Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FIBULA 5H LEFT

Facility

$2,679.05

Service Code	HCPCS C1713
Hospital Charge Code	270664044
Hospital Revenue Code	278
Min. Negotiated Rate	$76.09
Max. Negotiated Rate	$1,339.53
Rate for Payer: Aetna Commercial	$1,018.04
Rate for Payer: Aetna Medicare Advantage	$803.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.16
Rate for Payer: Cigna Commercial	$1,339.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.33
Rate for Payer: Qualcare PPO/HMO/WC	$401.86
Rate for Payer: UnitedHealthcare Community & State	$84.66
Rate for Payer: Wellpoint Medicaid Managed Care	$76.09

PLATE FIBULA 5H LEFT

Facility

$2,679.05

Service Code	HCPCS C1713
Hospital Charge Code	270664044
Hospital Revenue Code	278
Min. Negotiated Rate	$401.86
Max. Negotiated Rate	$648.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.33
Rate for Payer: Qualcare PPO/HMO/WC	$401.86

PLATE FIBULA 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691916
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

PLATE FIBULA 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691916
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE FIBULA 7 HOLE

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270668350
Hospital Revenue Code	278
Min. Negotiated Rate	$88.61
Max. Negotiated Rate	$1,560.00
Rate for Payer: Aetna Commercial	$1,185.60
Rate for Payer: Aetna Medicare Advantage	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$795.60
Rate for Payer: Cigna Commercial	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: Qualcare PPO/HMO/WC	$468.00
Rate for Payer: UnitedHealthcare Community & State	$98.59
Rate for Payer: Wellpoint Medicaid Managed Care	$88.61

PLATE FIBULA 7 HOLE

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270668350
Hospital Revenue Code	278
Min. Negotiated Rate	$468.00
Max. Negotiated Rate	$755.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: Qualcare PPO/HMO/WC	$468.00

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$4,326.00

Service Code	HCPCS C1713
Hospital Charge Code	270660713
Hospital Revenue Code	278
Min. Negotiated Rate	$122.86
Max. Negotiated Rate	$2,163.00
Rate for Payer: Aetna Commercial	$1,643.88
Rate for Payer: Aetna Medicare Advantage	$1,297.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.13
Rate for Payer: Cigna Commercial	$2,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.89
Rate for Payer: Qualcare PPO/HMO/WC	$648.90
Rate for Payer: UnitedHealthcare Community & State	$136.70
Rate for Payer: Wellpoint Medicaid Managed Care	$122.86

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$4,326.00

Service Code	HCPCS C1713
Hospital Charge Code	270660713
Hospital Revenue Code	278
Min. Negotiated Rate	$648.90
Max. Negotiated Rate	$1,046.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.89
Rate for Payer: Qualcare PPO/HMO/WC	$648.90

PLATE FIBULA ANKLE FX 9H RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700268
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 FIBULA ANKLE FX 9H RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700268
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 DISTAL 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687751
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

PLATE FIBULA DISTAL 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687751
Hospital Revenue Code	278
Min. Negotiated Rate	$110.05
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$122.45
Rate for Payer: Wellpoint Medicaid Managed Care	$110.05

PLATEFIBULALATLKG8H132MMRT

Facility

$4,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270695536
Hospital Revenue Code	278
Min. Negotiated Rate	$123.68
Max. Negotiated Rate	$2,177.50
Rate for Payer: Aetna Commercial	$1,654.90
Rate for Payer: Aetna Medicare Advantage	$1,306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,110.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,110.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$871.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,110.53
Rate for Payer: Cigna Commercial	$2,177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,053.91
Rate for Payer: Qualcare PPO/HMO/WC	$653.25
Rate for Payer: UnitedHealthcare Community & State	$137.62
Rate for Payer: Wellpoint Medicaid Managed Care	$123.68

PLATEFIBULALATLKG8H132MMRT

Facility

$4,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270695536
Hospital Revenue Code	278
Min. Negotiated Rate	$653.25
Max. Negotiated Rate	$1,053.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$871.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,053.91
Rate for Payer: Qualcare PPO/HMO/WC	$653.25

PLATE FIBULA LOCKING 4 HOLE

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691059
Hospital Revenue Code	278
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$94.80
Rate for Payer: Wellpoint Medicaid Managed Care	$85.20

PLATE FIBULA LOCKING 4 HOLE

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691059
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

PLATE FIBULAR 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691919
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE FIBULAR 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691919
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

PLATE FIBULAR STR 9-HOLE

Facility

$3,734.50

Service Code	HCPCS C1713
Hospital Charge Code	270701514
Hospital Revenue Code	278
Min. Negotiated Rate	$560.17
Max. Negotiated Rate	$903.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$746.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$903.75
Rate for Payer: Qualcare PPO/HMO/WC	$560.17

PLATE FIBULAR STR 9-HOLE

Facility

$3,734.50

Service Code	HCPCS C1713
Hospital Charge Code	270701514
Hospital Revenue Code	278
Min. Negotiated Rate	$106.06
Max. Negotiated Rate	$1,867.25
Rate for Payer: Aetna Commercial	$1,419.11
Rate for Payer: Aetna Medicare Advantage	$1,120.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$952.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$952.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$746.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$952.30
Rate for Payer: Cigna Commercial	$1,867.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$903.75
Rate for Payer: Qualcare PPO/HMO/WC	$560.17
Rate for Payer: UnitedHealthcare Community & State	$118.01
Rate for Payer: Wellpoint Medicaid Managed Care	$106.06

PLATE FIBULA STR 10 HOLES

Facility

$3,500.00

Hospital Charge Code	270669980
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE FIBULA STR 10 HOLES

Facility

$3,500.00

Hospital Charge Code	270669980
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

PLATE FIBULA STR 8 HOLES 108MM

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270665783
Hospital Revenue Code	278
Min. Negotiated Rate	$468.00
Max. Negotiated Rate	$755.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: Qualcare PPO/HMO/WC	$468.00

PLATE FIBULA STR 8 HOLES 108MM

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270665783
Hospital Revenue Code	278
Min. Negotiated Rate	$88.61
Max. Negotiated Rate	$1,560.00
Rate for Payer: Aetna Commercial	$1,185.60
Rate for Payer: Aetna Medicare Advantage	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$795.60
Rate for Payer: Cigna Commercial	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: Qualcare PPO/HMO/WC	$468.00
Rate for Payer: UnitedHealthcare Community & State	$98.59
Rate for Payer: Wellpoint Medicaid Managed Care	$88.61

PLATE FIBULA STRAIGHT 4H 60MM

Facility

$2,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270674889
Hospital Revenue Code	278
Min. Negotiated Rate	$68.73
Max. Negotiated Rate	$1,210.00
Rate for Payer: Aetna Commercial	$919.60
Rate for Payer: Aetna Medicare Advantage	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.10
Rate for Payer: Cigna Commercial	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00
Rate for Payer: UnitedHealthcare Community & State	$76.47
Rate for Payer: Wellpoint Medicaid Managed Care	$68.73

Know your out-of-pocket cost for care.

All Charges