Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CORTEX SCREW 3.5X48MM

Facility

$260.40

Service Code	HCPCS C1713
Hospital Charge Code	270704453
Hospital Revenue Code	278
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$130.20
Rate for Payer: Aetna Commercial	$98.95
Rate for Payer: Aetna Medicare Advantage	$78.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.40
Rate for Payer: Cigna Commercial	$130.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.02
Rate for Payer: Qualcare PPO/HMO/WC	$39.06
Rate for Payer: UnitedHealthcare Community & State	$8.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.40

CORTEX SCREW 3.5X50MM

Facility

$455.15

Service Code	HCPCS C1713
Hospital Charge Code	270699291
Hospital Revenue Code	278
Min. Negotiated Rate	$12.93
Max. Negotiated Rate	$227.57
Rate for Payer: Aetna Commercial	$172.96
Rate for Payer: Aetna Medicare Advantage	$136.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.06
Rate for Payer: Cigna Commercial	$227.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.15
Rate for Payer: Qualcare PPO/HMO/WC	$68.27
Rate for Payer: UnitedHealthcare Community & State	$14.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.93

CORTEX SCREW 3.5X50MM

Facility

$455.15

Service Code	HCPCS C1713
Hospital Charge Code	270699291
Hospital Revenue Code	278
Min. Negotiated Rate	$68.27
Max. Negotiated Rate	$110.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.15
Rate for Payer: Qualcare PPO/HMO/WC	$68.27

CORTEX SCREW SELF TAP 18

Facility

$353.30

Service Code	HCPCS C1713
Hospital Charge Code	270680931
Hospital Revenue Code	278
Min. Negotiated Rate	$52.99
Max. Negotiated Rate	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.99

CORTEX SCREW SELF TAP 18

Facility

$353.30

Service Code	HCPCS C1713
Hospital Charge Code	270680931
Hospital Revenue Code	278
Min. Negotiated Rate	$10.03
Max. Negotiated Rate	$176.65
Rate for Payer: Aetna Commercial	$134.25
Rate for Payer: Aetna Medicare Advantage	$105.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.09
Rate for Payer: Cigna Commercial	$176.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.99
Rate for Payer: UnitedHealthcare Community & State	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$10.03

CORTEX SCREW SELF TAP 30

Facility

$333.00

Service Code	HCPCS C1713
Hospital Charge Code	270656616
Hospital Revenue Code	278
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$126.54
Rate for Payer: Aetna Medicare Advantage	$99.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.92
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.59
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Community & State	$10.52
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

CORTEX SCREW SELF TAP 30

Facility

$333.00

Service Code	HCPCS C1713
Hospital Charge Code	270656616
Hospital Revenue Code	278
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$80.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.59
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

CORT FIX POLYAX SCR 5.5 5X45MM

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270691061
Hospital Revenue Code	278
Min. Negotiated Rate	$1,088.14
Max. Negotiated Rate	$1,755.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.14

CORT FIX POLYAX SCR 5.5 5X45MM

Facility

$7,254.30

Service Code	HCPCS C1713
Hospital Charge Code	270691061
Hospital Revenue Code	278
Min. Negotiated Rate	$206.02
Max. Negotiated Rate	$3,627.15
Rate for Payer: Aetna Commercial	$2,756.63
Rate for Payer: Aetna Medicare Advantage	$2,176.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,849.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,849.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,849.85
Rate for Payer: Cigna Commercial	$3,627.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,755.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.14
Rate for Payer: UnitedHealthcare Community & State	$229.24
Rate for Payer: Wellpoint Medicaid Managed Care	$206.02

CORTICAL BONE SCR 5.0MM X 36MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270681530
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CORTICAL BONE SCR 5.0MM X 36MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270681530
Hospital Revenue Code	278
Min. Negotiated Rate	$21.13
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Community & State	$23.51
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

CORTICAL BONE SCR 5.0MM X 44MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680795
Hospital Revenue Code	278
Min. Negotiated Rate	$21.13
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Community & State	$23.51
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

CORTICAL BONE SCR 5.0MM X 44MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680795
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CORTICAL BONE SCR 5.0MM X 50MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680794
Hospital Revenue Code	278
Min. Negotiated Rate	$21.13
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$282.72
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Community & State	$23.51
Rate for Payer: Wellpoint Medicaid Managed Care	$21.13

CORTICAL BONE SCR 5.0MM X 50MM

Facility

$744.00

Service Code	HCPCS C1713
Hospital Charge Code	270680794
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

CORTICAL BONE SCR 5.0MM X 60 M

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688656
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CORTICAL BONE SCR 5.0MM X 60 M

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688656
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CORTICAL BONE SCREW 2.0MM X 40

Facility

$768.00

Service Code	HCPCS C1713
Hospital Charge Code	270681749
Hospital Revenue Code	278
Min. Negotiated Rate	$115.20
Max. Negotiated Rate	$185.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: Qualcare PPO/HMO/WC	$115.20

CORTICAL BONE SCREW 2.0MM X 40

Facility

$768.00

Service Code	HCPCS C1713
Hospital Charge Code	270681749
Hospital Revenue Code	278
Min. Negotiated Rate	$21.81
Max. Negotiated Rate	$384.00
Rate for Payer: Aetna Commercial	$291.84
Rate for Payer: Aetna Medicare Advantage	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.84
Rate for Payer: Cigna Commercial	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: Qualcare PPO/HMO/WC	$115.20
Rate for Payer: UnitedHealthcare Community & State	$24.27
Rate for Payer: Wellpoint Medicaid Managed Care	$21.81

CORTICAL BONE SCREW 5.0MMX42M

Facility

$722.40

Service Code	HCPCS C1713
Hospital Charge Code	270679177
Hospital Revenue Code	278
Min. Negotiated Rate	$108.36
Max. Negotiated Rate	$174.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.82
Rate for Payer: Qualcare PPO/HMO/WC	$108.36

CORTICAL BONE SCREW 5.0MMX42M

Facility

$722.40

Service Code	HCPCS C1713
Hospital Charge Code	270679177
Hospital Revenue Code	278
Min. Negotiated Rate	$20.52
Max. Negotiated Rate	$361.20
Rate for Payer: Aetna Commercial	$274.51
Rate for Payer: Aetna Medicare Advantage	$216.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.21
Rate for Payer: Cigna Commercial	$361.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.82
Rate for Payer: Qualcare PPO/HMO/WC	$108.36
Rate for Payer: UnitedHealthcare Community & State	$22.83
Rate for Payer: Wellpoint Medicaid Managed Care	$20.52

CORTICAL BONE SCREW 5.0MM X 46

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684664
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CORTICAL BONE SCREW 5.0MM X 46

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684664
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

CORTICAL BONE SCREW 5.0MMX48MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684349
Hospital Revenue Code	278
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Community & State	$25.28
Rate for Payer: Wellpoint Medicaid Managed Care	$22.72

CORTICAL BONE SCREW 5.0MMX48MM

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	270684349
Hospital Revenue Code	278
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$193.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.60
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

Know your out-of-pocket cost for care.

All Charges