Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 3.5mm TITAN LCDCP 8HOLE

Facility

$679.80

Service Code	HCPCS C1713
Hospital Charge Code	270603343
Hospital Revenue Code	278
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$339.90
Rate for Payer: Aetna Commercial	$258.32
Rate for Payer: Aetna Medicare Advantage	$203.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.35
Rate for Payer: Cigna Commercial	$339.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.51
Rate for Payer: Qualcare PPO/HMO/WC	$101.97
Rate for Payer: UnitedHealthcare Community & State	$21.48
Rate for Payer: Wellpoint Medicaid Managed Care	$19.31

PLATE 3.5MM TITAN RECON 10HOLE

Facility

$2,197.00

Service Code	HCPCS C1713
Hospital Charge Code	270603394
Hospital Revenue Code	278
Min. Negotiated Rate	$62.39
Max. Negotiated Rate	$1,098.50
Rate for Payer: Aetna Commercial	$834.86
Rate for Payer: Aetna Medicare Advantage	$659.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$560.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$560.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$560.24
Rate for Payer: Cigna Commercial	$1,098.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.67
Rate for Payer: Qualcare PPO/HMO/WC	$329.55
Rate for Payer: UnitedHealthcare Community & State	$69.43
Rate for Payer: Wellpoint Medicaid Managed Care	$62.39

PLATE 3.5MM TITAN RECON 10HOLE

Facility

$2,197.00

Service Code	HCPCS C1713
Hospital Charge Code	270603394
Hospital Revenue Code	278
Min. Negotiated Rate	$329.55
Max. Negotiated Rate	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.67
Rate for Payer: Qualcare PPO/HMO/WC	$329.55

PLATE 3.5MM VA GT PPFX HOOK LG

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697520
Hospital Revenue Code	278
Min. Negotiated Rate	$328.33
Max. Negotiated Rate	$5,780.50
Rate for Payer: Aetna Commercial	$4,393.18
Rate for Payer: Aetna Medicare Advantage	$3,468.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,948.05
Rate for Payer: Cigna Commercial	$5,780.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15
Rate for Payer: UnitedHealthcare Community & State	$365.33
Rate for Payer: Wellpoint Medicaid Managed Care	$328.33

PLATE 3.5MM VA GT PPFX HOOK LG

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,734.15
Max. Negotiated Rate	$2,797.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15

PLATE 3.5MM VA GT PPFX HOOK SM

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697518
Hospital Revenue Code	278
Min. Negotiated Rate	$328.33
Max. Negotiated Rate	$5,780.50
Rate for Payer: Aetna Commercial	$4,393.18
Rate for Payer: Aetna Medicare Advantage	$3,468.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,948.05
Rate for Payer: Cigna Commercial	$5,780.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15
Rate for Payer: UnitedHealthcare Community & State	$365.33
Rate for Payer: Wellpoint Medicaid Managed Care	$328.33

PLATE 3.5MM VA GT PPFX HOOK SM

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697518
Hospital Revenue Code	278
Min. Negotiated Rate	$1,734.15
Max. Negotiated Rate	$2,797.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15

PLATE 3.5 VA LCP TIBIA

Facility

$6,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270665277
Hospital Revenue Code	278
Min. Negotiated Rate	$947.25
Max. Negotiated Rate	$1,528.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,528.23
Rate for Payer: Qualcare PPO/HMO/WC	$947.25

PLATE 3.5 VA LCP TIBIA

Facility

$6,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270665277
Hospital Revenue Code	278
Min. Negotiated Rate	$179.35
Max. Negotiated Rate	$3,157.50
Rate for Payer: Aetna Commercial	$2,399.70
Rate for Payer: Aetna Medicare Advantage	$1,894.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,610.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,610.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,610.33
Rate for Payer: Cigna Commercial	$3,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,528.23
Rate for Payer: Qualcare PPO/HMO/WC	$947.25
Rate for Payer: UnitedHealthcare Community & State	$199.55
Rate for Payer: Wellpoint Medicaid Managed Care	$179.35

PLATE 3.5VA LOCKING 4H

Facility

$3,638.00

Service Code	HCPCS C1713
Hospital Charge Code	270693774
Hospital Revenue Code	278
Min. Negotiated Rate	$545.70
Max. Negotiated Rate	$880.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$727.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.40
Rate for Payer: Qualcare PPO/HMO/WC	$545.70

PLATE 3.5VA LOCKING 4H

Facility

$3,638.00

Service Code	HCPCS C1713
Hospital Charge Code	270693774
Hospital Revenue Code	278
Min. Negotiated Rate	$103.32
Max. Negotiated Rate	$1,819.00
Rate for Payer: Aetna Commercial	$1,382.44
Rate for Payer: Aetna Medicare Advantage	$1,091.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$927.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$927.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$727.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$927.69
Rate for Payer: Cigna Commercial	$1,819.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.40
Rate for Payer: Qualcare PPO/HMO/WC	$545.70
Rate for Payer: UnitedHealthcare Community & State	$114.96
Rate for Payer: Wellpoint Medicaid Managed Care	$103.32

PLATE 3.5VA RIT PROXIMAL

Facility

$9,053.20

Service Code	HCPCS C1713
Hospital Charge Code	270688360
Hospital Revenue Code	278
Min. Negotiated Rate	$1,357.98
Max. Negotiated Rate	$2,190.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,810.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,190.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,357.98

PLATE 3.5VA RIT PROXIMAL

Facility

$9,053.20

Service Code	HCPCS C1713
Hospital Charge Code	270688360
Hospital Revenue Code	278
Min. Negotiated Rate	$257.11
Max. Negotiated Rate	$4,526.60
Rate for Payer: Aetna Commercial	$3,440.22
Rate for Payer: Aetna Medicare Advantage	$2,715.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,308.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,308.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,810.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,308.57
Rate for Payer: Cigna Commercial	$4,526.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,190.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,357.98
Rate for Payer: UnitedHealthcare Community & State	$286.08
Rate for Payer: Wellpoint Medicaid Managed Care	$257.11

PLATE 36MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270689965
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

PLATE 36MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270689965
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

PLATE 3 HOLE

Facility

$10,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270665933
Hospital Revenue Code	278
Min. Negotiated Rate	$303.31
Max. Negotiated Rate	$5,340.00
Rate for Payer: Aetna Commercial	$4,058.40
Rate for Payer: Aetna Medicare Advantage	$3,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,723.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,723.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,723.40
Rate for Payer: Cigna Commercial	$5,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,584.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,602.00
Rate for Payer: UnitedHealthcare Community & State	$337.49
Rate for Payer: Wellpoint Medicaid Managed Care	$303.31

PLATE 3 HOLE

Facility

$10,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270665933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,602.00
Max. Negotiated Rate	$2,584.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,584.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,602.00

PLATE 3 LEVEL 45MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694168
Hospital Revenue Code	278
Min. Negotiated Rate	$546.70
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$608.30
Rate for Payer: Wellpoint Medicaid Managed Care	$546.70

PLATE 3 LEVEL 45MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694168
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

PLATE 3MM WEDGE

Facility

$7,537.50

Service Code	HCPCS C1713
Hospital Charge Code	270679461
Hospital Revenue Code	278
Min. Negotiated Rate	$214.06
Max. Negotiated Rate	$3,768.75
Rate for Payer: Aetna Commercial	$2,864.25
Rate for Payer: Aetna Medicare Advantage	$2,261.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,922.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,922.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,507.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,922.06
Rate for Payer: Cigna Commercial	$3,768.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,824.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.62
Rate for Payer: UnitedHealthcare Community & State	$238.19
Rate for Payer: Wellpoint Medicaid Managed Care	$214.06

PLATE 3MM WEDGE

Facility

$7,537.50

Service Code	HCPCS C1713
Hospital Charge Code	270679461
Hospital Revenue Code	278
Min. Negotiated Rate	$1,130.62
Max. Negotiated Rate	$1,824.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,824.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.62

PLATE 4.0 MM X 14 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692990
Hospital Revenue Code	278
Min. Negotiated Rate	$35.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Community & State	$39.50
Rate for Payer: Wellpoint Medicaid Managed Care	$35.50

PLATE 4.0 MM X 14 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692990
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

PLATE 41 MM X 2 LEVEL FUS

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692107
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

PLATE 41 MM X 2 LEVEL FUS

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692107
Hospital Revenue Code	278
Min. Negotiated Rate	$390.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$5,225.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50
Rate for Payer: UnitedHealthcare Community & State	$434.50
Rate for Payer: Wellpoint Medicaid Managed Care	$390.50

Know your out-of-pocket cost for care.

All Charges