Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

4.0MM SCHNZ SCRW SPADEPNT 80MM

Facility

$378.75

Service Code	HCPCS C1713
Hospital Charge Code	270601801
Hospital Revenue Code	278
Min. Negotiated Rate	$10.76
Max. Negotiated Rate	$189.38
Rate for Payer: Aetna Commercial	$143.93
Rate for Payer: Aetna Medicare Advantage	$113.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.58
Rate for Payer: Cigna Commercial	$189.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$56.81
Rate for Payer: UnitedHealthcare Community & State	$11.97
Rate for Payer: Wellpoint Medicaid Managed Care	$10.76

4.0MM SCHNZ SCRW SPADEPNT 80MM

Facility

$378.75

Service Code	HCPCS C1713
Hospital Charge Code	270601801
Hospital Revenue Code	278
Min. Negotiated Rate	$56.81
Max. Negotiated Rate	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$56.81

4.0MM SCHNZ SCRW SPADPNT 100MM

Facility

$378.75

Service Code	HCPCS C1713
Hospital Charge Code	270601802
Hospital Revenue Code	278
Min. Negotiated Rate	$56.81
Max. Negotiated Rate	$91.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$56.81

4.0MM SCHNZ SCRW SPADPNT 100MM

Facility

$378.75

Service Code	HCPCS C1713
Hospital Charge Code	270601802
Hospital Revenue Code	278
Min. Negotiated Rate	$10.76
Max. Negotiated Rate	$189.38
Rate for Payer: Aetna Commercial	$143.93
Rate for Payer: Aetna Medicare Advantage	$113.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.58
Rate for Payer: Cigna Commercial	$189.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$56.81
Rate for Payer: UnitedHealthcare Community & State	$11.97
Rate for Payer: Wellpoint Medicaid Managed Care	$10.76

4.0mm SELF-DRILL SCHANZ SCREW

Facility

$643.75

Hospital Charge Code	270702320
Hospital Revenue Code	278
Min. Negotiated Rate	$96.56
Max. Negotiated Rate	$155.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.79
Rate for Payer: Qualcare PPO/HMO/WC	$96.56

4.0mm SELF-DRILL SCHANZ SCREW

Facility

$643.75

Hospital Charge Code	270702320
Hospital Revenue Code	278
Min. Negotiated Rate	$18.28
Max. Negotiated Rate	$321.88
Rate for Payer: Aetna Commercial	$244.62
Rate for Payer: Aetna Medicare Advantage	$193.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.16
Rate for Payer: Cigna Commercial	$321.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.79
Rate for Payer: Qualcare PPO/HMO/WC	$96.56
Rate for Payer: UnitedHealthcare Community & State	$20.34
Rate for Payer: Wellpoint Medicaid Managed Care	$18.28

4.0MM TAP GPS

Facility

$6,190.00

Hospital Charge Code	270697223
Hospital Revenue Code	272
Min. Negotiated Rate	$175.80
Max. Negotiated Rate	$3,095.00
Rate for Payer: Aetna Commercial	$2,352.20
Rate for Payer: Aetna Medicare Advantage	$1,857.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,578.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,578.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,578.45
Rate for Payer: Cigna Commercial	$3,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,609.40
Rate for Payer: Oxford Commercial	$1,238.00
Rate for Payer: Qualcare PPO/HMO/WC	$928.50
Rate for Payer: UnitedHealthcare Commercial	$1,238.00
Rate for Payer: UnitedHealthcare Community & State	$195.60
Rate for Payer: Wellpoint Medicaid Managed Care	$175.80

4.0MM TAP GPS

Facility

$6,190.00

Hospital Charge Code	270697223
Hospital Revenue Code	272
Min. Negotiated Rate	$928.50
Max. Negotiated Rate	$928.50
Rate for Payer: Qualcare PPO/HMO/WC	$928.50

4.0MM X 36MM PTTHR CANN SCREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270671979
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

4.0MM X 36MM PTTHR CANN SCREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270671979
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

4.0 SCREW

Facility

$652.00

Hospital Charge Code	270335946
Hospital Revenue Code	278
Min. Negotiated Rate	$97.80
Max. Negotiated Rate	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.78
Rate for Payer: Qualcare PPO/HMO/WC	$97.80

4.0 SCREW

Facility

$652.00

Hospital Charge Code	270335946
Hospital Revenue Code	278
Min. Negotiated Rate	$18.52
Max. Negotiated Rate	$326.00
Rate for Payer: Aetna Commercial	$247.76
Rate for Payer: Aetna Medicare Advantage	$195.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.26
Rate for Payer: Cigna Commercial	$326.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.78
Rate for Payer: Qualcare PPO/HMO/WC	$97.80
Rate for Payer: UnitedHealthcare Community & State	$20.60
Rate for Payer: Wellpoint Medicaid Managed Care	$18.52

4.0X10 PART THD CANC SCR

Facility

$302.50

Service Code	HCPCS C1713
Hospital Charge Code	270704665
Hospital Revenue Code	278
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$151.25
Rate for Payer: Aetna Commercial	$114.95
Rate for Payer: Aetna Medicare Advantage	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.14
Rate for Payer: Cigna Commercial	$151.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$45.38
Rate for Payer: UnitedHealthcare Community & State	$9.56
Rate for Payer: Wellpoint Medicaid Managed Care	$8.59

4.0X10 PART THD CANC SCR

Facility

$302.50

Service Code	HCPCS C1713
Hospital Charge Code	270704665
Hospital Revenue Code	278
Min. Negotiated Rate	$45.38
Max. Negotiated Rate	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$45.38

4.0X12MM BONE SCREW

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270705463
Hospital Revenue Code	278
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Community & State	$16.59
Rate for Payer: Wellpoint Medicaid Managed Care	$14.91

4.0X12MM BONE SCREW

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270705463
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

4.0X42 LOCKING SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270671295
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

4.0X42 LOCKING SCREW

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270671295
Hospital Revenue Code	278
Min. Negotiated Rate	$27.84
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$372.50
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04
Rate for Payer: UnitedHealthcare Community & State	$30.98
Rate for Payer: Wellpoint Medicaid Managed Care	$27.84

4.25X16MM VARIABLE SCREW

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270704838
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

4.25X16MM VARIABLE SCREW

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270704838
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

4.2X14MM SCREW

Facility

$4,275.00

Service Code	HCPCS 4275
Hospital Charge Code	270704993
Hospital Revenue Code	278
Min. Negotiated Rate	$121.41
Max. Negotiated Rate	$2,137.50
Rate for Payer: Aetna Commercial	$1,624.50
Rate for Payer: Aetna Medicare Advantage	$1,282.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,090.12
Rate for Payer: Cigna Commercial	$2,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25
Rate for Payer: UnitedHealthcare Community & State	$135.09
Rate for Payer: Wellpoint Medicaid Managed Care	$121.41

4.2X14MM SCREW

Facility

$4,275.00

Service Code	HCPCS 4275
Hospital Charge Code	270704993
Hospital Revenue Code	278
Min. Negotiated Rate	$641.25
Max. Negotiated Rate	$1,034.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25

4.2X23MM SCREW

Facility

$4,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270704995
Hospital Revenue Code	278
Min. Negotiated Rate	$121.41
Max. Negotiated Rate	$2,137.50
Rate for Payer: Aetna Commercial	$1,624.50
Rate for Payer: Aetna Medicare Advantage	$1,282.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,090.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,090.12
Rate for Payer: Cigna Commercial	$2,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25
Rate for Payer: UnitedHealthcare Community & State	$135.09
Rate for Payer: Wellpoint Medicaid Managed Care	$121.41

4.2X23MM SCREW

Facility

$4,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270704995
Hospital Revenue Code	278
Min. Negotiated Rate	$641.25
Max. Negotiated Rate	$1,034.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.55
Rate for Payer: Qualcare PPO/HMO/WC	$641.25

42X4.0 LOCKING SCREW

Facility

$752.70

Service Code	HCPCS C1713
Hospital Charge Code	270656441
Hospital Revenue Code	278
Min. Negotiated Rate	$112.91
Max. Negotiated Rate	$182.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.15
Rate for Payer: Qualcare PPO/HMO/WC	$112.91

Know your out-of-pocket cost for care.

All Charges