Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 3.5MM RECON 9HOLES/106MM

Facility

$2,163.00

Service Code	HCPCS C1713
Hospital Charge Code	270655716
Hospital Revenue Code	278
Min. Negotiated Rate	$61.43
Max. Negotiated Rate	$1,081.50
Rate for Payer: Aetna Commercial	$821.94
Rate for Payer: Aetna Medicare Advantage	$648.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.57
Rate for Payer: Cigna Commercial	$1,081.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.45
Rate for Payer: Qualcare PPO/HMO/WC	$324.45
Rate for Payer: UnitedHealthcare Community & State	$68.35
Rate for Payer: Wellpoint Medicaid Managed Care	$61.43

PLATE 3.5MM RECON 9HOLES/106MM

Facility

$2,163.00

Service Code	HCPCS C1713
Hospital Charge Code	270655716
Hospital Revenue Code	278
Min. Negotiated Rate	$324.45
Max. Negotiated Rate	$523.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$523.45
Rate for Payer: Qualcare PPO/HMO/WC	$324.45

PLATE 3.5MM RECONS

Facility

$2,246.45

Service Code	HCPCS C1713
Hospital Charge Code	270655710
Hospital Revenue Code	278
Min. Negotiated Rate	$63.80
Max. Negotiated Rate	$1,123.22
Rate for Payer: Aetna Commercial	$853.65
Rate for Payer: Aetna Medicare Advantage	$673.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$449.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$572.84
Rate for Payer: Cigna Commercial	$1,123.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.64
Rate for Payer: Qualcare PPO/HMO/WC	$336.97
Rate for Payer: UnitedHealthcare Community & State	$70.99
Rate for Payer: Wellpoint Medicaid Managed Care	$63.80

PLATE 3.5MM RECONS

Facility

$2,246.45

Service Code	HCPCS C1713
Hospital Charge Code	270655710
Hospital Revenue Code	278
Min. Negotiated Rate	$336.97
Max. Negotiated Rate	$543.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$449.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.64
Rate for Payer: Qualcare PPO/HMO/WC	$336.97

PLATE 3.5MM RECONST 5

Facility

$1,671.70

Service Code	HCPCS C1713
Hospital Charge Code	270603389
Hospital Revenue Code	278
Min. Negotiated Rate	$47.48
Max. Negotiated Rate	$835.85
Rate for Payer: Aetna Commercial	$635.25
Rate for Payer: Aetna Medicare Advantage	$501.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$334.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$426.28
Rate for Payer: Cigna Commercial	$835.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$404.55
Rate for Payer: Qualcare PPO/HMO/WC	$250.75
Rate for Payer: UnitedHealthcare Community & State	$52.83
Rate for Payer: Wellpoint Medicaid Managed Care	$47.48

PLATE 3.5MM RECONST 5

Facility

$1,671.70

Service Code	HCPCS C1713
Hospital Charge Code	270603389
Hospital Revenue Code	278
Min. Negotiated Rate	$250.75
Max. Negotiated Rate	$404.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$334.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$404.55
Rate for Payer: Qualcare PPO/HMO/WC	$250.75

PLATE 3.5MM T3 HOLES OBLIQUE

Facility

$988.80

Service Code	HCPCS C1713
Hospital Charge Code	270655670
Hospital Revenue Code	278
Min. Negotiated Rate	$28.08
Max. Negotiated Rate	$494.40
Rate for Payer: Aetna Commercial	$375.74
Rate for Payer: Aetna Medicare Advantage	$296.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.14
Rate for Payer: Cigna Commercial	$494.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.29
Rate for Payer: Qualcare PPO/HMO/WC	$148.32
Rate for Payer: UnitedHealthcare Community & State	$31.25
Rate for Payer: Wellpoint Medicaid Managed Care	$28.08

PLATE 3.5MM T3 HOLES OBLIQUE

Facility

$988.80

Service Code	HCPCS C1713
Hospital Charge Code	270655670
Hospital Revenue Code	278
Min. Negotiated Rate	$148.32
Max. Negotiated Rate	$239.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.29
Rate for Payer: Qualcare PPO/HMO/WC	$148.32

PLATE 3.5MM T3 HOLES RT ANGLE

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270655659
Hospital Revenue Code	278
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$271.93
Rate for Payer: Aetna Commercial	$206.66
Rate for Payer: Aetna Medicare Advantage	$163.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.68
Rate for Payer: Cigna Commercial	$271.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: Qualcare PPO/HMO/WC	$81.58
Rate for Payer: UnitedHealthcare Community & State	$17.19
Rate for Payer: Wellpoint Medicaid Managed Care	$15.45

PLATE 3.5MM T3 HOLES RT ANGLE

Facility

$543.85

Service Code	HCPCS C1713
Hospital Charge Code	270655659
Hospital Revenue Code	278
Min. Negotiated Rate	$81.58
Max. Negotiated Rate	$131.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.61
Rate for Payer: Qualcare PPO/HMO/WC	$81.58

PLATE 3.5MM T5 HOLES OBLIQUE

Facility

$1,016.60

Service Code	HCPCS C1713
Hospital Charge Code	270655671
Hospital Revenue Code	278
Min. Negotiated Rate	$152.49
Max. Negotiated Rate	$246.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.02
Rate for Payer: Qualcare PPO/HMO/WC	$152.49

PLATE 3.5MM T5 HOLES OBLIQUE

Facility

$1,016.60

Service Code	HCPCS C1713
Hospital Charge Code	270655671
Hospital Revenue Code	278
Min. Negotiated Rate	$28.87
Max. Negotiated Rate	$508.30
Rate for Payer: Aetna Commercial	$386.31
Rate for Payer: Aetna Medicare Advantage	$304.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.23
Rate for Payer: Cigna Commercial	$508.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.02
Rate for Payer: Qualcare PPO/HMO/WC	$152.49
Rate for Payer: UnitedHealthcare Community & State	$32.12
Rate for Payer: Wellpoint Medicaid Managed Care	$28.87

PLATE 3.5MM T5 HOLES RT ANGLE

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270603400
Hospital Revenue Code	278
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$236.02
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17
Rate for Payer: UnitedHealthcare Community & State	$19.63
Rate for Payer: Wellpoint Medicaid Managed Care	$17.64

PLATE 3.5MM T5 HOLES RT ANGLE

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270603400
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE 3.5MM T 6 HOLES RT ANGL

Facility

$988.80

Service Code	HCPCS C1713
Hospital Charge Code	270655669
Hospital Revenue Code	278
Min. Negotiated Rate	$148.32
Max. Negotiated Rate	$239.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.29
Rate for Payer: Qualcare PPO/HMO/WC	$148.32

PLATE 3.5MM T 6 HOLES RT ANGL

Facility

$988.80

Service Code	HCPCS C1713
Hospital Charge Code	270655669
Hospital Revenue Code	278
Min. Negotiated Rate	$28.08
Max. Negotiated Rate	$494.40
Rate for Payer: Aetna Commercial	$375.74
Rate for Payer: Aetna Medicare Advantage	$296.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.14
Rate for Payer: Cigna Commercial	$494.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.29
Rate for Payer: Qualcare PPO/HMO/WC	$148.32
Rate for Payer: UnitedHealthcare Community & State	$31.25
Rate for Payer: Wellpoint Medicaid Managed Care	$28.08

PLATE 3.5mm TIBIAL 6HOLE 102mm

Facility

$6,129.00

Hospital Charge Code	270645725
Hospital Revenue Code	278
Min. Negotiated Rate	$174.06
Max. Negotiated Rate	$3,064.50
Rate for Payer: Aetna Commercial	$2,329.02
Rate for Payer: Aetna Medicare Advantage	$1,838.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,562.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,562.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,225.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,562.89
Rate for Payer: Cigna Commercial	$3,064.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.22
Rate for Payer: Qualcare PPO/HMO/WC	$919.35
Rate for Payer: UnitedHealthcare Community & State	$193.68
Rate for Payer: Wellpoint Medicaid Managed Care	$174.06

PLATE 3.5mm TIBIAL 6HOLE 102mm

Facility

$6,129.00

Hospital Charge Code	270645725
Hospital Revenue Code	278
Min. Negotiated Rate	$919.35
Max. Negotiated Rate	$1,483.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,225.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.22
Rate for Payer: Qualcare PPO/HMO/WC	$919.35

PLATE 3.5mm TITAN LCDCP 5HOLE

Facility

$580.90

Service Code	HCPCS C1713
Hospital Charge Code	270603340
Hospital Revenue Code	278
Min. Negotiated Rate	$87.14
Max. Negotiated Rate	$140.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.58
Rate for Payer: Qualcare PPO/HMO/WC	$87.14

PLATE 3.5mm TITAN LCDCP 5HOLE

Facility

$580.90

Service Code	HCPCS C1713
Hospital Charge Code	270603340
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$290.45
Rate for Payer: Aetna Commercial	$220.74
Rate for Payer: Aetna Medicare Advantage	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.13
Rate for Payer: Cigna Commercial	$290.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.58
Rate for Payer: Qualcare PPO/HMO/WC	$87.14
Rate for Payer: UnitedHealthcare Community & State	$18.36
Rate for Payer: Wellpoint Medicaid Managed Care	$16.50

PLATE 3.5mm TITAN LCDCP 6HOLE

Facility

$395.00

Service Code	HCPCS C1713
Hospital Charge Code	270603341
Hospital Revenue Code	278
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$95.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

PLATE 3.5mm TITAN LCDCP 6HOLE

Facility

$395.00

Service Code	HCPCS C1713
Hospital Charge Code	270603341
Hospital Revenue Code	278
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.59
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Community & State	$12.48
Rate for Payer: Wellpoint Medicaid Managed Care	$11.22

PLATE 3.5mm TITAN LCDCP 7HOLE

Facility

$645.80

Service Code	HCPCS C1713
Hospital Charge Code	270603342
Hospital Revenue Code	278
Min. Negotiated Rate	$96.87
Max. Negotiated Rate	$156.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$96.87

PLATE 3.5mm TITAN LCDCP 7HOLE

Facility

$645.80

Service Code	HCPCS C1713
Hospital Charge Code	270603342
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$322.90
Rate for Payer: Aetna Commercial	$245.40
Rate for Payer: Aetna Medicare Advantage	$193.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.68
Rate for Payer: Cigna Commercial	$322.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$96.87
Rate for Payer: UnitedHealthcare Community & State	$20.41
Rate for Payer: Wellpoint Medicaid Managed Care	$18.34

PLATE 3.5mm TITAN LCDCP 8HOLE

Facility

$679.80

Service Code	HCPCS C1713
Hospital Charge Code	270603343
Hospital Revenue Code	278
Min. Negotiated Rate	$101.97
Max. Negotiated Rate	$164.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.51
Rate for Payer: Qualcare PPO/HMO/WC	$101.97

Know your out-of-pocket cost for care.

All Charges