Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DISTALFIBULA 15HOLE 2.7R

Facility

$4,938.00

Hospital Charge Code	270664151
Hospital Revenue Code	278
Min. Negotiated Rate	$740.70
Max. Negotiated Rate	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$740.70

PLATE DISTALFIBULA 15HOLE 2.7R

Facility

$4,938.00

Hospital Charge Code	270664151
Hospital Revenue Code	278
Min. Negotiated Rate	$140.24
Max. Negotiated Rate	$2,469.00
Rate for Payer: Aetna Commercial	$1,876.44
Rate for Payer: Aetna Medicare Advantage	$1,481.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.19
Rate for Payer: Cigna Commercial	$2,469.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$740.70
Rate for Payer: UnitedHealthcare Community & State	$156.04
Rate for Payer: Wellpoint Medicaid Managed Care	$140.24

PLATE DISTAL FIBULA 4H 2.7x3.5

Facility

$6,282.00

Service Code	HCPCS C1713
Hospital Charge Code	270668470
Hospital Revenue Code	278
Min. Negotiated Rate	$942.30
Max. Negotiated Rate	$1,520.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,520.24
Rate for Payer: Qualcare PPO/HMO/WC	$942.30

PLATE DISTAL FIBULA 4H 2.7x3.5

Facility

$6,282.00

Service Code	HCPCS C1713
Hospital Charge Code	270668470
Hospital Revenue Code	278
Min. Negotiated Rate	$178.41
Max. Negotiated Rate	$3,141.00
Rate for Payer: Aetna Commercial	$2,387.16
Rate for Payer: Aetna Medicare Advantage	$1,884.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.91
Rate for Payer: Cigna Commercial	$3,141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,520.24
Rate for Payer: Qualcare PPO/HMO/WC	$942.30
Rate for Payer: UnitedHealthcare Community & State	$198.51
Rate for Payer: Wellpoint Medicaid Managed Care	$178.41

PLATE DISTAL FIBULA 5 HOLE

Facility

$2,972.65

Service Code	HCPCS C1713
Hospital Charge Code	270686753
Hospital Revenue Code	278
Min. Negotiated Rate	$84.42
Max. Negotiated Rate	$1,486.33
Rate for Payer: Aetna Commercial	$1,129.61
Rate for Payer: Aetna Medicare Advantage	$891.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$594.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.03
Rate for Payer: Cigna Commercial	$1,486.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.38
Rate for Payer: Qualcare PPO/HMO/WC	$445.90
Rate for Payer: UnitedHealthcare Community & State	$93.94
Rate for Payer: Wellpoint Medicaid Managed Care	$84.42

PLATE DISTAL FIBULA 5 HOLE

Facility

$2,972.65

Service Code	HCPCS C1713
Hospital Charge Code	270686753
Hospital Revenue Code	278
Min. Negotiated Rate	$445.90
Max. Negotiated Rate	$719.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$594.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.38
Rate for Payer: Qualcare PPO/HMO/WC	$445.90

PLATE DISTAL FIBULA 6HOLE

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270671888
Hospital Revenue Code	278
Min. Negotiated Rate	$102.95
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Community & State	$114.55
Rate for Payer: Wellpoint Medicaid Managed Care	$102.95

PLATE DISTAL FIBULA 6HOLE

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270671888
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

PLATE DISTAL FIBULA 8H 2.7x3.5

Facility

$10,690.00

Service Code	HCPCS C1713
Hospital Charge Code	270672089
Hospital Revenue Code	278
Min. Negotiated Rate	$303.60
Max. Negotiated Rate	$5,345.00
Rate for Payer: Aetna Commercial	$4,062.20
Rate for Payer: Aetna Medicare Advantage	$3,207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,725.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,725.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,725.95
Rate for Payer: Cigna Commercial	$5,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,586.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,603.50
Rate for Payer: UnitedHealthcare Community & State	$337.80
Rate for Payer: Wellpoint Medicaid Managed Care	$303.60

PLATE DISTAL FIBULA 8H 2.7x3.5

Facility

$10,690.00

Service Code	HCPCS C1713
Hospital Charge Code	270672089
Hospital Revenue Code	278
Min. Negotiated Rate	$1,603.50
Max. Negotiated Rate	$2,586.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,586.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,603.50

PLATE DISTAL FIBULA SS LEFT 4H

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270660175
Hospital Revenue Code	278
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

PLATE DISTAL FIBULA SS LEFT 4H

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270660175
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

PLATE DISTAL FIBULA SS LEFT 5H

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270671887
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLATE DISTAL FIBULA SS LEFT 5H

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270671887
Hospital Revenue Code	278
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

PLATE DISTAL FIBULA SS LEFT 8H

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270669995
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 DISTAL FIBULA SS LEFT 8H

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270669995
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 DISTAL FIBULA SS LFT 10H

Facility

$4,250.00

Hospital Charge Code	270671889
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

PLATE DISTAL FIBULA SS LFT 10H

Facility

$4,250.00

Hospital Charge Code	270671889
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

PLATE DISTAL FIBULA SS LFT 12H

Facility

$4,300.00

Hospital Charge Code	270671890
Hospital Revenue Code	278
Min. Negotiated Rate	$122.12
Max. Negotiated Rate	$2,150.00
Rate for Payer: Aetna Commercial	$1,634.00
Rate for Payer: Aetna Medicare Advantage	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.50
Rate for Payer: Cigna Commercial	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$645.00
Rate for Payer: UnitedHealthcare Community & State	$135.88
Rate for Payer: Wellpoint Medicaid Managed Care	$122.12

PLATE DISTAL FIBULA SS LFT 12H

Facility

$4,300.00

Hospital Charge Code	270671890
Hospital Revenue Code	278
Min. Negotiated Rate	$645.00
Max. Negotiated Rate	$1,040.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$645.00

PLATE DISTAL FIBULA SS LFT 14H

Facility

$4,350.00

Hospital Charge Code	270671891
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

PLATE DISTAL FIBULA SS LFT 14H

Facility

$4,350.00

Hospital Charge Code	270671891
Hospital Revenue Code	278
Min. Negotiated Rate	$123.54
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,653.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50
Rate for Payer: UnitedHealthcare Community & State	$137.46
Rate for Payer: Wellpoint Medicaid Managed Care	$123.54

PLATE DISTAL FIBULA SS RT 10H

Facility

$4,250.00

Hospital Charge Code	270671892
Hospital Revenue Code	278
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

PLATE DISTAL FIBULA SS RT 10H

Facility

$4,250.00

Hospital Charge Code	270671892
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

PLATE DISTAL FIBULA SS RT 12H

Facility

$4,300.00

Hospital Charge Code	270671893
Hospital Revenue Code	278
Min. Negotiated Rate	$122.12
Max. Negotiated Rate	$2,150.00
Rate for Payer: Aetna Commercial	$1,634.00
Rate for Payer: Aetna Medicare Advantage	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.50
Rate for Payer: Cigna Commercial	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$645.00
Rate for Payer: UnitedHealthcare Community & State	$135.88
Rate for Payer: Wellpoint Medicaid Managed Care	$122.12

Know your out-of-pocket cost for care.

All Charges