Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DIST FEM NCB 15H LT317MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699605
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PLATE DIST FEM NCB 15H LT317MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699605
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

PLATE DIST LAT FEM LT FEM 10H

Facility

$14,942.05

Service Code	HCPCS C1713
Hospital Charge Code	270693021
Hospital Revenue Code	278
Min. Negotiated Rate	$424.35
Max. Negotiated Rate	$7,471.02
Rate for Payer: Aetna Commercial	$5,677.98
Rate for Payer: Aetna Medicare Advantage	$4,482.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,810.22
Rate for Payer: Cigna Commercial	$7,471.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.31
Rate for Payer: UnitedHealthcare Community & State	$472.17
Rate for Payer: Wellpoint Medicaid Managed Care	$424.35

PLATE DIST LAT FEM LT FEM 10H

Facility

$14,942.05

Service Code	HCPCS C1713
Hospital Charge Code	270693021
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.31
Max. Negotiated Rate	$3,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.31

PLATE DISTL CLAVICAL 10 HOLE L

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270687601
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 DISTL CLAVICAL 10 HOLE L

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270687601
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 DISTL CLAVICAL 10 HOLE R

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270687602
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 DISTL CLAVICAL 10 HOLE R

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270687602
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 DIST RAD VOL STD 3H RT

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664368
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 DIST RAD VOL STD 3H RT

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270664368
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 DM TIBIA RT 10H LT 175MM

Facility

$12,751.25

Service Code	HCPCS C1713
Hospital Charge Code	270699640
Hospital Revenue Code	278
Min. Negotiated Rate	$362.14
Max. Negotiated Rate	$6,375.62
Rate for Payer: Aetna Commercial	$4,845.48
Rate for Payer: Aetna Medicare Advantage	$3,825.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,251.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,251.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,550.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,251.57
Rate for Payer: Cigna Commercial	$6,375.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,085.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.69
Rate for Payer: UnitedHealthcare Community & State	$402.94
Rate for Payer: Wellpoint Medicaid Managed Care	$362.14

PLATE DM TIBIA RT 10H LT 175MM

Facility

$12,751.25

Service Code	HCPCS C1713
Hospital Charge Code	270699640
Hospital Revenue Code	278
Min. Negotiated Rate	$1,912.69
Max. Negotiated Rate	$3,085.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,550.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,085.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.69

PLATE DORSAL 2.4X51MM 5H-90

Facility

$2,373.00

Hospital Charge Code	270661609
Hospital Revenue Code	278
Min. Negotiated Rate	$355.95
Max. Negotiated Rate	$574.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.27
Rate for Payer: Qualcare PPO/HMO/WC	$355.95

PLATE DORSAL 2.4X51MM 5H-90

Facility

$2,373.00

Hospital Charge Code	270661609
Hospital Revenue Code	278
Min. Negotiated Rate	$67.39
Max. Negotiated Rate	$1,186.50
Rate for Payer: Aetna Commercial	$901.74
Rate for Payer: Aetna Medicare Advantage	$711.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.12
Rate for Payer: Cigna Commercial	$1,186.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.27
Rate for Payer: Qualcare PPO/HMO/WC	$355.95
Rate for Payer: UnitedHealthcare Community & State	$74.99
Rate for Payer: Wellpoint Medicaid Managed Care	$67.39

PLATE DORS DIST RADI 3H-90

Facility

$2,506.00

Service Code	HCPCS C1713
Hospital Charge Code	270661613
Hospital Revenue Code	278
Min. Negotiated Rate	$375.90
Max. Negotiated Rate	$606.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.45
Rate for Payer: Qualcare PPO/HMO/WC	$375.90

PLATE DORS DIST RADI 3H-90

Facility

$2,506.00

Service Code	HCPCS C1713
Hospital Charge Code	270661613
Hospital Revenue Code	278
Min. Negotiated Rate	$71.17
Max. Negotiated Rate	$1,253.00
Rate for Payer: Aetna Commercial	$952.28
Rate for Payer: Aetna Medicare Advantage	$751.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.03
Rate for Payer: Cigna Commercial	$1,253.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.45
Rate for Payer: Qualcare PPO/HMO/WC	$375.90
Rate for Payer: UnitedHealthcare Community & State	$79.19
Rate for Payer: Wellpoint Medicaid Managed Care	$71.17

PLATE DSTI PI 8-HI ANTMCL POST

Facility

$5,472.50

Service Code	HCPCS C1713
Hospital Charge Code	270702044
Hospital Revenue Code	278
Min. Negotiated Rate	$155.42
Max. Negotiated Rate	$2,736.25
Rate for Payer: Aetna Commercial	$2,079.55
Rate for Payer: Aetna Medicare Advantage	$1,641.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,395.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,395.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,395.49
Rate for Payer: Cigna Commercial	$2,736.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.35
Rate for Payer: Qualcare PPO/HMO/WC	$820.88
Rate for Payer: UnitedHealthcare Community & State	$172.93
Rate for Payer: Wellpoint Medicaid Managed Care	$155.42

PLATE DSTI PI 8-HI ANTMCL POST

Facility

$5,472.50

Service Code	HCPCS C1713
Hospital Charge Code	270702044
Hospital Revenue Code	278
Min. Negotiated Rate	$820.88
Max. Negotiated Rate	$1,324.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.35
Rate for Payer: Qualcare PPO/HMO/WC	$820.88

PLATE DVR LOCK MINI RT

Facility

$6,352.50

Service Code	HCPCS C1716
Hospital Charge Code	270702388
Hospital Revenue Code	278
Min. Negotiated Rate	$180.41
Max. Negotiated Rate	$2,166.34
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.34
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,537.31
Rate for Payer: Qualcare PPO/HMO/WC	$952.88
Rate for Payer: UnitedHealthcare Community & State	$200.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$180.41

PLATE DVR LOCK MINI RT

Facility

$6,352.50

Service Code	HCPCS C1716
Hospital Charge Code	270702388
Hospital Revenue Code	278
Min. Negotiated Rate	$952.88
Max. Negotiated Rate	$1,537.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,537.31
Rate for Payer: Qualcare PPO/HMO/WC	$952.88

PLATE DVR WIDE HEAD RIGHT

Facility

$5,395.00

Hospital Charge Code	270671835
Hospital Revenue Code	278
Min. Negotiated Rate	$153.22
Max. Negotiated Rate	$2,697.50
Rate for Payer: Aetna Commercial	$2,050.10
Rate for Payer: Aetna Medicare Advantage	$1,618.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,375.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,375.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,375.72
Rate for Payer: Cigna Commercial	$2,697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,305.59
Rate for Payer: Qualcare PPO/HMO/WC	$809.25
Rate for Payer: UnitedHealthcare Community & State	$170.48
Rate for Payer: Wellpoint Medicaid Managed Care	$153.22

PLATE DVR WIDE HEAD RIGHT

Facility

$5,395.00

Hospital Charge Code	270671835
Hospital Revenue Code	278
Min. Negotiated Rate	$809.25
Max. Negotiated Rate	$1,305.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,305.59
Rate for Payer: Qualcare PPO/HMO/WC	$809.25

PLATE DVR WRIST SPANNING 180MM

Facility

$16,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270699272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.75
Max. Negotiated Rate	$3,955.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,269.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,955.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.75

PLATE DVR WRIST SPANNING 180MM

Facility

$16,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270699272
Hospital Revenue Code	278
Min. Negotiated Rate	$464.20
Max. Negotiated Rate	$8,172.50
Rate for Payer: Aetna Commercial	$6,211.10
Rate for Payer: Aetna Medicare Advantage	$4,903.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,167.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,167.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,167.98
Rate for Payer: Cigna Commercial	$8,172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,955.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.75
Rate for Payer: UnitedHealthcare Community & State	$516.50
Rate for Payer: Wellpoint Medicaid Managed Care	$464.20

PLATE END MIS HA MINUTEMAN G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693753
Hospital Revenue Code	278
Min. Negotiated Rate	$1,136.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$15,200.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Community & State	$1,264.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1,136.00

Know your out-of-pocket cost for care.

All Charges