Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 72MM 4 LEVEL

Facility

$8,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705762
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$3,325.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Community & State	$276.50
Rate for Payer: Wellpoint Medicaid Managed Care	$248.50

PLATE 7 HOLE

Facility

$1,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270685167
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

PLATE 7 HOLE

Facility

$1,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270685167
Hospital Revenue Code	278
Min. Negotiated Rate	$36.21
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25
Rate for Payer: UnitedHealthcare Community & State	$40.29
Rate for Payer: Wellpoint Medicaid Managed Care	$36.21

PLATE 7 HOLES VDF 125MM

Facility

$5,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270671145
Hospital Revenue Code	278
Min. Negotiated Rate	$834.75
Max. Negotiated Rate	$1,346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.73
Rate for Payer: Qualcare PPO/HMO/WC	$834.75

PLATE 7 HOLES VDF 125MM

Facility

$5,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270671145
Hospital Revenue Code	278
Min. Negotiated Rate	$158.05
Max. Negotiated Rate	$2,782.50
Rate for Payer: Aetna Commercial	$2,114.70
Rate for Payer: Aetna Medicare Advantage	$1,669.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,419.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,419.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,419.08
Rate for Payer: Cigna Commercial	$2,782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.73
Rate for Payer: Qualcare PPO/HMO/WC	$834.75
Rate for Payer: UnitedHealthcare Community & State	$175.85
Rate for Payer: Wellpoint Medicaid Managed Care	$158.05

PLATE 7 MM 4 HOLE

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270693118
Hospital Revenue Code	278
Min. Negotiated Rate	$268.38
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$3,591.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50
Rate for Payer: UnitedHealthcare Community & State	$298.62
Rate for Payer: Wellpoint Medicaid Managed Care	$268.38

PLATE 7 MM 4 HOLE

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270693118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 80 HOLE THIRD TUBE

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270682857
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

PLATE 80 HOLE THIRD TUBE

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270682857
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80MM LORDOTIC PRE-BENT.

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703622
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80MM LORDOTIC PRE-BENT.

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703622
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

PLATE 8 HOLES 2.0 MM X 48MM

Facility

$1,308.00

Service Code	HCPCS C1713
Hospital Charge Code	270667562
Hospital Revenue Code	278
Min. Negotiated Rate	$37.15
Max. Negotiated Rate	$654.00
Rate for Payer: Aetna Commercial	$497.04
Rate for Payer: Aetna Medicare Advantage	$392.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$333.54
Rate for Payer: Cigna Commercial	$654.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.54
Rate for Payer: Qualcare PPO/HMO/WC	$196.20
Rate for Payer: UnitedHealthcare Community & State	$41.33
Rate for Payer: Wellpoint Medicaid Managed Care	$37.15

PLATE 8 HOLES 2.0 MM X 48MM

Facility

$1,308.00

Service Code	HCPCS C1713
Hospital Charge Code	270667562
Hospital Revenue Code	278
Min. Negotiated Rate	$196.20
Max. Negotiated Rate	$316.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.54
Rate for Payer: Qualcare PPO/HMO/WC	$196.20

PLATE 8 HOLES 88MM RIGHT

Facility

$8,350.00

Hospital Charge Code	270670805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$2,020.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

PLATE 8 HOLES 88MM RIGHT

Facility

$8,350.00

Hospital Charge Code	270670805
Hospital Revenue Code	278
Min. Negotiated Rate	$237.14
Max. Negotiated Rate	$4,175.00
Rate for Payer: Aetna Commercial	$3,173.00
Rate for Payer: Aetna Medicare Advantage	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,129.25
Rate for Payer: Cigna Commercial	$4,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50
Rate for Payer: UnitedHealthcare Community & State	$263.86
Rate for Payer: Wellpoint Medicaid Managed Care	$237.14

PLATE 8MM 4 HOLE PLATE MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693272
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 8MM 4 HOLE PLATE MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693272
Hospital Revenue Code	278
Min. Negotiated Rate	$268.38
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$3,591.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50
Rate for Payer: UnitedHealthcare Community & State	$298.62
Rate for Payer: Wellpoint Medicaid Managed Care	$268.38

PLATE 8MM CERES-C

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692581
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATE 8MM CERES-C

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692581
Hospital Revenue Code	278
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,800.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$316.00
Rate for Payer: Wellpoint Medicaid Managed Care	$284.00

PLATE 9H 3.5CM LCP METAPHYSEAL

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270656671
Hospital Revenue Code	278
Min. Negotiated Rate	$580.05
Max. Negotiated Rate	$935.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: Qualcare PPO/HMO/WC	$580.05

PLATE 9H 3.5CM LCP METAPHYSEAL

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270656671
Hospital Revenue Code	278
Min. Negotiated Rate	$109.82
Max. Negotiated Rate	$1,933.50
Rate for Payer: Aetna Commercial	$1,469.46
Rate for Payer: Aetna Medicare Advantage	$1,160.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.09
Rate for Payer: Cigna Commercial	$1,933.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: Qualcare PPO/HMO/WC	$580.05
Rate for Payer: UnitedHealthcare Community & State	$122.20
Rate for Payer: Wellpoint Medicaid Managed Care	$109.82

PLATE 9MM 4 HOLE

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705745
Hospital Revenue Code	278
Min. Negotiated Rate	$298.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,990.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Community & State	$331.80
Rate for Payer: Wellpoint Medicaid Managed Care	$298.20

PLATE 9MM 4 HOLE

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705745
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

PLATE ACDF VAULT C 16X14X6MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695547
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE ACDF VAULT C 16X14X6MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695547
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

Know your out-of-pocket cost for care.

All Charges