Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 2.4 MM 4 HOLE 6 HOLE ST

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270688276
Hospital Revenue Code	278
Min. Negotiated Rate	$243.67
Max. Negotiated Rate	$4,290.00
Rate for Payer: Aetna Commercial	$3,260.40
Rate for Payer: Aetna Medicare Advantage	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,187.90
Rate for Payer: Cigna Commercial	$4,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00
Rate for Payer: UnitedHealthcare Community & State	$271.13
Rate for Payer: Wellpoint Medicaid Managed Care	$243.67

PLATE 2.4 MM 4 HOLE 6 HOLE ST

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270688276
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$2,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

PLATE 2.4MM LCP 7 HOLES 60MM

Facility

$930.00

Hospital Charge Code	270670055
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

PLATE 2.4MM LCP 7 HOLES 60MM

Facility

$930.00

Hospital Charge Code	270670055
Hospital Revenue Code	278
Min. Negotiated Rate	$26.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Community & State	$29.39
Rate for Payer: Wellpoint Medicaid Managed Care	$26.41

PLATE 24MM SLIM 1LVL

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705536
Hospital Revenue Code	278
Min. Negotiated Rate	$134.90
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$150.10
Rate for Payer: Wellpoint Medicaid Managed Care	$134.90

PLATE 24MM SLIM 1LVL

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705536
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PLATE 2.4MM ST 12 HOLES

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270656291
Hospital Revenue Code	278
Min. Negotiated Rate	$172.80
Max. Negotiated Rate	$278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80

PLATE 2.4MM ST 12 HOLES

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270656291
Hospital Revenue Code	278
Min. Negotiated Rate	$32.72
Max. Negotiated Rate	$576.00
Rate for Payer: Aetna Commercial	$437.76
Rate for Payer: Aetna Medicare Advantage	$345.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.76
Rate for Payer: Cigna Commercial	$576.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80
Rate for Payer: UnitedHealthcare Community & State	$36.40
Rate for Payer: Wellpoint Medicaid Managed Care	$32.72

PLATE 2.4MM STR 6 HOLE

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270654858
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$243.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

PLATE 2.4MM STR 6 HOLE

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270654858
Hospital Revenue Code	278
Min. Negotiated Rate	$28.61
Max. Negotiated Rate	$503.68
Rate for Payer: Aetna Commercial	$382.79
Rate for Payer: Aetna Medicare Advantage	$302.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.87
Rate for Payer: Cigna Commercial	$503.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10
Rate for Payer: UnitedHealthcare Community & State	$31.83
Rate for Payer: Wellpoint Medicaid Managed Care	$28.61

PLATE 2.4mm TI 8 HOLE 54mm

Facility

$1,241.25

Service Code	HCPCS C1713
Hospital Charge Code	270680929
Hospital Revenue Code	278
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$620.62
Rate for Payer: Aetna Commercial	$471.68
Rate for Payer: Aetna Medicare Advantage	$372.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.52
Rate for Payer: Cigna Commercial	$620.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.38
Rate for Payer: Qualcare PPO/HMO/WC	$186.19
Rate for Payer: UnitedHealthcare Community & State	$39.22
Rate for Payer: Wellpoint Medicaid Managed Care	$35.25

PLATE 2.4mm TI 8 HOLE 54mm

Facility

$1,241.25

Service Code	HCPCS C1713
Hospital Charge Code	270680929
Hospital Revenue Code	278
Min. Negotiated Rate	$186.19
Max. Negotiated Rate	$300.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.38
Rate for Payer: Qualcare PPO/HMO/WC	$186.19

PLATE 2.4MM VA LCP 6H 4H RT

Facility

$4,713.80

Service Code	HCPCS C1713
Hospital Charge Code	270693749
Hospital Revenue Code	278
Min. Negotiated Rate	$707.07
Max. Negotiated Rate	$1,140.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.74
Rate for Payer: Qualcare PPO/HMO/WC	$707.07

PLATE 2.4MM VA LCP 6H 4H RT

Facility

$4,713.80

Service Code	HCPCS C1713
Hospital Charge Code	270693749
Hospital Revenue Code	278
Min. Negotiated Rate	$133.87
Max. Negotiated Rate	$2,356.90
Rate for Payer: Aetna Commercial	$1,791.24
Rate for Payer: Aetna Medicare Advantage	$1,414.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,202.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,202.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,202.02
Rate for Payer: Cigna Commercial	$2,356.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.74
Rate for Payer: Qualcare PPO/HMO/WC	$707.07
Rate for Payer: UnitedHealthcare Community & State	$148.96
Rate for Payer: Wellpoint Medicaid Managed Care	$133.87

PLATE 2.4 X 2.7

Facility

$4,328.45

Service Code	HCPCS C1713
Hospital Charge Code	270675216
Hospital Revenue Code	278
Min. Negotiated Rate	$649.27
Max. Negotiated Rate	$1,047.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.48
Rate for Payer: Qualcare PPO/HMO/WC	$649.27

PLATE 2.4 X 2.7

Facility

$4,328.45

Service Code	HCPCS C1713
Hospital Charge Code	270675216
Hospital Revenue Code	278
Min. Negotiated Rate	$122.93
Max. Negotiated Rate	$2,164.22
Rate for Payer: Aetna Commercial	$1,644.81
Rate for Payer: Aetna Medicare Advantage	$1,298.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.75
Rate for Payer: Cigna Commercial	$2,164.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.48
Rate for Payer: Qualcare PPO/HMO/WC	$649.27
Rate for Payer: UnitedHealthcare Community & State	$136.78
Rate for Payer: Wellpoint Medicaid Managed Care	$122.93

PLATE 2.7MM STRAIGHT 10H

Facility

$1,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270702677
Hospital Revenue Code	278
Min. Negotiated Rate	$156.75
Max. Negotiated Rate	$252.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: Qualcare PPO/HMO/WC	$156.75

PLATE 2.7MM STRAIGHT 10H

Facility

$1,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270702677
Hospital Revenue Code	278
Min. Negotiated Rate	$29.68
Max. Negotiated Rate	$522.50
Rate for Payer: Aetna Commercial	$397.10
Rate for Payer: Aetna Medicare Advantage	$313.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.48
Rate for Payer: Cigna Commercial	$522.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: Qualcare PPO/HMO/WC	$156.75
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

PLATE 2.7MM STRAIGHT 6H

Facility

$1,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270702676
Hospital Revenue Code	278
Min. Negotiated Rate	$29.68
Max. Negotiated Rate	$522.50
Rate for Payer: Aetna Commercial	$397.10
Rate for Payer: Aetna Medicare Advantage	$313.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.48
Rate for Payer: Cigna Commercial	$522.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: Qualcare PPO/HMO/WC	$156.75
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

PLATE 2.7MM STRAIGHT 6H

Facility

$1,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270702676
Hospital Revenue Code	278
Min. Negotiated Rate	$156.75
Max. Negotiated Rate	$252.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: Qualcare PPO/HMO/WC	$156.75

PLATE 2.7MM T 3 HOLES/32MM

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603416
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE 2.7MM T 3 HOLES/32MM

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603416
Hospital Revenue Code	278
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$132.10
Rate for Payer: Aetna Commercial	$100.40
Rate for Payer: Aetna Medicare Advantage	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.37
Rate for Payer: Cigna Commercial	$132.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$39.63
Rate for Payer: UnitedHealthcare Community & State	$8.35
Rate for Payer: Wellpoint Medicaid Managed Care	$7.50

PLATE 2.7mmTIAN CONDYL 6HOLE L

Facility

$1,421.40

Service Code	HCPCS C1713
Hospital Charge Code	270604077
Hospital Revenue Code	278
Min. Negotiated Rate	$213.21
Max. Negotiated Rate	$343.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.98
Rate for Payer: Qualcare PPO/HMO/WC	$213.21

PLATE 2.7mmTIAN CONDYL 6HOLE L

Facility

$1,421.40

Service Code	HCPCS C1713
Hospital Charge Code	270604077
Hospital Revenue Code	278
Min. Negotiated Rate	$40.37
Max. Negotiated Rate	$710.70
Rate for Payer: Aetna Commercial	$540.13
Rate for Payer: Aetna Medicare Advantage	$426.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.46
Rate for Payer: Cigna Commercial	$710.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.98
Rate for Payer: Qualcare PPO/HMO/WC	$213.21
Rate for Payer: UnitedHealthcare Community & State	$44.92
Rate for Payer: Wellpoint Medicaid Managed Care	$40.37

PLATE 2.7mmTITAN CHOND 6HOLE R

Facility

$1,421.40

Service Code	HCPCS C1713
Hospital Charge Code	270604078
Hospital Revenue Code	278
Min. Negotiated Rate	$213.21
Max. Negotiated Rate	$343.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.98
Rate for Payer: Qualcare PPO/HMO/WC	$213.21

Know your out-of-pocket cost for care.

All Charges