Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 1.5mm TITAN T H4-S9HOLE

Facility

$939.00

Service Code	HCPCS C1713
Hospital Charge Code	270604104
Hospital Revenue Code	278
Min. Negotiated Rate	$140.85
Max. Negotiated Rate	$227.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.24
Rate for Payer: Qualcare PPO/HMO/WC	$140.85

PLATE 1.5mm TITAN T H4-S9HOLE

Facility

$939.00

Service Code	HCPCS C1713
Hospital Charge Code	270604104
Hospital Revenue Code	278
Min. Negotiated Rate	$26.67
Max. Negotiated Rate	$469.50
Rate for Payer: Aetna Commercial	$356.82
Rate for Payer: Aetna Medicare Advantage	$281.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.44
Rate for Payer: Cigna Commercial	$469.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.24
Rate for Payer: Qualcare PPO/HMO/WC	$140.85
Rate for Payer: UnitedHealthcare Community & State	$29.67
Rate for Payer: Wellpoint Medicaid Managed Care	$26.67

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270332587
Hospital Revenue Code	278
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$238.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270332587
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.00
Rate for Payer: Aetna Commercial	$373.92
Rate for Payer: Aetna Medicare Advantage	$295.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.92
Rate for Payer: Cigna Commercial	$492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60
Rate for Payer: UnitedHealthcare Community & State	$31.09
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270335737
Hospital Revenue Code	278
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$492.00
Rate for Payer: Aetna Commercial	$373.92
Rate for Payer: Aetna Medicare Advantage	$295.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.92
Rate for Payer: Cigna Commercial	$492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60
Rate for Payer: UnitedHealthcare Community & State	$31.09
Rate for Payer: Wellpoint Medicaid Managed Care	$27.95

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270335737
Hospital Revenue Code	278
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$238.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PLATE 16MM

Facility

$2,825.00

Hospital Charge Code	270702552
Hospital Revenue Code	278
Min. Negotiated Rate	$80.23
Max. Negotiated Rate	$1,412.50
Rate for Payer: Aetna Commercial	$1,073.50
Rate for Payer: Aetna Medicare Advantage	$847.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$720.38
Rate for Payer: Cigna Commercial	$1,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75
Rate for Payer: UnitedHealthcare Community & State	$89.27
Rate for Payer: Wellpoint Medicaid Managed Care	$80.23

PLATE 16MM

Facility

$2,825.00

Hospital Charge Code	270702552
Hospital Revenue Code	278
Min. Negotiated Rate	$423.75
Max. Negotiated Rate	$683.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75

PLATE 16X14MM 7DEG 7H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704845
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PLATE 16X14MM 7DEG 7H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704845
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

PLATE 16X14MM 7DEG 8H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704842
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PLATE 16X14MM 7DEG 8H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704842
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

PLATE 18MM

Facility

$2,825.00

Hospital Charge Code	270702369
Hospital Revenue Code	278
Min. Negotiated Rate	$80.23
Max. Negotiated Rate	$1,412.50
Rate for Payer: Aetna Commercial	$1,073.50
Rate for Payer: Aetna Medicare Advantage	$847.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$720.38
Rate for Payer: Cigna Commercial	$1,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75
Rate for Payer: UnitedHealthcare Community & State	$89.27
Rate for Payer: Wellpoint Medicaid Managed Care	$80.23

PLATE 18MM

Facility

$2,825.00

Hospital Charge Code	270702369
Hospital Revenue Code	278
Min. Negotiated Rate	$423.75
Max. Negotiated Rate	$683.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75

PLATE 1MPJ FUSION SM RT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270693507
Hospital Revenue Code	278
Min. Negotiated Rate	$257.45
Max. Negotiated Rate	$4,532.50
Rate for Payer: Aetna Commercial	$3,444.70
Rate for Payer: Aetna Medicare Advantage	$2,719.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,311.57
Rate for Payer: Cigna Commercial	$4,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75
Rate for Payer: UnitedHealthcare Community & State	$286.45
Rate for Payer: Wellpoint Medicaid Managed Care	$257.45

PLATE 1MPJ FUSION SM RT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270693507
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$2,193.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE 2.0 MM

Facility

$2,702.10

Service Code	HCPCS C1713
Hospital Charge Code	270686172
Hospital Revenue Code	278
Min. Negotiated Rate	$76.74
Max. Negotiated Rate	$1,351.05
Rate for Payer: Aetna Commercial	$1,026.80
Rate for Payer: Aetna Medicare Advantage	$810.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.04
Rate for Payer: Cigna Commercial	$1,351.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.91
Rate for Payer: Qualcare PPO/HMO/WC	$405.31
Rate for Payer: UnitedHealthcare Community & State	$85.39
Rate for Payer: Wellpoint Medicaid Managed Care	$76.74

PLATE 2.0 MM

Facility

$2,702.10

Service Code	HCPCS C1713
Hospital Charge Code	270686172
Hospital Revenue Code	278
Min. Negotiated Rate	$405.31
Max. Negotiated Rate	$653.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.91
Rate for Payer: Qualcare PPO/HMO/WC	$405.31

PLATE 20MM

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270704431
Hospital Revenue Code	279
Min. Negotiated Rate	$148.39
Max. Negotiated Rate	$2,612.50
Rate for Payer: Aetna Commercial	$1,985.50
Rate for Payer: Aetna Medicare Advantage	$1,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,332.38
Rate for Payer: Cigna Commercial	$2,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,358.50
Rate for Payer: Oxford Commercial	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$783.75
Rate for Payer: UnitedHealthcare Commercial	$1,045.00
Rate for Payer: UnitedHealthcare Community & State	$165.11
Rate for Payer: Wellpoint Medicaid Managed Care	$148.39

PLATE 20MM

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270704431
Hospital Revenue Code	279
Min. Negotiated Rate	$783.75
Max. Negotiated Rate	$783.75
Rate for Payer: Qualcare PPO/HMO/WC	$783.75

PLATE 20MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATE 20MM

Facility

$2,825.00

Hospital Charge Code	270702698
Hospital Revenue Code	278
Min. Negotiated Rate	$423.75
Max. Negotiated Rate	$683.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75

PLATE 20MM

Facility

$2,825.00

Hospital Charge Code	270702698
Hospital Revenue Code	278
Min. Negotiated Rate	$80.23
Max. Negotiated Rate	$1,412.50
Rate for Payer: Aetna Commercial	$1,073.50
Rate for Payer: Aetna Medicare Advantage	$847.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$720.38
Rate for Payer: Cigna Commercial	$1,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75
Rate for Payer: UnitedHealthcare Community & State	$89.27
Rate for Payer: Wellpoint Medicaid Managed Care	$80.23

PLATE 20MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704661
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

PLATE 2.0mm TITAN CHON 6HOLE L

Facility

$1,288.55

Service Code	HCPCS C1713
Hospital Charge Code	270604099
Hospital Revenue Code	278
Min. Negotiated Rate	$193.28
Max. Negotiated Rate	$311.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.83
Rate for Payer: Qualcare PPO/HMO/WC	$193.28

Know your out-of-pocket cost for care.

All Charges