Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 2.7mm TITAN DCP 10HOLE

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270604087
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$573.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE 2.7mm TITAN DCP 10HOLE

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270604087
Hospital Revenue Code	278
Min. Negotiated Rate	$67.31
Max. Negotiated Rate	$1,185.03
Rate for Payer: Aetna Commercial	$900.62
Rate for Payer: Aetna Medicare Advantage	$711.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.36
Rate for Payer: Cigna Commercial	$1,185.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: Qualcare PPO/HMO/WC	$355.51
Rate for Payer: UnitedHealthcare Community & State	$74.89
Rate for Payer: Wellpoint Medicaid Managed Care	$67.31

PLATE 2.7mm TITAN DCP 12HOLE

Facility

$2,629.60

Service Code	HCPCS C1713
Hospital Charge Code	270604088
Hospital Revenue Code	278
Min. Negotiated Rate	$74.68
Max. Negotiated Rate	$1,314.80
Rate for Payer: Aetna Commercial	$999.25
Rate for Payer: Aetna Medicare Advantage	$788.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$670.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$670.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$670.55
Rate for Payer: Cigna Commercial	$1,314.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$636.36
Rate for Payer: Qualcare PPO/HMO/WC	$394.44
Rate for Payer: UnitedHealthcare Community & State	$83.10
Rate for Payer: Wellpoint Medicaid Managed Care	$74.68

PLATE 2.7mm TITAN DCP 12HOLE

Facility

$2,629.60

Service Code	HCPCS C1713
Hospital Charge Code	270604088
Hospital Revenue Code	278
Min. Negotiated Rate	$394.44
Max. Negotiated Rate	$636.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$636.36
Rate for Payer: Qualcare PPO/HMO/WC	$394.44

PLATE 2.7mmTITAN DCP 2HOLE

Facility

$1,140.20

Service Code	HCPCS C1713
Hospital Charge Code	270604080
Hospital Revenue Code	278
Min. Negotiated Rate	$32.38
Max. Negotiated Rate	$570.10
Rate for Payer: Aetna Commercial	$433.28
Rate for Payer: Aetna Medicare Advantage	$342.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.75
Rate for Payer: Cigna Commercial	$570.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.93
Rate for Payer: Qualcare PPO/HMO/WC	$171.03
Rate for Payer: UnitedHealthcare Community & State	$36.03
Rate for Payer: Wellpoint Medicaid Managed Care	$32.38

PLATE 2.7mmTITAN DCP 2HOLE

Facility

$1,140.20

Service Code	HCPCS C1713
Hospital Charge Code	270604080
Hospital Revenue Code	278
Min. Negotiated Rate	$171.03
Max. Negotiated Rate	$275.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.93
Rate for Payer: Qualcare PPO/HMO/WC	$171.03

PLATE 2.7mm TITAN DCP 5HOLE

Facility

$1,609.90

Service Code	HCPCS C1713
Hospital Charge Code	270604082
Hospital Revenue Code	278
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$804.95
Rate for Payer: Aetna Commercial	$611.76
Rate for Payer: Aetna Medicare Advantage	$482.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.52
Rate for Payer: Cigna Commercial	$804.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.60
Rate for Payer: Qualcare PPO/HMO/WC	$241.49
Rate for Payer: UnitedHealthcare Community & State	$50.87
Rate for Payer: Wellpoint Medicaid Managed Care	$45.72

PLATE 2.7mm TITAN DCP 5HOLE

Facility

$1,609.90

Service Code	HCPCS C1713
Hospital Charge Code	270604082
Hospital Revenue Code	278
Min. Negotiated Rate	$241.49
Max. Negotiated Rate	$389.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.60
Rate for Payer: Qualcare PPO/HMO/WC	$241.49

PLATE 2.7mm TITAN DCP 6HOLE

Facility

$1,724.20

Service Code	HCPCS C1713
Hospital Charge Code	270604083
Hospital Revenue Code	278
Min. Negotiated Rate	$258.63
Max. Negotiated Rate	$417.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.26
Rate for Payer: Qualcare PPO/HMO/WC	$258.63

PLATE 2.7mm TITAN DCP 6HOLE

Facility

$1,724.20

Service Code	HCPCS C1713
Hospital Charge Code	270604083
Hospital Revenue Code	278
Min. Negotiated Rate	$48.97
Max. Negotiated Rate	$862.10
Rate for Payer: Aetna Commercial	$655.20
Rate for Payer: Aetna Medicare Advantage	$517.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.67
Rate for Payer: Cigna Commercial	$862.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.26
Rate for Payer: Qualcare PPO/HMO/WC	$258.63
Rate for Payer: UnitedHealthcare Community & State	$54.48
Rate for Payer: Wellpoint Medicaid Managed Care	$48.97

PLATE 2.7mm TITAN DCP 7HOLE

Facility

$1,918.90

Service Code	HCPCS C1713
Hospital Charge Code	270603530
Hospital Revenue Code	278
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$959.45
Rate for Payer: Aetna Commercial	$729.18
Rate for Payer: Aetna Medicare Advantage	$575.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.32
Rate for Payer: Cigna Commercial	$959.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.37
Rate for Payer: Qualcare PPO/HMO/WC	$287.83
Rate for Payer: UnitedHealthcare Community & State	$60.64
Rate for Payer: Wellpoint Medicaid Managed Care	$54.50

PLATE 2.7mm TITAN DCP 7HOLE

Facility

$1,918.90

Service Code	HCPCS C1713
Hospital Charge Code	270603530
Hospital Revenue Code	278
Min. Negotiated Rate	$287.83
Max. Negotiated Rate	$464.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.37
Rate for Payer: Qualcare PPO/HMO/WC	$287.83

PLATE 2.7mm TITAN DCP 8HOLE

Facility

$2,008.50

Service Code	HCPCS C1713
Hospital Charge Code	270603531
Hospital Revenue Code	278
Min. Negotiated Rate	$301.27
Max. Negotiated Rate	$486.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.06
Rate for Payer: Qualcare PPO/HMO/WC	$301.27

PLATE 2.7mm TITAN DCP 8HOLE

Facility

$2,008.50

Service Code	HCPCS C1713
Hospital Charge Code	270603531
Hospital Revenue Code	278
Min. Negotiated Rate	$57.04
Max. Negotiated Rate	$1,004.25
Rate for Payer: Aetna Commercial	$763.23
Rate for Payer: Aetna Medicare Advantage	$602.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.17
Rate for Payer: Cigna Commercial	$1,004.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.06
Rate for Payer: Qualcare PPO/HMO/WC	$301.27
Rate for Payer: UnitedHealthcare Community & State	$63.47
Rate for Payer: Wellpoint Medicaid Managed Care	$57.04

PLATE 2.7mm TITAN DCP 9HOLE

Facility

$2,187.70

Service Code	HCPCS C1713
Hospital Charge Code	270604086
Hospital Revenue Code	278
Min. Negotiated Rate	$328.15
Max. Negotiated Rate	$529.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$437.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.42
Rate for Payer: Qualcare PPO/HMO/WC	$328.15

PLATE 2.7mm TITAN DCP 9HOLE

Facility

$2,187.70

Service Code	HCPCS C1713
Hospital Charge Code	270604086
Hospital Revenue Code	278
Min. Negotiated Rate	$62.13
Max. Negotiated Rate	$1,093.85
Rate for Payer: Aetna Commercial	$831.33
Rate for Payer: Aetna Medicare Advantage	$656.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$557.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$557.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$437.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$557.86
Rate for Payer: Cigna Commercial	$1,093.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$529.42
Rate for Payer: Qualcare PPO/HMO/WC	$328.15
Rate for Payer: UnitedHealthcare Community & State	$69.13
Rate for Payer: Wellpoint Medicaid Managed Care	$62.13

PLATE 28MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705476
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 28MM

Facility

$12,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270703900
Hospital Revenue Code	278
Min. Negotiated Rate	$359.97
Max. Negotiated Rate	$6,337.50
Rate for Payer: Aetna Commercial	$4,816.50
Rate for Payer: Aetna Medicare Advantage	$3,802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,232.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,232.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,232.12
Rate for Payer: Cigna Commercial	$6,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,067.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,901.25
Rate for Payer: UnitedHealthcare Community & State	$400.53
Rate for Payer: Wellpoint Medicaid Managed Care	$359.97

PLATE 28MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705476
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 28MM

Facility

$12,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270703900
Hospital Revenue Code	278
Min. Negotiated Rate	$1,901.25
Max. Negotiated Rate	$3,067.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,067.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,901.25

PLATE 28MM 2 LEVEL

Facility

$7,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270705765
Hospital Revenue Code	278
Min. Negotiated Rate	$1,091.25
Max. Negotiated Rate	$1,760.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,760.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,091.25

PLATE 28MM 2 LEVEL

Facility

$7,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270705765
Hospital Revenue Code	278
Min. Negotiated Rate	$206.61
Max. Negotiated Rate	$3,637.50
Rate for Payer: Aetna Commercial	$2,764.50
Rate for Payer: Aetna Medicare Advantage	$2,182.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,855.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,855.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,855.12
Rate for Payer: Cigna Commercial	$3,637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,760.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,091.25
Rate for Payer: UnitedHealthcare Community & State	$229.89
Rate for Payer: Wellpoint Medicaid Managed Care	$206.61

PLATE 2H LONG STR LARGE 17MM

Facility

$805.00

Service Code	HCPCS C1713
Hospital Charge Code	270697127
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$194.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.81
Rate for Payer: Qualcare PPO/HMO/WC	$120.75

PLATE 2H LONG STR LARGE 17MM

Facility

$805.00

Service Code	HCPCS C1713
Hospital Charge Code	270697127
Hospital Revenue Code	278
Min. Negotiated Rate	$22.86
Max. Negotiated Rate	$402.50
Rate for Payer: Aetna Commercial	$305.90
Rate for Payer: Aetna Medicare Advantage	$241.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.28
Rate for Payer: Cigna Commercial	$402.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.81
Rate for Payer: Qualcare PPO/HMO/WC	$120.75
Rate for Payer: UnitedHealthcare Community & State	$25.44
Rate for Payer: Wellpoint Medicaid Managed Care	$22.86

Know your out-of-pocket cost for care.

All Charges