Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ACP 1.9H 3LEVEL 52MM

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694727
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$3,162.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 54MM 3-LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270695128
Hospital Revenue Code	278
Min. Negotiated Rate	$371.13
Max. Negotiated Rate	$6,534.00
Rate for Payer: Aetna Commercial	$4,965.84
Rate for Payer: Aetna Medicare Advantage	$3,920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,332.34
Rate for Payer: Cigna Commercial	$6,534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20
Rate for Payer: UnitedHealthcare Community & State	$412.95
Rate for Payer: Wellpoint Medicaid Managed Care	$371.13

PLATE ACP 1.9H 54MM 3-LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270695128
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$3,162.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 56MM 3LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694183
Hospital Revenue Code	278
Min. Negotiated Rate	$371.13
Max. Negotiated Rate	$6,534.00
Rate for Payer: Aetna Commercial	$4,965.84
Rate for Payer: Aetna Medicare Advantage	$3,920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,332.34
Rate for Payer: Cigna Commercial	$6,534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20
Rate for Payer: UnitedHealthcare Community & State	$412.95
Rate for Payer: Wellpoint Medicaid Managed Care	$371.13

PLATE ACP 1.9H 56MM 3LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694183
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$3,162.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP GRUVE 20MM 1681-020

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698920
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE ACP GRUVE 20MM 1681-020

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698920
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

PLATE ALIP 25MM

Facility

$28,297.50

Service Code	HCPCS C1713
Hospital Charge Code	270679296
Hospital Revenue Code	278
Min. Negotiated Rate	$803.65
Max. Negotiated Rate	$14,148.75
Rate for Payer: Aetna Commercial	$10,753.05
Rate for Payer: Aetna Medicare Advantage	$8,489.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,215.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,215.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,659.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,215.86
Rate for Payer: Cigna Commercial	$14,148.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,847.99
Rate for Payer: Qualcare PPO/HMO/WC	$4,244.62
Rate for Payer: UnitedHealthcare Community & State	$894.20
Rate for Payer: Wellpoint Medicaid Managed Care	$803.65

PLATE ALIP 25MM

Facility

$28,297.50

Service Code	HCPCS C1713
Hospital Charge Code	270679296
Hospital Revenue Code	278
Min. Negotiated Rate	$4,244.62
Max. Negotiated Rate	$6,847.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,659.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,847.99
Rate for Payer: Qualcare PPO/HMO/WC	$4,244.62

PLATE AMBASSADOR 1 LEVEL 14MM

Facility

$19,250.55

Service Code	HCPCS C1713
Hospital Charge Code	270695211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.58
Max. Negotiated Rate	$4,658.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.58

PLATE AMBASSADOR 1 LEVEL 14MM

Facility

$19,250.55

Service Code	HCPCS C1713
Hospital Charge Code	270695211
Hospital Revenue Code	278
Min. Negotiated Rate	$546.72
Max. Negotiated Rate	$9,625.27
Rate for Payer: Aetna Commercial	$7,315.21
Rate for Payer: Aetna Medicare Advantage	$5,775.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.89
Rate for Payer: Cigna Commercial	$9,625.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.58
Rate for Payer: UnitedHealthcare Community & State	$608.32
Rate for Payer: Wellpoint Medicaid Managed Care	$546.72

PLATE, AMP-LTX, 2-HOLE

Facility

$15,505.00

Hospital Charge Code	270702580
Hospital Revenue Code	278
Min. Negotiated Rate	$440.34
Max. Negotiated Rate	$7,752.50
Rate for Payer: Aetna Commercial	$5,891.90
Rate for Payer: Aetna Medicare Advantage	$4,651.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,953.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,953.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,953.78
Rate for Payer: Cigna Commercial	$7,752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,752.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.75
Rate for Payer: UnitedHealthcare Community & State	$489.96
Rate for Payer: Wellpoint Medicaid Managed Care	$440.34

PLATE, AMP-LTX, 2-HOLE

Facility

$15,505.00

Hospital Charge Code	270702580
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.75
Max. Negotiated Rate	$3,752.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,752.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.75

PLATE ANCHON 22 MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692208
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 ANCHON 22 MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692208
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 ANCHORING MED 10H 16MM

Facility

$28,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680019
Hospital Revenue Code	278
Min. Negotiated Rate	$795.20
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$884.80
Rate for Payer: Wellpoint Medicaid Managed Care	$795.20

PLATE ANCHORING MED 10H 16MM

Facility

$28,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680019
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

PLATE ANCHORING ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270692180
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

PLATE ANCHORING ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270692180
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE ANCHORING S

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683450
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

PLATE ANCHORING S

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683450
Hospital Revenue Code	278
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$474.00
Rate for Payer: Wellpoint Medicaid Managed Care	$426.00

PLATE ANKLE FUSION POSTERIOR R

Facility

$11,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,706.25
Max. Negotiated Rate	$2,752.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,752.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,706.25

PLATE ANKLE FUSION POSTERIOR R

Facility

$11,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678710
Hospital Revenue Code	278
Min. Negotiated Rate	$323.05
Max. Negotiated Rate	$5,687.50
Rate for Payer: Aetna Commercial	$4,322.50
Rate for Payer: Aetna Medicare Advantage	$3,412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,900.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,900.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,900.62
Rate for Payer: Cigna Commercial	$5,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,752.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,706.25
Rate for Payer: UnitedHealthcare Community & State	$359.45
Rate for Payer: Wellpoint Medicaid Managed Care	$323.05

PLATE ANT CERV 1 LEV 16MM

Facility

$12,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270695715
Hospital Revenue Code	278
Min. Negotiated Rate	$348.61
Max. Negotiated Rate	$6,137.50
Rate for Payer: Aetna Commercial	$4,664.50
Rate for Payer: Aetna Medicare Advantage	$3,682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,130.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,130.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,130.12
Rate for Payer: Cigna Commercial	$6,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,970.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,841.25
Rate for Payer: UnitedHealthcare Community & State	$387.89
Rate for Payer: Wellpoint Medicaid Managed Care	$348.61

PLATE ANT CERV 1 LEV 16MM

Facility

$12,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270695715
Hospital Revenue Code	278
Min. Negotiated Rate	$1,841.25
Max. Negotiated Rate	$2,970.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,970.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,841.25

Know your out-of-pocket cost for care.

All Charges