Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CLAVICAL SYSTEM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687868
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$4,275.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50
Rate for Payer: UnitedHealthcare Community & State	$355.50
Rate for Payer: Wellpoint Medicaid Managed Care	$319.50

PLATE CLAVICLA ANT 7 HOLE

Facility

$4,274.35

Service Code	HCPCS C1713
Hospital Charge Code	270685591
Hospital Revenue Code	278
Min. Negotiated Rate	$641.15
Max. Negotiated Rate	$1,034.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$854.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.39
Rate for Payer: Qualcare PPO/HMO/WC	$641.15

PLATE CLAVICLA ANT 7 HOLE

Facility

$4,274.35

Service Code	HCPCS C1713
Hospital Charge Code	270685591
Hospital Revenue Code	278
Min. Negotiated Rate	$121.39
Max. Negotiated Rate	$2,137.18
Rate for Payer: Aetna Commercial	$1,624.25
Rate for Payer: Aetna Medicare Advantage	$1,282.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,089.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,089.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$854.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,089.96
Rate for Payer: Cigna Commercial	$2,137.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,034.39
Rate for Payer: Qualcare PPO/HMO/WC	$641.15
Rate for Payer: UnitedHealthcare Community & State	$135.07
Rate for Payer: Wellpoint Medicaid Managed Care	$121.39

PLATE CLAVICLE 2.7MM LT CS2

Facility

$4,919.20

Service Code	HCPCS C1713
Hospital Charge Code	270693039
Hospital Revenue Code	278
Min. Negotiated Rate	$139.71
Max. Negotiated Rate	$2,459.60
Rate for Payer: Aetna Commercial	$1,869.30
Rate for Payer: Aetna Medicare Advantage	$1,475.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,254.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,254.40
Rate for Payer: Cigna Commercial	$2,459.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.45
Rate for Payer: Qualcare PPO/HMO/WC	$737.88
Rate for Payer: UnitedHealthcare Community & State	$155.45
Rate for Payer: Wellpoint Medicaid Managed Care	$139.71

PLATE CLAVICLE 2.7MM LT CS2

Facility

$4,919.20

Service Code	HCPCS C1713
Hospital Charge Code	270693039
Hospital Revenue Code	278
Min. Negotiated Rate	$737.88
Max. Negotiated Rate	$1,190.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.45
Rate for Payer: Qualcare PPO/HMO/WC	$737.88

PLATECLAVICLE3.5MMLCP5HRT94MM

Facility

$5,721.15

Service Code	HCPCS C1713
Hospital Charge Code	270697376
Hospital Revenue Code	278
Min. Negotiated Rate	$858.17
Max. Negotiated Rate	$1,384.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.52
Rate for Payer: Qualcare PPO/HMO/WC	$858.17

PLATECLAVICLE3.5MMLCP5HRT94MM

Facility

$5,721.15

Service Code	HCPCS C1713
Hospital Charge Code	270697376
Hospital Revenue Code	278
Min. Negotiated Rate	$162.48
Max. Negotiated Rate	$2,860.57
Rate for Payer: Aetna Commercial	$2,174.04
Rate for Payer: Aetna Medicare Advantage	$1,716.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,458.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,458.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,458.89
Rate for Payer: Cigna Commercial	$2,860.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.52
Rate for Payer: Qualcare PPO/HMO/WC	$858.17
Rate for Payer: UnitedHealthcare Community & State	$180.79
Rate for Payer: Wellpoint Medicaid Managed Care	$162.48

PLATE CLAVICLE 6 HOLE

Facility

$9,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270672584
Hospital Revenue Code	278
Min. Negotiated Rate	$260.71
Max. Negotiated Rate	$4,590.00
Rate for Payer: Aetna Commercial	$3,488.40
Rate for Payer: Aetna Medicare Advantage	$2,754.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,340.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,340.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,340.90
Rate for Payer: Cigna Commercial	$4,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,221.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,377.00
Rate for Payer: UnitedHealthcare Community & State	$290.09
Rate for Payer: Wellpoint Medicaid Managed Care	$260.71

PLATE CLAVICLE 6 HOLE

Facility

$9,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270672584
Hospital Revenue Code	278
Min. Negotiated Rate	$1,377.00
Max. Negotiated Rate	$2,221.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,221.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,377.00

PLATE CLAVICLE SUPER 3.5MM 8 H

Facility

$4,460.30

Service Code	HCPCS C1776
Hospital Charge Code	270689730
Hospital Revenue Code	278
Min. Negotiated Rate	$126.67
Max. Negotiated Rate	$2,230.15
Rate for Payer: Aetna Commercial	$1,694.91
Rate for Payer: Aetna Medicare Advantage	$1,338.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.38
Rate for Payer: Cigna Commercial	$2,230.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.39
Rate for Payer: Qualcare PPO/HMO/WC	$669.04
Rate for Payer: UnitedHealthcare Community & State	$140.95
Rate for Payer: Wellpoint Medicaid Managed Care	$126.67

PLATE CLAVICLE SUPER 3.5MM 8 H

Facility

$4,460.30

Service Code	HCPCS C1776
Hospital Charge Code	270689730
Hospital Revenue Code	278
Min. Negotiated Rate	$669.04
Max. Negotiated Rate	$1,079.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.39
Rate for Payer: Qualcare PPO/HMO/WC	$669.04

PLATE CLAVICLE WITH LAT EXT

Facility

$4,904.45

Service Code	HCPCS C1713
Hospital Charge Code	270688478
Hospital Revenue Code	278
Min. Negotiated Rate	$735.67
Max. Negotiated Rate	$1,186.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$980.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.88
Rate for Payer: Qualcare PPO/HMO/WC	$735.67

PLATE CLAVICLE WITH LAT EXT

Facility

$4,904.45

Service Code	HCPCS C1713
Hospital Charge Code	270688478
Hospital Revenue Code	278
Min. Negotiated Rate	$139.29
Max. Negotiated Rate	$2,452.22
Rate for Payer: Aetna Commercial	$1,863.69
Rate for Payer: Aetna Medicare Advantage	$1,471.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,250.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,250.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$980.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,250.63
Rate for Payer: Cigna Commercial	$2,452.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,186.88
Rate for Payer: Qualcare PPO/HMO/WC	$735.67
Rate for Payer: UnitedHealthcare Community & State	$154.98
Rate for Payer: Wellpoint Medicaid Managed Care	$139.29

PLATE CLAW II 2HOLE 20MM

Facility

$10,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270676415
Hospital Revenue Code	278
Min. Negotiated Rate	$1,601.25
Max. Negotiated Rate	$2,583.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,583.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,601.25

PLATE CLAW II 2HOLE 20MM

Facility

$10,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270676415
Hospital Revenue Code	278
Min. Negotiated Rate	$303.17
Max. Negotiated Rate	$5,337.50
Rate for Payer: Aetna Commercial	$4,056.50
Rate for Payer: Aetna Medicare Advantage	$3,202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,722.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,722.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,722.12
Rate for Payer: Cigna Commercial	$5,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,583.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,601.25
Rate for Payer: UnitedHealthcare Community & State	$337.33
Rate for Payer: Wellpoint Medicaid Managed Care	$303.17

PLATE CLC FRAC PERIMETER SM

Facility

$6,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270667699
Hospital Revenue Code	278
Min. Negotiated Rate	$188.01
Max. Negotiated Rate	$3,310.00
Rate for Payer: Aetna Commercial	$2,515.60
Rate for Payer: Aetna Medicare Advantage	$1,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,688.10
Rate for Payer: Cigna Commercial	$3,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: Qualcare PPO/HMO/WC	$993.00
Rate for Payer: UnitedHealthcare Community & State	$209.19
Rate for Payer: Wellpoint Medicaid Managed Care	$188.01

PLATE CLC FRAC PERIMETER SM

Facility

$6,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270667699
Hospital Revenue Code	278
Min. Negotiated Rate	$993.00
Max. Negotiated Rate	$1,602.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: Qualcare PPO/HMO/WC	$993.00

PLATE CLC FRAC STD X-SM/SM

Facility

$6,620.00

Hospital Charge Code	270656830
Hospital Revenue Code	278
Min. Negotiated Rate	$188.01
Max. Negotiated Rate	$3,310.00
Rate for Payer: Aetna Commercial	$2,515.60
Rate for Payer: Aetna Medicare Advantage	$1,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,688.10
Rate for Payer: Cigna Commercial	$3,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: Qualcare PPO/HMO/WC	$993.00
Rate for Payer: UnitedHealthcare Community & State	$209.19
Rate for Payer: Wellpoint Medicaid Managed Care	$188.01

PLATE CLC FRAC STD X-SM/SM

Facility

$6,620.00

Hospital Charge Code	270656830
Hospital Revenue Code	278
Min. Negotiated Rate	$993.00
Max. Negotiated Rate	$1,602.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: Qualcare PPO/HMO/WC	$993.00

PLATE CLOVERLEAF

Facility

$1,792.20

Service Code	HCPCS C1713
Hospital Charge Code	270655699
Hospital Revenue Code	278
Min. Negotiated Rate	$50.90
Max. Negotiated Rate	$896.10
Rate for Payer: Aetna Commercial	$681.04
Rate for Payer: Aetna Medicare Advantage	$537.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.01
Rate for Payer: Cigna Commercial	$896.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.71
Rate for Payer: Qualcare PPO/HMO/WC	$268.83
Rate for Payer: UnitedHealthcare Community & State	$56.63
Rate for Payer: Wellpoint Medicaid Managed Care	$50.90

PLATE CLOVERLEAF

Facility

$1,792.20

Service Code	HCPCS C1713
Hospital Charge Code	270655699
Hospital Revenue Code	278
Min. Negotiated Rate	$268.83
Max. Negotiated Rate	$433.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.71
Rate for Payer: Qualcare PPO/HMO/WC	$268.83

PLATE CLOVERLEAF 3H 88MM

Facility

$1,291.60

Service Code	HCPCS C1713
Hospital Charge Code	270604061
Hospital Revenue Code	278
Min. Negotiated Rate	$36.68
Max. Negotiated Rate	$645.80
Rate for Payer: Aetna Commercial	$490.81
Rate for Payer: Aetna Medicare Advantage	$387.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.36
Rate for Payer: Cigna Commercial	$645.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.74
Rate for Payer: UnitedHealthcare Community & State	$40.81
Rate for Payer: Wellpoint Medicaid Managed Care	$36.68

PLATE CLOVERLEAF 3H 88MM

Facility

$1,291.60

Service Code	HCPCS C1713
Hospital Charge Code	270604061
Hospital Revenue Code	278
Min. Negotiated Rate	$193.74
Max. Negotiated Rate	$312.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.74

PLATE CLOVERLEAF 8 HOLES

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270655707
Hospital Revenue Code	278
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,112.40
Rate for Payer: Aetna Commercial	$845.42
Rate for Payer: Aetna Medicare Advantage	$667.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.32
Rate for Payer: Cigna Commercial	$1,112.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72
Rate for Payer: UnitedHealthcare Community & State	$70.30
Rate for Payer: Wellpoint Medicaid Managed Care	$63.18

PLATE CLOVERLEAF 8 HOLES

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270655707
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$538.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

Know your out-of-pocket cost for care.

All Charges