.38

SCREW VSD 32MM 14MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696323
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

SCREW VSD 32MM 14MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696323
Hospital Revenue Code	278
Min. Negotiated Rate	$546.70
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$608.30
Rate for Payer: Wellpoint Medicaid Managed Care	$546.70

SCREW VSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695489
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW VSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695489
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

SCREW VSD 4X16 MM

Facility

$875.00

Hospital Charge Code	270703097
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

Know your out-of-pocket cost for care.

All Charges