Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VSD 4X16 MM

Facility

$875.00

Hospital Charge Code	270703097
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 VSD 5X20MM

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703637
Hospital Revenue Code	278
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$361.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50
Rate for Payer: UnitedHealthcare Community & State	$30.02
Rate for Payer: Wellpoint Medicaid Managed Care	$26.98

SCREW VSD 5X20MM

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703637
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW WEDGE 8x25MM

Facility

$955.00

Hospital Charge Code	270676063
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WEDGE 8x25MM

Facility

$955.00

Hospital Charge Code	270676063
Hospital Revenue Code	278
Min. Negotiated Rate	$27.12
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: Wellpoint Medicaid Managed Care	$27.12

SCREW WEDGE 8x25MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673447
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WEDGE 8x25MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673447
Hospital Revenue Code	278
Min. Negotiated Rate	$27.12
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: Wellpoint Medicaid Managed Care	$27.12

SCREW WEDGE 9x20MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673448
Hospital Revenue Code	278
Min. Negotiated Rate	$27.12
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: Wellpoint Medicaid Managed Care	$27.12

SCREW WEDGE 9x20MM UNIVERSAL

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270673448
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WEDGE 9X25MM UNIVERSAL

Facility

$955.00

Hospital Charge Code	270670501
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

SCREW WEDGE 9X25MM UNIVERSAL

Facility

$955.00

Hospital Charge Code	270670501
Hospital Revenue Code	278
Min. Negotiated Rate	$27.12
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$362.90
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: Wellpoint Medicaid Managed Care	$27.12

SCREW WHEAD COMP 4.3MM X 34

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688009
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25
Rate for Payer: UnitedHealthcare Community & State	$59.25
Rate for Payer: Wellpoint Medicaid Managed Care	$53.25

SCREW WHEAD COMP 4.3MM X 34

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688009
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

SCREW X-CORE MINI TI LOCK,E

Facility

$2,475.00

Hospital Charge Code	270666086
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW X-CORE MINI TI LOCK,E

Facility

$2,475.00

Hospital Charge Code	270666086
Hospital Revenue Code	278
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

SCREW XTAB CANN FEN POLYAX 7.5

Facility

$9,250.00

Hospital Charge Code	270701735
Hospital Revenue Code	278
Min. Negotiated Rate	$262.70
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$3,515.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50
Rate for Payer: UnitedHealthcare Community & State	$292.30
Rate for Payer: Wellpoint Medicaid Managed Care	$262.70

SCREW XTAB CANN FEN POLYAX 7.5

Facility

$9,250.00

Hospital Charge Code	270701735
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

SCREW ZAVATION SDVA 4.0X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699099
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 ZAVATION SDVA 4.0X12MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699099
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 ZEVO VAR SD 3.5X13MM

Facility

$2,486.25

Service Code	HCPCS C1713
Hospital Charge Code	270697820
Hospital Revenue Code	278
Min. Negotiated Rate	$372.94
Max. Negotiated Rate	$601.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$497.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$601.67
Rate for Payer: Qualcare PPO/HMO/WC	$372.94

SCREW ZEVO VAR SD 3.5X13MM

Facility

$2,486.25

Service Code	HCPCS C1713
Hospital Charge Code	270697820
Hospital Revenue Code	278
Min. Negotiated Rate	$70.61
Max. Negotiated Rate	$1,243.12
Rate for Payer: Aetna Commercial	$944.77
Rate for Payer: Aetna Medicare Advantage	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$633.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$633.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$633.99
Rate for Payer: Cigna Commercial	$1,243.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$601.67
Rate for Payer: Qualcare PPO/HMO/WC	$372.94
Rate for Payer: UnitedHealthcare Community & State	$78.57
Rate for Payer: Wellpoint Medicaid Managed Care	$70.61

SCREW ZEVO VAR SD 3.5X15MM

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270695968
Hospital Revenue Code	278
Min. Negotiated Rate	$438.00
Max. Negotiated Rate	$706.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: Qualcare PPO/HMO/WC	$438.00

SCREW ZEVO VAR SD 3.5X15MM

Facility

$2,920.00

Service Code	HCPCS C1713
Hospital Charge Code	270695968
Hospital Revenue Code	278
Min. Negotiated Rate	$82.93
Max. Negotiated Rate	$1,460.00
Rate for Payer: Aetna Commercial	$1,109.60
Rate for Payer: Aetna Medicare Advantage	$876.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$744.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$744.60
Rate for Payer: Cigna Commercial	$1,460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$706.64
Rate for Payer: Qualcare PPO/HMO/WC	$438.00
Rate for Payer: UnitedHealthcare Community & State	$92.27
Rate for Payer: Wellpoint Medicaid Managed Care	$82.93

SCREW ZIM CANC 6.5 16 45

Facility

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	270610370
Hospital Revenue Code	278
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

SCREW ZIM CANC 6.5 16 45

Facility

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	270610370
Hospital Revenue Code	278
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

Know your out-of-pocket cost for care.

All Charges