Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DISTAL FIBULA SS RT 12H

Facility

$4,300.00

Hospital Charge Code	270671893
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 RT 14H

Facility

$4,350.00

Hospital Charge Code	270671894
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 RT 14H

Facility

$4,350.00

Hospital Charge Code	270671894
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 4H

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659872
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 RT 4H

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659872
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 RT 5H

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270665697
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 RT 5H

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270665697
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 RT 8H

Facility

$3,975.00

Hospital Charge Code	270670522
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 RT 8H

Facility

$3,975.00

Hospital Charge Code	270670522
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 LATERAL 2.7m 5H L

Facility

$3,648.00

Hospital Charge Code	270674027
Hospital Revenue Code	272
Min. Negotiated Rate	$547.20
Max. Negotiated Rate	$547.20
Rate for Payer: Qualcare PPO/HMO/WC	$547.20

PLATE DISTAL LATERAL 2.7m 5H L

Facility

$3,648.00

Hospital Charge Code	270674027
Hospital Revenue Code	272
Min. Negotiated Rate	$103.60
Max. Negotiated Rate	$1,824.00
Rate for Payer: Aetna Commercial	$1,386.24
Rate for Payer: Aetna Medicare Advantage	$1,094.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.24
Rate for Payer: Cigna Commercial	$1,824.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$948.48
Rate for Payer: Oxford Commercial	$729.60
Rate for Payer: Qualcare PPO/HMO/WC	$547.20
Rate for Payer: UnitedHealthcare Commercial	$729.60
Rate for Payer: UnitedHealthcare Community & State	$115.28
Rate for Payer: Wellpoint Medicaid Managed Care	$103.60

PLATE DISTAL LATERAL 5H 2.7mm

Facility

$4,083.40

Service Code	HCPCS C1713
Hospital Charge Code	270661556
Hospital Revenue Code	278
Min. Negotiated Rate	$612.51
Max. Negotiated Rate	$988.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.18
Rate for Payer: Qualcare PPO/HMO/WC	$612.51

PLATE DISTAL LATERAL 5H 2.7mm

Facility

$4,083.40

Service Code	HCPCS C1713
Hospital Charge Code	270661556
Hospital Revenue Code	278
Min. Negotiated Rate	$115.97
Max. Negotiated Rate	$2,041.70
Rate for Payer: Aetna Commercial	$1,551.69
Rate for Payer: Aetna Medicare Advantage	$1,225.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,041.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,041.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$816.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,041.27
Rate for Payer: Cigna Commercial	$2,041.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$988.18
Rate for Payer: Qualcare PPO/HMO/WC	$612.51
Rate for Payer: UnitedHealthcare Community & State	$129.04
Rate for Payer: Wellpoint Medicaid Managed Care	$115.97

PLATE DISTAL NARROW 6 X 7 MM R

Facility

$23,995.00

Service Code	HCPCS C1713
Hospital Charge Code	270700835
Hospital Revenue Code	278
Min. Negotiated Rate	$681.46
Max. Negotiated Rate	$11,997.50
Rate for Payer: Aetna Commercial	$9,118.10
Rate for Payer: Aetna Medicare Advantage	$7,198.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,118.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,118.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,799.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,118.73
Rate for Payer: Cigna Commercial	$11,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,806.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,599.25
Rate for Payer: UnitedHealthcare Community & State	$758.24
Rate for Payer: Wellpoint Medicaid Managed Care	$681.46

PLATE DISTAL NARROW 6 X 7 MM R

Facility

$23,995.00

Service Code	HCPCS C1713
Hospital Charge Code	270700835
Hospital Revenue Code	278
Min. Negotiated Rate	$3,599.25
Max. Negotiated Rate	$5,806.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,799.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,806.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,599.25

PLATE DISTAL RADIUS 4 HOLE

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664366
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE DISTAL RADIUS 4 HOLE

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664366
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

PLATE DISTAL RADIUS NRW 3H RT

Facility

$3,973.75

Service Code	HCPCS C1713
Hospital Charge Code	270664185
Hospital Revenue Code	278
Min. Negotiated Rate	$596.06
Max. Negotiated Rate	$961.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$794.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.65
Rate for Payer: Qualcare PPO/HMO/WC	$596.06

PLATE DISTAL RADIUS NRW 3H RT

Facility

$3,973.75

Service Code	HCPCS C1713
Hospital Charge Code	270664185
Hospital Revenue Code	278
Min. Negotiated Rate	$112.85
Max. Negotiated Rate	$1,986.88
Rate for Payer: Aetna Commercial	$1,510.03
Rate for Payer: Aetna Medicare Advantage	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$794.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.31
Rate for Payer: Cigna Commercial	$1,986.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.65
Rate for Payer: Qualcare PPO/HMO/WC	$596.06
Rate for Payer: UnitedHealthcare Community & State	$125.57
Rate for Payer: Wellpoint Medicaid Managed Care	$112.85

PLATE DISTAL RADIUS NRW 4H LF

Facility

$4,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270664367
Hospital Revenue Code	278
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$1,131.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: Qualcare PPO/HMO/WC	$701.25

PLATE DISTAL RADIUS NRW 4H LF

Facility

$4,675.00

Service Code	HCPCS C1713
Hospital Charge Code	270664367
Hospital Revenue Code	278
Min. Negotiated Rate	$132.77
Max. Negotiated Rate	$2,337.50
Rate for Payer: Aetna Commercial	$1,776.50
Rate for Payer: Aetna Medicare Advantage	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,192.12
Rate for Payer: Cigna Commercial	$2,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: Qualcare PPO/HMO/WC	$701.25
Rate for Payer: UnitedHealthcare Community & State	$147.73
Rate for Payer: Wellpoint Medicaid Managed Care	$132.77

PLATE DISTAL RADUIS, 3 HOLE

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664365
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE DISTAL RADUIS, 3 HOLE

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664365
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

PLATE DISTAL TIBIA MED. 6H RT

Facility

$10,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270673661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,512.75
Max. Negotiated Rate	$2,440.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,017.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,440.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,512.75

PLATE DISTAL TIBIA MED. 6H RT

Facility

$10,085.00

Service Code	HCPCS C1713
Hospital Charge Code	270673661
Hospital Revenue Code	278
Min. Negotiated Rate	$286.41
Max. Negotiated Rate	$5,042.50
Rate for Payer: Aetna Commercial	$3,832.30
Rate for Payer: Aetna Medicare Advantage	$3,025.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,571.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,571.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,017.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,571.68
Rate for Payer: Cigna Commercial	$5,042.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,440.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,512.75
Rate for Payer: UnitedHealthcare Community & State	$318.69
Rate for Payer: Wellpoint Medicaid Managed Care	$286.41

Know your out-of-pocket cost for care.

All Charges