Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 4 HOLE 3.5x25MM

Facility

$7,990.00

Hospital Charge Code	270656794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,198.50
Max. Negotiated Rate	$1,933.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,598.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,933.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.50

PLATE 4 HOLES TUBULAR 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270656908
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PLATE 4 HOLES TUBULAR 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270656908
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Community & State	$10.90
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

PLATE 51MM 3-LEVEL

Facility

$13,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688528
Hospital Revenue Code	278
Min. Negotiated Rate	$391.92
Max. Negotiated Rate	$6,900.00
Rate for Payer: Aetna Commercial	$5,244.00
Rate for Payer: Aetna Medicare Advantage	$4,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,519.00
Rate for Payer: Cigna Commercial	$6,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,339.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.00
Rate for Payer: UnitedHealthcare Community & State	$436.08
Rate for Payer: Wellpoint Medicaid Managed Care	$391.92

PLATE 51MM 3-LEVEL

Facility

$13,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,070.00
Max. Negotiated Rate	$3,339.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,339.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.00

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270704950
Hospital Revenue Code	278
Min. Negotiated Rate	$214.42
Max. Negotiated Rate	$3,775.00
Rate for Payer: Aetna Commercial	$2,869.00
Rate for Payer: Aetna Medicare Advantage	$2,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.25
Rate for Payer: Cigna Commercial	$3,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50
Rate for Payer: UnitedHealthcare Community & State	$238.58
Rate for Payer: Wellpoint Medicaid Managed Care	$214.42

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270704950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$1,827.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270703950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$1,827.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270703950
Hospital Revenue Code	278
Min. Negotiated Rate	$214.42
Max. Negotiated Rate	$3,775.00
Rate for Payer: Aetna Commercial	$2,869.00
Rate for Payer: Aetna Medicare Advantage	$2,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.25
Rate for Payer: Cigna Commercial	$3,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50
Rate for Payer: UnitedHealthcare Community & State	$238.58
Rate for Payer: Wellpoint Medicaid Managed Care	$214.42

PLATE 5H LEFT

Facility

$4,378.55

Hospital Charge Code	270662179
Hospital Revenue Code	278
Min. Negotiated Rate	$124.35
Max. Negotiated Rate	$2,189.28
Rate for Payer: Aetna Commercial	$1,663.85
Rate for Payer: Aetna Medicare Advantage	$1,313.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,116.53
Rate for Payer: Cigna Commercial	$2,189.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.61
Rate for Payer: Qualcare PPO/HMO/WC	$656.78
Rate for Payer: UnitedHealthcare Community & State	$138.36
Rate for Payer: Wellpoint Medicaid Managed Care	$124.35

PLATE 5H LEFT

Facility

$4,378.55

Hospital Charge Code	270662179
Hospital Revenue Code	278
Min. Negotiated Rate	$656.78
Max. Negotiated Rate	$1,059.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.61
Rate for Payer: Qualcare PPO/HMO/WC	$656.78

PLATE 5 HOLE 1/3 TUBULAR

Facility

$460.00

Hospital Charge Code	270669257
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$111.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PLATE 5 HOLE 1/3 TUBULAR

Facility

$460.00

Hospital Charge Code	270669257
Hospital Revenue Code	278
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$174.80
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Community & State	$14.54
Rate for Payer: Wellpoint Medicaid Managed Care	$13.06

PLATE 5 HOLE CONNECTING

Facility

$551.85

Hospital Charge Code	270691900
Hospital Revenue Code	272
Min. Negotiated Rate	$82.78
Max. Negotiated Rate	$82.78
Rate for Payer: Qualcare PPO/HMO/WC	$82.78

PLATE 5 HOLE CONNECTING

Facility

$551.85

Hospital Charge Code	270691900
Hospital Revenue Code	272
Min. Negotiated Rate	$15.67
Max. Negotiated Rate	$275.93
Rate for Payer: Aetna Commercial	$209.70
Rate for Payer: Aetna Medicare Advantage	$165.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.72
Rate for Payer: Cigna Commercial	$275.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.48
Rate for Payer: Oxford Commercial	$110.37
Rate for Payer: Qualcare PPO/HMO/WC	$82.78
Rate for Payer: UnitedHealthcare Commercial	$110.37
Rate for Payer: UnitedHealthcare Community & State	$17.44
Rate for Payer: Wellpoint Medicaid Managed Care	$15.67

PLATE 5 HOLE LOCKING MEDIAL

Facility

$4,970.00

Hospital Charge Code	270702837
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$1,202.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$994.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.74
Rate for Payer: Qualcare PPO/HMO/WC	$745.50

PLATE 5 HOLE LOCKING MEDIAL

Facility

$4,970.00

Hospital Charge Code	270702837
Hospital Revenue Code	278
Min. Negotiated Rate	$141.15
Max. Negotiated Rate	$2,485.00
Rate for Payer: Aetna Commercial	$1,888.60
Rate for Payer: Aetna Medicare Advantage	$1,491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,267.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,267.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$994.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,267.35
Rate for Payer: Cigna Commercial	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.74
Rate for Payer: Qualcare PPO/HMO/WC	$745.50
Rate for Payer: UnitedHealthcare Community & State	$157.05
Rate for Payer: Wellpoint Medicaid Managed Care	$141.15

PLATE 5 HOLES TUBULAR 39MM

Facility

$366.00

Hospital Charge Code	270656909
Hospital Revenue Code	278
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.57
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.39

PLATE 5 HOLES TUBULAR 39MM

Facility

$366.00

Hospital Charge Code	270656909
Hospital Revenue Code	278
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$88.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.57
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

PLATE 5 HOLE Utility pole

Facility

$8,100.00

Hospital Charge Code	270669406
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.00
Max. Negotiated Rate	$1,960.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

PLATE 5 HOLE Utility pole

Facility

$8,100.00

Hospital Charge Code	270669406
Hospital Revenue Code	278
Min. Negotiated Rate	$230.04
Max. Negotiated Rate	$4,050.00
Rate for Payer: Aetna Commercial	$3,078.00
Rate for Payer: Aetna Medicare Advantage	$2,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.50
Rate for Payer: Cigna Commercial	$4,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00
Rate for Payer: UnitedHealthcare Community & State	$255.96
Rate for Payer: Wellpoint Medicaid Managed Care	$230.04

PLATE 5TH HOOK MET

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270680981
Hospital Revenue Code	278
Min. Negotiated Rate	$153.36
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$2,052.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

PLATE 5TH HOOK MET

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270680981
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

PLATE 60 MM

Facility

$5,500.00

Hospital Charge Code	270703447
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 60 MM

Facility

$5,500.00

Hospital Charge Code	270703447
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

Know your out-of-pocket cost for care.

All Charges