Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 63MM

Facility

$5,150.00

Hospital Charge Code	270703362
Hospital Revenue Code	278
Min. Negotiated Rate	$146.26
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,957.00
Rate for Payer: Aetna Medicare Advantage	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,313.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,313.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,313.25
Rate for Payer: Cigna Commercial	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.30
Rate for Payer: Qualcare PPO/HMO/WC	$772.50
Rate for Payer: UnitedHealthcare Community & State	$162.74
Rate for Payer: Wellpoint Medicaid Managed Care	$146.26

PLATE 63MM

Facility

$5,150.00

Hospital Charge Code	270703362
Hospital Revenue Code	278
Min. Negotiated Rate	$772.50
Max. Negotiated Rate	$1,246.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,246.30
Rate for Payer: Qualcare PPO/HMO/WC	$772.50

PLATE 64MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704427
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 64MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704427
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 65MM 4 LEVEL CURE

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698845
Hospital Revenue Code	278
Min. Negotiated Rate	$475.63
Max. Negotiated Rate	$8,373.75
Rate for Payer: Aetna Commercial	$6,364.05
Rate for Payer: Aetna Medicare Advantage	$5,024.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,270.61
Rate for Payer: Cigna Commercial	$8,373.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12
Rate for Payer: UnitedHealthcare Community & State	$529.22
Rate for Payer: Wellpoint Medicaid Managed Care	$475.63

PLATE 65MM 4 LEVEL CURE

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$4,052.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

PLATE 6.5MMX30MM

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695936
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

PLATE 6.5MMX30MM

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695936
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

PLATE 6H 76MM

Facility

$4,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270699982
Hospital Revenue Code	278
Min. Negotiated Rate	$132.06
Max. Negotiated Rate	$2,325.00
Rate for Payer: Aetna Commercial	$1,767.00
Rate for Payer: Aetna Medicare Advantage	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,185.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,185.75
Rate for Payer: Cigna Commercial	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50
Rate for Payer: UnitedHealthcare Community & State	$146.94
Rate for Payer: Wellpoint Medicaid Managed Care	$132.06

PLATE 6H 76MM

Facility

$4,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270699982
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$1,125.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.30
Rate for Payer: Qualcare PPO/HMO/WC	$697.50

PLATE 6 HOLE

Facility

$3,205.00

Hospital Charge Code	270702597
Hospital Revenue Code	278
Min. Negotiated Rate	$91.02
Max. Negotiated Rate	$1,602.50
Rate for Payer: Aetna Commercial	$1,217.90
Rate for Payer: Aetna Medicare Advantage	$961.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$817.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$817.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$641.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$817.27
Rate for Payer: Cigna Commercial	$1,602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.61
Rate for Payer: Qualcare PPO/HMO/WC	$480.75
Rate for Payer: UnitedHealthcare Community & State	$101.28
Rate for Payer: Wellpoint Medicaid Managed Care	$91.02

PLATE 6 HOLE

Facility

$3,205.00

Hospital Charge Code	270702597
Hospital Revenue Code	278
Min. Negotiated Rate	$480.75
Max. Negotiated Rate	$775.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$641.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.61
Rate for Payer: Qualcare PPO/HMO/WC	$480.75

PLATE 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270690254
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

PLATE 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270690254
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE 6 HOLE LATERAL LF

Facility

$7,500.00

Hospital Charge Code	270667386
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

PLATE 6 HOLE LATERAL LF

Facility

$7,500.00

Hospital Charge Code	270667386
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PLATE 6 HOLES 2.0 MM X 36MM

Facility

$1,152.00

Hospital Charge Code	270667565
Hospital Revenue Code	278
Min. Negotiated Rate	$172.80
Max. Negotiated Rate	$278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80

PLATE 6 HOLES 2.0 MM X 36MM

Facility

$1,152.00

Hospital Charge Code	270667565
Hospital Revenue Code	278
Min. Negotiated Rate	$32.72
Max. Negotiated Rate	$576.00
Rate for Payer: Aetna Commercial	$437.76
Rate for Payer: Aetna Medicare Advantage	$345.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.76
Rate for Payer: Cigna Commercial	$576.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80
Rate for Payer: UnitedHealthcare Community & State	$36.40
Rate for Payer: Wellpoint Medicaid Managed Care	$32.72

PLATE 6 HOLES TUBULAR WITH

Facility

$396.00

Service Code	HCPCS C1713
Hospital Charge Code	270656910
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$198.00
Rate for Payer: Aetna Commercial	$150.48
Rate for Payer: Aetna Medicare Advantage	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.98
Rate for Payer: Cigna Commercial	$198.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.83
Rate for Payer: Qualcare PPO/HMO/WC	$59.40
Rate for Payer: UnitedHealthcare Community & State	$12.51
Rate for Payer: Wellpoint Medicaid Managed Care	$11.25

PLATE 6 HOLES TUBULAR WITH

Facility

$396.00

Service Code	HCPCS C1713
Hospital Charge Code	270656910
Hospital Revenue Code	278
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$95.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.83
Rate for Payer: Qualcare PPO/HMO/WC	$59.40

PLATE 6 HOLE Utility pole

Facility

$8,100.00

Hospital Charge Code	270669408
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 6 HOLE Utility pole

Facility

$8,100.00

Hospital Charge Code	270669408
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 6 HOLE VOLAR 80MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694034
Hospital Revenue Code	278
Min. Negotiated Rate	$141.29
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Community & State	$157.21
Rate for Payer: Wellpoint Medicaid Managed Care	$141.29

PLATE 6 HOLE VOLAR 80MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694034
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

PLATE 72MM 4 LEVEL

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705762
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

Know your out-of-pocket cost for care.

All Charges