Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLATE EXPRESSEW II AC DIVBRD

Facility

$1,020.00

Hospital Charge Code	270672122
Hospital Revenue Code	278
Min. Negotiated Rate	$28.97
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$387.60
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00
Rate for Payer: UnitedHealthcare Community & State	$32.23
Rate for Payer: Wellpoint Medicaid Managed Care	$28.97

PLATE EXPRESSEW II AC DIVBRD

Facility

$1,020.00

Hospital Charge Code	270672122
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

PLATE EXTVOLAR DR 53MM 3 HOLE

Facility

$10,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270703684
Hospital Revenue Code	278
Min. Negotiated Rate	$1,540.50
Max. Negotiated Rate	$2,485.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,054.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,485.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,540.50

PLATE EXTVOLAR DR 53MM 3 HOLE

Facility

$10,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270703684
Hospital Revenue Code	278
Min. Negotiated Rate	$291.67
Max. Negotiated Rate	$5,135.00
Rate for Payer: Aetna Commercial	$3,902.60
Rate for Payer: Aetna Medicare Advantage	$3,081.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,618.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,618.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,054.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,618.85
Rate for Payer: Cigna Commercial	$5,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,485.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,540.50
Rate for Payer: UnitedHealthcare Community & State	$324.53
Rate for Payer: Wellpoint Medicaid Managed Care	$291.67

PLATE FEM DIST LAT 12H 274MM

Facility

$16,190.30

Service Code	HCPCS C1713
Hospital Charge Code	270697352
Hospital Revenue Code	278
Min. Negotiated Rate	$459.80
Max. Negotiated Rate	$8,095.15
Rate for Payer: Aetna Commercial	$6,152.31
Rate for Payer: Aetna Medicare Advantage	$4,857.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,238.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.53
Rate for Payer: Cigna Commercial	$8,095.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,918.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.55
Rate for Payer: UnitedHealthcare Community & State	$511.61
Rate for Payer: Wellpoint Medicaid Managed Care	$459.80

PLATE FEM DIST LAT 12H 274MM

Facility

$16,190.30

Service Code	HCPCS C1713
Hospital Charge Code	270697352
Hospital Revenue Code	278
Min. Negotiated Rate	$2,428.55
Max. Negotiated Rate	$3,918.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,238.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,918.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.55

PLATE FEM DIST LAT RT 6H 166MM

Facility

$15,160.10

Service Code	HCPCS C1713
Hospital Charge Code	270697989
Hospital Revenue Code	278
Min. Negotiated Rate	$2,274.01
Max. Negotiated Rate	$3,668.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,032.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,668.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,274.01

PLATE FEM DIST LAT RT 6H 166MM

Facility

$15,160.10

Service Code	HCPCS C1713
Hospital Charge Code	270697989
Hospital Revenue Code	278
Min. Negotiated Rate	$430.55
Max. Negotiated Rate	$7,580.05
Rate for Payer: Aetna Commercial	$5,760.84
Rate for Payer: Aetna Medicare Advantage	$4,548.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,865.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,865.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,032.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,865.83
Rate for Payer: Cigna Commercial	$7,580.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,668.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,274.01
Rate for Payer: UnitedHealthcare Community & State	$479.06
Rate for Payer: Wellpoint Medicaid Managed Care	$430.55

PLATE FEMUR DISTAL 10H 238mm R

Facility

$11,871.00

Hospital Charge Code	270673781
Hospital Revenue Code	278
Min. Negotiated Rate	$337.14
Max. Negotiated Rate	$5,935.50
Rate for Payer: Aetna Commercial	$4,510.98
Rate for Payer: Aetna Medicare Advantage	$3,561.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,374.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.11
Rate for Payer: Cigna Commercial	$5,935.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,872.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,780.65
Rate for Payer: UnitedHealthcare Community & State	$375.12
Rate for Payer: Wellpoint Medicaid Managed Care	$337.14

PLATE FEMUR DISTAL 10H 238mm R

Facility

$11,871.00

Hospital Charge Code	270673781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,780.65
Max. Negotiated Rate	$2,872.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,374.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,872.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,780.65

PLATE FIB 3DI 89MM RT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$1,890.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB 3DI 89MM RT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700377
Hospital Revenue Code	278
Min. Negotiated Rate	$221.88
Max. Negotiated Rate	$3,906.28
Rate for Payer: Aetna Commercial	$2,968.77
Rate for Payer: Aetna Medicare Advantage	$2,343.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,992.20
Rate for Payer: Cigna Commercial	$3,906.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88
Rate for Payer: UnitedHealthcare Community & State	$246.88
Rate for Payer: Wellpoint Medicaid Managed Care	$221.88

PLATE FIB LAT 3DI 77MM LT

Facility

$7,642.60

Service Code	HCPCS C1713
Hospital Charge Code	270700343
Hospital Revenue Code	278
Min. Negotiated Rate	$217.05
Max. Negotiated Rate	$3,821.30
Rate for Payer: Aetna Commercial	$2,904.19
Rate for Payer: Aetna Medicare Advantage	$2,292.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,948.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,948.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,528.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,948.86
Rate for Payer: Cigna Commercial	$3,821.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,849.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.39
Rate for Payer: UnitedHealthcare Community & State	$241.51
Rate for Payer: Wellpoint Medicaid Managed Care	$217.05

PLATE FIB LAT 3DI 77MM LT

Facility

$7,642.60

Service Code	HCPCS C1713
Hospital Charge Code	270700343
Hospital Revenue Code	278
Min. Negotiated Rate	$1,146.39
Max. Negotiated Rate	$1,849.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,528.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,849.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.39

PLATE FIB LAT 3DI 89MM LT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700379
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$1,890.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB LAT 3DI 89MM LT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700379
Hospital Revenue Code	278
Min. Negotiated Rate	$221.88
Max. Negotiated Rate	$3,906.28
Rate for Payer: Aetna Commercial	$2,968.77
Rate for Payer: Aetna Medicare Advantage	$2,343.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,992.20
Rate for Payer: Cigna Commercial	$3,906.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88
Rate for Payer: UnitedHealthcare Community & State	$246.88
Rate for Payer: Wellpoint Medicaid Managed Care	$221.88

PLATE FIB PIT 13 HI ANTMCL RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270702043
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$1,660.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE FIB PIT 13 HI ANTMCL RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270702043
Hospital Revenue Code	278
Min. Negotiated Rate	$194.86
Max. Negotiated Rate	$3,430.62
Rate for Payer: Aetna Commercial	$2,607.28
Rate for Payer: Aetna Medicare Advantage	$2,058.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,749.62
Rate for Payer: Cigna Commercial	$3,430.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19
Rate for Payer: UnitedHealthcare Community & State	$216.82
Rate for Payer: Wellpoint Medicaid Managed Care	$194.86

PLATE FIBULA 11 HOLE 2.7

Facility

$4,602.00

Hospital Charge Code	270664325
Hospital Revenue Code	278
Min. Negotiated Rate	$690.30
Max. Negotiated Rate	$1,113.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$920.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.68
Rate for Payer: Qualcare PPO/HMO/WC	$690.30

PLATE FIBULA 11 HOLE 2.7

Facility

$4,602.00

Hospital Charge Code	270664325
Hospital Revenue Code	278
Min. Negotiated Rate	$130.70
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$1,748.76
Rate for Payer: Aetna Medicare Advantage	$1,380.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,173.51
Rate for Payer: Cigna Commercial	$2,301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.68
Rate for Payer: Qualcare PPO/HMO/WC	$690.30
Rate for Payer: UnitedHealthcare Community & State	$145.42
Rate for Payer: Wellpoint Medicaid Managed Care	$130.70

PLATE FIBULA 4 HOLE 88MM

Facility

$3,303.30

Service Code	HCPCS C1713
Hospital Charge Code	270660367
Hospital Revenue Code	278
Min. Negotiated Rate	$495.50
Max. Negotiated Rate	$799.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.40
Rate for Payer: Qualcare PPO/HMO/WC	$495.50

PLATE FIBULA 4 HOLE 88MM

Facility

$3,303.30

Service Code	HCPCS C1713
Hospital Charge Code	270660367
Hospital Revenue Code	278
Min. Negotiated Rate	$93.81
Max. Negotiated Rate	$1,651.65
Rate for Payer: Aetna Commercial	$1,255.25
Rate for Payer: Aetna Medicare Advantage	$990.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$842.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$842.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$842.34
Rate for Payer: Cigna Commercial	$1,651.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.40
Rate for Payer: Qualcare PPO/HMO/WC	$495.50
Rate for Payer: UnitedHealthcare Community & State	$104.38
Rate for Payer: Wellpoint Medicaid Managed Care	$93.81

PLATE FIBULA 4 HOLE RIGHT 2.7/

Facility

$4,118.90

Service Code	HCPCS C1713
Hospital Charge Code	270668000
Hospital Revenue Code	278
Min. Negotiated Rate	$617.84
Max. Negotiated Rate	$996.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.77
Rate for Payer: Qualcare PPO/HMO/WC	$617.84

PLATE FIBULA 4 HOLE RIGHT 2.7/

Facility

$4,118.90

Service Code	HCPCS C1713
Hospital Charge Code	270668000
Hospital Revenue Code	278
Min. Negotiated Rate	$116.98
Max. Negotiated Rate	$2,059.45
Rate for Payer: Aetna Commercial	$1,565.18
Rate for Payer: Aetna Medicare Advantage	$1,235.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,050.32
Rate for Payer: Cigna Commercial	$2,059.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.77
Rate for Payer: Qualcare PPO/HMO/WC	$617.84
Rate for Payer: UnitedHealthcare Community & State	$130.16
Rate for Payer: Wellpoint Medicaid Managed Care	$116.98

Know your out-of-pocket cost for care.

All Charges