Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CLOVERLEAF THIN

Facility

$1,331.80

Service Code	HCPCS C1713
Hospital Charge Code	270655695
Hospital Revenue Code	278
Min. Negotiated Rate	$199.77
Max. Negotiated Rate	$322.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.30
Rate for Payer: Qualcare PPO/HMO/WC	$199.77

PLATE CLOVERLEAF THIN

Facility

$1,331.80

Service Code	HCPCS C1713
Hospital Charge Code	270655695
Hospital Revenue Code	278
Min. Negotiated Rate	$37.82
Max. Negotiated Rate	$665.90
Rate for Payer: Aetna Commercial	$506.08
Rate for Payer: Aetna Medicare Advantage	$399.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.61
Rate for Payer: Cigna Commercial	$665.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.30
Rate for Payer: Qualcare PPO/HMO/WC	$199.77
Rate for Payer: UnitedHealthcare Community & State	$42.08
Rate for Payer: Wellpoint Medicaid Managed Care	$37.82

PLATE CLOVERLEAF THIN

Facility

$1,424.50

Service Code	HCPCS C1713
Hospital Charge Code	270655698
Hospital Revenue Code	278
Min. Negotiated Rate	$40.46
Max. Negotiated Rate	$712.25
Rate for Payer: Aetna Commercial	$541.31
Rate for Payer: Aetna Medicare Advantage	$427.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.25
Rate for Payer: Cigna Commercial	$712.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.73
Rate for Payer: Qualcare PPO/HMO/WC	$213.68
Rate for Payer: UnitedHealthcare Community & State	$45.01
Rate for Payer: Wellpoint Medicaid Managed Care	$40.46

PLATE CLOVERLEAF THIN

Facility

$1,424.50

Service Code	HCPCS C1713
Hospital Charge Code	270655698
Hospital Revenue Code	278
Min. Negotiated Rate	$213.68
Max. Negotiated Rate	$344.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.73
Rate for Payer: Qualcare PPO/HMO/WC	$213.68

PLATE CLOVERLEAF THIN

Facility

$2,034.00

Service Code	HCPCS C1713
Hospital Charge Code	270655705
Hospital Revenue Code	278
Min. Negotiated Rate	$57.77
Max. Negotiated Rate	$1,017.00
Rate for Payer: Aetna Commercial	$772.92
Rate for Payer: Aetna Medicare Advantage	$610.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.67
Rate for Payer: Cigna Commercial	$1,017.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: Qualcare PPO/HMO/WC	$305.10
Rate for Payer: UnitedHealthcare Community & State	$64.27
Rate for Payer: Wellpoint Medicaid Managed Care	$57.77

PLATE CLOVERLEAF THIN

Facility

$2,034.00

Service Code	HCPCS C1713
Hospital Charge Code	270655705
Hospital Revenue Code	278
Min. Negotiated Rate	$305.10
Max. Negotiated Rate	$492.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: Qualcare PPO/HMO/WC	$305.10

PLATE CLOVERLEAF THIN 10HOLES

Facility

$2,334.00

Service Code	HCPCS C1713
Hospital Charge Code	270655708
Hospital Revenue Code	278
Min. Negotiated Rate	$66.29
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$886.92
Rate for Payer: Aetna Medicare Advantage	$700.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.17
Rate for Payer: Cigna Commercial	$1,167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.83
Rate for Payer: Qualcare PPO/HMO/WC	$350.10
Rate for Payer: UnitedHealthcare Community & State	$73.75
Rate for Payer: Wellpoint Medicaid Managed Care	$66.29

PLATE CLOVERLEAF THIN 10HOLES

Facility

$2,334.00

Service Code	HCPCS C1713
Hospital Charge Code	270655708
Hospital Revenue Code	278
Min. Negotiated Rate	$350.10
Max. Negotiated Rate	$564.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.83
Rate for Payer: Qualcare PPO/HMO/WC	$350.10

PLATE CLOVERLEAF THIN 6 HOLES

Facility

$1,946.70

Service Code	HCPCS C1713
Hospital Charge Code	270655702
Hospital Revenue Code	278
Min. Negotiated Rate	$55.29
Max. Negotiated Rate	$973.35
Rate for Payer: Aetna Commercial	$739.75
Rate for Payer: Aetna Medicare Advantage	$584.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$496.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$496.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$496.41
Rate for Payer: Cigna Commercial	$973.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.10
Rate for Payer: Qualcare PPO/HMO/WC	$292.00
Rate for Payer: UnitedHealthcare Community & State	$61.52
Rate for Payer: Wellpoint Medicaid Managed Care	$55.29

PLATE CLOVERLEAF THIN 6 HOLES

Facility

$1,946.70

Service Code	HCPCS C1713
Hospital Charge Code	270655702
Hospital Revenue Code	278
Min. Negotiated Rate	$292.00
Max. Negotiated Rate	$471.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.10
Rate for Payer: Qualcare PPO/HMO/WC	$292.00

PLATE CLOVERLF 2.4/2.7X45MM

Facility

$13,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270700030
Hospital Revenue Code	278
Min. Negotiated Rate	$2,061.00
Max. Negotiated Rate	$3,325.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00

PLATE CLOVERLF 2.4/2.7X45MM

Facility

$13,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270700030
Hospital Revenue Code	278
Min. Negotiated Rate	$390.22
Max. Negotiated Rate	$6,870.00
Rate for Payer: Aetna Commercial	$5,221.20
Rate for Payer: Aetna Medicare Advantage	$4,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,503.70
Rate for Payer: Cigna Commercial	$6,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00
Rate for Payer: UnitedHealthcare Community & State	$434.18
Rate for Payer: Wellpoint Medicaid Managed Care	$390.22

PLATE COMP LCK 10 HOLE 5.0MM

Facility

$12,034.15

Service Code	HCPCS C1713
Hospital Charge Code	270700876
Hospital Revenue Code	278
Min. Negotiated Rate	$1,805.12
Max. Negotiated Rate	$2,912.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,912.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,805.12

PLATE COMP LCK 10 HOLE 5.0MM

Facility

$12,034.15

Service Code	HCPCS C1713
Hospital Charge Code	270700876
Hospital Revenue Code	278
Min. Negotiated Rate	$341.77
Max. Negotiated Rate	$6,017.07
Rate for Payer: Aetna Commercial	$4,572.98
Rate for Payer: Aetna Medicare Advantage	$3,610.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,068.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,068.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,068.71
Rate for Payer: Cigna Commercial	$6,017.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,912.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,805.12
Rate for Payer: UnitedHealthcare Community & State	$380.28
Rate for Payer: Wellpoint Medicaid Managed Care	$341.77

PLATE COMP LKG 187MM 10H 3.5MM

Facility

$8,186.75

Service Code	HCPCS C1713
Hospital Charge Code	270697112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,228.01
Max. Negotiated Rate	$1,981.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,637.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,981.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,228.01

PLATE COMP LKG 187MM 10H 3.5MM

Facility

$8,186.75

Service Code	HCPCS C1713
Hospital Charge Code	270697112
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$4,093.38
Rate for Payer: Aetna Commercial	$3,110.97
Rate for Payer: Aetna Medicare Advantage	$2,456.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,087.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,087.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,637.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,087.62
Rate for Payer: Cigna Commercial	$4,093.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,981.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,228.01
Rate for Payer: UnitedHealthcare Community & State	$258.70
Rate for Payer: Wellpoint Medicaid Managed Care	$232.50

PLATE COMPRESSION 3HOLE 20MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677562
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 COMPRESSION 3HOLE 20MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677562
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 COMPRESSION 3HOLE 25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677561
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 COMPRESSION 3HOLE 25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677561
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 COMPRESSION 4 HOLE

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270679503
Hospital Revenue Code	278
Min. Negotiated Rate	$169.69
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$2,270.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Community & State	$188.81
Rate for Payer: Wellpoint Medicaid Managed Care	$169.69

PLATE COMPRESSION 4 HOLE

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270679503
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

PLATECOMPVALCP2.8/3.5X169MM8H

Facility

$5,896.20

Service Code	HCPCS C1713
Hospital Charge Code	270698571
Hospital Revenue Code	278
Min. Negotiated Rate	$884.43
Max. Negotiated Rate	$1,426.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.88
Rate for Payer: Qualcare PPO/HMO/WC	$884.43

PLATECOMPVALCP2.8/3.5X169MM8H

Facility

$5,896.20

Service Code	HCPCS C1713
Hospital Charge Code	270698571
Hospital Revenue Code	278
Min. Negotiated Rate	$167.45
Max. Negotiated Rate	$2,948.10
Rate for Payer: Aetna Commercial	$2,240.56
Rate for Payer: Aetna Medicare Advantage	$1,768.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,503.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,503.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,179.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,503.53
Rate for Payer: Cigna Commercial	$2,948.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,426.88
Rate for Payer: Qualcare PPO/HMO/WC	$884.43
Rate for Payer: UnitedHealthcare Community & State	$186.32
Rate for Payer: Wellpoint Medicaid Managed Care	$167.45

PLATE CONDYLAR 10H 230MM RT S

Facility

$7,545.00

Service Code	HCPCS C1713
Hospital Charge Code	270675713
Hospital Revenue Code	278
Min. Negotiated Rate	$214.28
Max. Negotiated Rate	$3,772.50
Rate for Payer: Aetna Commercial	$2,867.10
Rate for Payer: Aetna Medicare Advantage	$2,263.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,923.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,923.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,923.97
Rate for Payer: Cigna Commercial	$3,772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,825.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,131.75
Rate for Payer: UnitedHealthcare Community & State	$238.42
Rate for Payer: Wellpoint Medicaid Managed Care	$214.28

Know your out-of-pocket cost for care.

All Charges