Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 1/3 TUBULAR 3HOLE 37MM

Facility

$244.10

Service Code	HCPCS C1713
Hospital Charge Code	270603363
Hospital Revenue Code	278
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$122.05
Rate for Payer: Aetna Commercial	$92.76
Rate for Payer: Aetna Medicare Advantage	$73.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.25
Rate for Payer: Cigna Commercial	$122.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.07
Rate for Payer: Qualcare PPO/HMO/WC	$36.62
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$6.93

PLATE 1/3 TUBULAR 4HOLE 49MM

Facility

$289.65

Service Code	HCPCS C1713
Hospital Charge Code	270601907
Hospital Revenue Code	278
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$144.82
Rate for Payer: Aetna Commercial	$110.07
Rate for Payer: Aetna Medicare Advantage	$86.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.86
Rate for Payer: Cigna Commercial	$144.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: Qualcare PPO/HMO/WC	$43.45
Rate for Payer: UnitedHealthcare Community & State	$9.15
Rate for Payer: Wellpoint Medicaid Managed Care	$8.23

PLATE 1/3 TUBULAR 4HOLE 49MM

Facility

$289.65

Service Code	HCPCS C1713
Hospital Charge Code	270601907
Hospital Revenue Code	278
Min. Negotiated Rate	$43.45
Max. Negotiated Rate	$70.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: Qualcare PPO/HMO/WC	$43.45

PLATE 1/3 TUBULAR 5H 61MM

Facility

$289.65

Service Code	HCPCS C1713
Hospital Charge Code	270601908
Hospital Revenue Code	278
Min. Negotiated Rate	$43.45
Max. Negotiated Rate	$70.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: Qualcare PPO/HMO/WC	$43.45

PLATE 1/3 TUBULAR 5H 61MM

Facility

$289.65

Service Code	HCPCS C1713
Hospital Charge Code	270601908
Hospital Revenue Code	278
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$144.82
Rate for Payer: Aetna Commercial	$110.07
Rate for Payer: Aetna Medicare Advantage	$86.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.86
Rate for Payer: Cigna Commercial	$144.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.10
Rate for Payer: Qualcare PPO/HMO/WC	$43.45
Rate for Payer: UnitedHealthcare Community & State	$9.15
Rate for Payer: Wellpoint Medicaid Managed Care	$8.23

PLATE 1/3 TUBULAR 6HOLE 73MM

Facility

$292.00

Service Code	HCPCS C1713
Hospital Charge Code	270603381
Hospital Revenue Code	278
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$146.00
Rate for Payer: Aetna Commercial	$110.96
Rate for Payer: Aetna Medicare Advantage	$87.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.46
Rate for Payer: Cigna Commercial	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.80
Rate for Payer: UnitedHealthcare Community & State	$9.23
Rate for Payer: Wellpoint Medicaid Managed Care	$8.29

PLATE 1/3 TUBULAR 6HOLE 73MM

Facility

$292.00

Service Code	HCPCS C1713
Hospital Charge Code	270603381
Hospital Revenue Code	278
Min. Negotiated Rate	$43.80
Max. Negotiated Rate	$70.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.66
Rate for Payer: Qualcare PPO/HMO/WC	$43.80

PLATE 1/3 TUBULAR 7H 85MM

Facility

$300.75

Service Code	HCPCS C1713
Hospital Charge Code	270601911
Hospital Revenue Code	278
Min. Negotiated Rate	$45.11
Max. Negotiated Rate	$72.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.78
Rate for Payer: Qualcare PPO/HMO/WC	$45.11

PLATE 1/3 TUBULAR 7H 85MM

Facility

$300.75

Service Code	HCPCS C1713
Hospital Charge Code	270601911
Hospital Revenue Code	278
Min. Negotiated Rate	$8.54
Max. Negotiated Rate	$150.38
Rate for Payer: Aetna Commercial	$114.28
Rate for Payer: Aetna Medicare Advantage	$90.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.69
Rate for Payer: Cigna Commercial	$150.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.78
Rate for Payer: Qualcare PPO/HMO/WC	$45.11
Rate for Payer: UnitedHealthcare Community & State	$9.50
Rate for Payer: Wellpoint Medicaid Managed Care	$8.54

PLATE 1/3 TUBULAR 8 X 97MM

Facility

$302.80

Service Code	HCPCS C1713
Hospital Charge Code	270603383
Hospital Revenue Code	278
Min. Negotiated Rate	$45.42
Max. Negotiated Rate	$73.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.28
Rate for Payer: Qualcare PPO/HMO/WC	$45.42

PLATE 1/3 TUBULAR 8 X 97MM

Facility

$302.80

Service Code	HCPCS C1713
Hospital Charge Code	270603383
Hospital Revenue Code	278
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$151.40
Rate for Payer: Aetna Commercial	$115.06
Rate for Payer: Aetna Medicare Advantage	$90.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.21
Rate for Payer: Cigna Commercial	$151.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.28
Rate for Payer: Qualcare PPO/HMO/WC	$45.42
Rate for Payer: UnitedHealthcare Community & State	$9.57
Rate for Payer: Wellpoint Medicaid Managed Care	$8.60

PLATE 1/3 TUBULAR 9H 109MM

Facility

$312.10

Service Code	HCPCS C1713
Hospital Charge Code	270651852
Hospital Revenue Code	278
Min. Negotiated Rate	$46.81
Max. Negotiated Rate	$75.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.53
Rate for Payer: Qualcare PPO/HMO/WC	$46.81

PLATE 1/3 TUBULAR 9H 109MM

Facility

$312.10

Service Code	HCPCS C1713
Hospital Charge Code	270651852
Hospital Revenue Code	278
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$156.05
Rate for Payer: Aetna Commercial	$118.60
Rate for Payer: Aetna Medicare Advantage	$93.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.59
Rate for Payer: Cigna Commercial	$156.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.53
Rate for Payer: Qualcare PPO/HMO/WC	$46.81
Rate for Payer: UnitedHealthcare Community & State	$9.86
Rate for Payer: Wellpoint Medicaid Managed Care	$8.86

PLATE 14HOLE CONDYLAR LEFT

Facility

$7,477.80

Service Code	HCPCS C1713
Hospital Charge Code	270656609
Hospital Revenue Code	278
Min. Negotiated Rate	$212.37
Max. Negotiated Rate	$3,738.90
Rate for Payer: Aetna Commercial	$2,841.56
Rate for Payer: Aetna Medicare Advantage	$2,243.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.84
Rate for Payer: Cigna Commercial	$3,738.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,809.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.67
Rate for Payer: UnitedHealthcare Community & State	$236.30
Rate for Payer: Wellpoint Medicaid Managed Care	$212.37

PLATE 14HOLE CONDYLAR LEFT

Facility

$7,477.80

Service Code	HCPCS C1713
Hospital Charge Code	270656609
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.67
Max. Negotiated Rate	$1,809.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,809.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.67

PLATE 14MM

Facility

$4,775.00

Hospital Charge Code	270703046
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$1,155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

PLATE 14MM

Facility

$4,775.00

Hospital Charge Code	270703046
Hospital Revenue Code	278
Min. Negotiated Rate	$135.61
Max. Negotiated Rate	$2,387.50
Rate for Payer: Aetna Commercial	$1,814.50
Rate for Payer: Aetna Medicare Advantage	$1,432.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,217.62
Rate for Payer: Cigna Commercial	$2,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25
Rate for Payer: UnitedHealthcare Community & State	$150.89
Rate for Payer: Wellpoint Medicaid Managed Care	$135.61

PLATE 1.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270685254
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

PLATE 1.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270685254
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

PLATE 1.5mm TITAN CHON 6HOLE L

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604105
Hospital Revenue Code	278
Min. Negotiated Rate	$34.75
Max. Negotiated Rate	$611.83
Rate for Payer: Aetna Commercial	$464.99
Rate for Payer: Aetna Medicare Advantage	$367.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.03
Rate for Payer: Cigna Commercial	$611.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55
Rate for Payer: UnitedHealthcare Community & State	$38.67
Rate for Payer: Wellpoint Medicaid Managed Care	$34.75

PLATE 1.5mm TITAN CHON 6HOLE L

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604105
Hospital Revenue Code	278
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$296.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55

PLATE 1.5mm TITAN CHON 6HOLE R

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604106
Hospital Revenue Code	278
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$296.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55

PLATE 1.5mm TITAN CHON 6HOLE R

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604106
Hospital Revenue Code	278
Min. Negotiated Rate	$34.75
Max. Negotiated Rate	$611.83
Rate for Payer: Aetna Commercial	$464.99
Rate for Payer: Aetna Medicare Advantage	$367.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.03
Rate for Payer: Cigna Commercial	$611.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55
Rate for Payer: UnitedHealthcare Community & State	$38.67
Rate for Payer: Wellpoint Medicaid Managed Care	$34.75

PLATE 1.5mm TITAN T H3-S9HOLE

Facility

$861.00

Hospital Charge Code	270604103
Hospital Revenue Code	278
Min. Negotiated Rate	$129.15
Max. Negotiated Rate	$208.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.36
Rate for Payer: Qualcare PPO/HMO/WC	$129.15

PLATE 1.5mm TITAN T H3-S9HOLE

Facility

$861.00

Hospital Charge Code	270604103
Hospital Revenue Code	278
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$430.50
Rate for Payer: Aetna Commercial	$327.18
Rate for Payer: Aetna Medicare Advantage	$258.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.56
Rate for Payer: Cigna Commercial	$430.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.36
Rate for Payer: Qualcare PPO/HMO/WC	$129.15
Rate for Payer: UnitedHealthcare Community & State	$27.21
Rate for Payer: Wellpoint Medicaid Managed Care	$24.45

Know your out-of-pocket cost for care.

All Charges