Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 32MM 3-LEVEL

Facility

$13,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270688525
Hospital Revenue Code	278
Min. Negotiated Rate	$1,965.00
Max. Negotiated Rate	$3,170.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,170.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,965.00

PLATE 34MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705062
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE 34MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705062
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

PLATE 34MM 2 HOLE

Facility

$16,341.90

Service Code	HCPCS C1713
Hospital Charge Code	270703616
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.28
Max. Negotiated Rate	$3,954.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,268.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,954.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.28

PLATE 34MM 2 HOLE

Facility

$16,341.90

Service Code	HCPCS C1713
Hospital Charge Code	270703616
Hospital Revenue Code	278
Min. Negotiated Rate	$464.11
Max. Negotiated Rate	$8,170.95
Rate for Payer: Aetna Commercial	$6,209.92
Rate for Payer: Aetna Medicare Advantage	$4,902.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,268.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,167.18
Rate for Payer: Cigna Commercial	$8,170.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,954.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.28
Rate for Payer: UnitedHealthcare Community & State	$516.40
Rate for Payer: Wellpoint Medicaid Managed Care	$464.11

PLATE 3.5 LCP PROX HUM 6H163MM

Facility

$28,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270699354
Hospital Revenue Code	278
Min. Negotiated Rate	$796.48
Max. Negotiated Rate	$14,022.50
Rate for Payer: Aetna Commercial	$10,657.10
Rate for Payer: Aetna Medicare Advantage	$8,413.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,151.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,151.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,151.48
Rate for Payer: Cigna Commercial	$14,022.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,786.89
Rate for Payer: Qualcare PPO/HMO/WC	$4,206.75
Rate for Payer: UnitedHealthcare Community & State	$886.22
Rate for Payer: Wellpoint Medicaid Managed Care	$796.48

PLATE 3.5 LCP PROX HUM 6H163MM

Facility

$28,045.00

Service Code	HCPCS C1713
Hospital Charge Code	270699354
Hospital Revenue Code	278
Min. Negotiated Rate	$4,206.75
Max. Negotiated Rate	$6,786.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,609.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,786.89
Rate for Payer: Qualcare PPO/HMO/WC	$4,206.75

PLATE 3.5 LCP PROX HUM 8H RT

Facility

$11,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270696393
Hospital Revenue Code	278
Min. Negotiated Rate	$1,710.00
Max. Negotiated Rate	$2,758.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,758.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,710.00

PLATE 3.5 LCP PROX HUM 8H RT

Facility

$11,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270696393
Hospital Revenue Code	278
Min. Negotiated Rate	$323.76
Max. Negotiated Rate	$5,700.00
Rate for Payer: Aetna Commercial	$4,332.00
Rate for Payer: Aetna Medicare Advantage	$3,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,907.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,907.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,907.00
Rate for Payer: Cigna Commercial	$5,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,758.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,710.00
Rate for Payer: UnitedHealthcare Community & State	$360.24
Rate for Payer: Wellpoint Medicaid Managed Care	$323.76

PLATE3.5MM LC-DCP10HOLES/129MM

Facility

$741.60

Service Code	HCPCS C1713
Hospital Charge Code	270655654
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$179.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.47
Rate for Payer: Qualcare PPO/HMO/WC	$111.24

PLATE3.5MM LC-DCP10HOLES/129MM

Facility

$741.60

Service Code	HCPCS C1713
Hospital Charge Code	270655654
Hospital Revenue Code	278
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$370.80
Rate for Payer: Aetna Commercial	$281.81
Rate for Payer: Aetna Medicare Advantage	$222.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.11
Rate for Payer: Cigna Commercial	$370.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.47
Rate for Payer: Qualcare PPO/HMO/WC	$111.24
Rate for Payer: UnitedHealthcare Community & State	$23.43
Rate for Payer: Wellpoint Medicaid Managed Care	$21.06

PLATE3.5MM LC-DCP 9HOLES/116MM

Facility

$732.35

Service Code	HCPCS C1713
Hospital Charge Code	270655652
Hospital Revenue Code	278
Min. Negotiated Rate	$109.85
Max. Negotiated Rate	$177.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.23
Rate for Payer: Qualcare PPO/HMO/WC	$109.85

PLATE3.5MM LC-DCP 9HOLES/116MM

Facility

$732.35

Service Code	HCPCS C1713
Hospital Charge Code	270655652
Hospital Revenue Code	278
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$366.18
Rate for Payer: Aetna Commercial	$278.29
Rate for Payer: Aetna Medicare Advantage	$219.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.75
Rate for Payer: Cigna Commercial	$366.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.23
Rate for Payer: Qualcare PPO/HMO/WC	$109.85
Rate for Payer: UnitedHealthcare Community & State	$23.14
Rate for Payer: Wellpoint Medicaid Managed Care	$20.80

PLATE 3.5MM LCP PROX HUMERUS

Facility

$6,702.00

Hospital Charge Code	270656206
Hospital Revenue Code	278
Min. Negotiated Rate	$1,005.30
Max. Negotiated Rate	$1,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,340.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.30

PLATE 3.5MM LCP PROX HUMERUS

Facility

$6,702.00

Hospital Charge Code	270656206
Hospital Revenue Code	278
Min. Negotiated Rate	$190.34
Max. Negotiated Rate	$3,351.00
Rate for Payer: Aetna Commercial	$2,546.76
Rate for Payer: Aetna Medicare Advantage	$2,010.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,709.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,709.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,340.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,709.01
Rate for Payer: Cigna Commercial	$3,351.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,621.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.30
Rate for Payer: UnitedHealthcare Community & State	$211.78
Rate for Payer: Wellpoint Medicaid Managed Care	$190.34

PLATE 3.5MM LCP PROX HUMERUS

Facility

$6,498.00

Hospital Charge Code	270656205
Hospital Revenue Code	278
Min. Negotiated Rate	$974.70
Max. Negotiated Rate	$1,572.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,299.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,572.52
Rate for Payer: Qualcare PPO/HMO/WC	$974.70

PLATE 3.5MM LCP PROX HUMERUS

Facility

$6,498.00

Hospital Charge Code	270656205
Hospital Revenue Code	278
Min. Negotiated Rate	$184.54
Max. Negotiated Rate	$3,249.00
Rate for Payer: Aetna Commercial	$2,469.24
Rate for Payer: Aetna Medicare Advantage	$1,949.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,656.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,656.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,299.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,656.99
Rate for Payer: Cigna Commercial	$3,249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,572.52
Rate for Payer: Qualcare PPO/HMO/WC	$974.70
Rate for Payer: UnitedHealthcare Community & State	$205.34
Rate for Payer: Wellpoint Medicaid Managed Care	$184.54

PLATE3.5MMLCPPROXTIB8HR145MM

Facility

$8,399.40

Service Code	HCPCS C1713
Hospital Charge Code	270696100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,259.91
Max. Negotiated Rate	$2,032.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,679.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.91

PLATE3.5MMLCPPROXTIB8HR145MM

Facility

$8,399.40

Service Code	HCPCS C1713
Hospital Charge Code	270696100
Hospital Revenue Code	278
Min. Negotiated Rate	$238.54
Max. Negotiated Rate	$4,199.70
Rate for Payer: Aetna Commercial	$3,191.77
Rate for Payer: Aetna Medicare Advantage	$2,519.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,141.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,679.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,141.85
Rate for Payer: Cigna Commercial	$4,199.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,032.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,259.91
Rate for Payer: UnitedHealthcare Community & State	$265.42
Rate for Payer: Wellpoint Medicaid Managed Care	$238.54

PLATE 3.5 MM POW LOCK

Facility

$6,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270684000
Hospital Revenue Code	278
Min. Negotiated Rate	$959.25
Max. Negotiated Rate	$1,547.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.59
Rate for Payer: Qualcare PPO/HMO/WC	$959.25

PLATE 3.5 MM POW LOCK

Facility

$6,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270684000
Hospital Revenue Code	278
Min. Negotiated Rate	$181.62
Max. Negotiated Rate	$3,197.50
Rate for Payer: Aetna Commercial	$2,430.10
Rate for Payer: Aetna Medicare Advantage	$1,918.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,630.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,630.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,630.72
Rate for Payer: Cigna Commercial	$3,197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.59
Rate for Payer: Qualcare PPO/HMO/WC	$959.25
Rate for Payer: UnitedHealthcare Community & State	$202.08
Rate for Payer: Wellpoint Medicaid Managed Care	$181.62

PLATE 3.5MM RECON 6HOLE/70MM

Facility

$1,928.15

Service Code	HCPCS C1713
Hospital Charge Code	270603390
Hospital Revenue Code	278
Min. Negotiated Rate	$54.76
Max. Negotiated Rate	$964.08
Rate for Payer: Aetna Commercial	$732.70
Rate for Payer: Aetna Medicare Advantage	$578.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$491.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$491.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$491.68
Rate for Payer: Cigna Commercial	$964.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.61
Rate for Payer: Qualcare PPO/HMO/WC	$289.22
Rate for Payer: UnitedHealthcare Community & State	$60.93
Rate for Payer: Wellpoint Medicaid Managed Care	$54.76

PLATE 3.5MM RECON 6HOLE/70MM

Facility

$1,928.15

Service Code	HCPCS C1713
Hospital Charge Code	270603390
Hospital Revenue Code	278
Min. Negotiated Rate	$289.22
Max. Negotiated Rate	$466.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$466.61
Rate for Payer: Qualcare PPO/HMO/WC	$289.22

PLATE 3.5MM RECON 7HOLE/82MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270603391
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE 3.5MM RECON 7HOLE/82MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270603391
Hospital Revenue Code	278
Min. Negotiated Rate	$30.53
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Community & State	$33.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

Know your out-of-pocket cost for care.

All Charges