Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FIBULA STRAIGHT 4H 60MM

Facility

$2,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270674889
Hospital Revenue Code	278
Min. Negotiated Rate	$363.00
Max. Negotiated Rate	$585.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.64
Rate for Payer: Qualcare PPO/HMO/WC	$363.00

PLATE FIBULA TI 11H CLUSTER RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700402
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 TI 11H CLUSTER RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700402
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 VA-LCP 2.7MM LT3H

Facility

$4,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695311
Hospital Revenue Code	278
Min. Negotiated Rate	$124.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,662.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25
Rate for Payer: UnitedHealthcare Community & State	$138.25
Rate for Payer: Wellpoint Medicaid Managed Care	$124.25

PLATE FIBULA VA-LCP 2.7MM LT3H

Facility

$4,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695311
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

PLATE FIRST TMT FUSION 2.4/ 2.

Facility

$4,541.75

Service Code	HCPCS C1713
Hospital Charge Code	270681819
Hospital Revenue Code	278
Min. Negotiated Rate	$128.99
Max. Negotiated Rate	$2,270.88
Rate for Payer: Aetna Commercial	$1,725.87
Rate for Payer: Aetna Medicare Advantage	$1,362.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,158.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,158.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$908.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,158.15
Rate for Payer: Cigna Commercial	$2,270.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,099.10
Rate for Payer: Qualcare PPO/HMO/WC	$681.26
Rate for Payer: UnitedHealthcare Community & State	$143.52
Rate for Payer: Wellpoint Medicaid Managed Care	$128.99

PLATE FIRST TMT FUSION 2.4/ 2.

Facility

$4,541.75

Service Code	HCPCS C1713
Hospital Charge Code	270681819
Hospital Revenue Code	278
Min. Negotiated Rate	$681.26
Max. Negotiated Rate	$1,099.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$908.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,099.10
Rate for Payer: Qualcare PPO/HMO/WC	$681.26

PLATE FOREFOOT UNIVERSAL 18MM

Facility

$6,279.10

Hospital Charge Code	270657193
Hospital Revenue Code	278
Min. Negotiated Rate	$941.87
Max. Negotiated Rate	$1,519.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.54
Rate for Payer: Qualcare PPO/HMO/WC	$941.87

PLATE FOREFOOT UNIVERSAL 18MM

Facility

$6,279.10

Hospital Charge Code	270657193
Hospital Revenue Code	278
Min. Negotiated Rate	$178.33
Max. Negotiated Rate	$3,139.55
Rate for Payer: Aetna Commercial	$2,386.06
Rate for Payer: Aetna Medicare Advantage	$1,883.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.17
Rate for Payer: Cigna Commercial	$3,139.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.54
Rate for Payer: Qualcare PPO/HMO/WC	$941.87
Rate for Payer: UnitedHealthcare Community & State	$198.42
Rate for Payer: Wellpoint Medicaid Managed Care	$178.33

PLATE,FRAGMENT DISTAL ULNA

Facility

$4,475.00

Hospital Charge Code	270668300
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,FRAGMENT DISTAL ULNA

Facility

$4,475.00

Hospital Charge Code	270668300
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, FRAGMENT PROTEAN DOUBLE

Facility

$4,475.00

Hospital Charge Code	270668298
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, FRAGMENT PROTEAN DOUBLE

Facility

$4,475.00

Hospital Charge Code	270668298
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 FUSION 1MPJ SM 7D LT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270694322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$2,193.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE FUSION 1MPJ SM 7D LT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270694322
Hospital Revenue Code	278
Min. Negotiated Rate	$257.45
Max. Negotiated Rate	$4,532.50
Rate for Payer: Aetna Commercial	$3,444.70
Rate for Payer: Aetna Medicare Advantage	$2,719.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,311.57
Rate for Payer: Cigna Commercial	$4,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75
Rate for Payer: UnitedHealthcare Community & State	$286.45
Rate for Payer: Wellpoint Medicaid Managed Care	$257.45

PLATE FUSION MIS HA COATED G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694466
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 FUSION MIS HA COATED G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694466
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

PLATE FUSION VA-LCP 2.4/2.7MM

Facility

$3,909.00

Hospital Charge Code	270676909
Hospital Revenue Code	278
Min. Negotiated Rate	$586.35
Max. Negotiated Rate	$945.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35

PLATE FUSION VA-LCP 2.4/2.7MM

Facility

$3,909.00

Hospital Charge Code	270676909
Hospital Revenue Code	278
Min. Negotiated Rate	$111.02
Max. Negotiated Rate	$1,954.50
Rate for Payer: Aetna Commercial	$1,485.42
Rate for Payer: Aetna Medicare Advantage	$1,172.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$996.79
Rate for Payer: Cigna Commercial	$1,954.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35
Rate for Payer: UnitedHealthcare Community & State	$123.52
Rate for Payer: Wellpoint Medicaid Managed Care	$111.02

PLATE FUSION WRIST NEUTRAL

Facility

$11,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270691338
Hospital Revenue Code	278
Min. Negotiated Rate	$329.01
Max. Negotiated Rate	$5,792.50
Rate for Payer: Aetna Commercial	$4,402.30
Rate for Payer: Aetna Medicare Advantage	$3,475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,954.18
Rate for Payer: Cigna Commercial	$5,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75
Rate for Payer: UnitedHealthcare Community & State	$366.09
Rate for Payer: Wellpoint Medicaid Managed Care	$329.01

PLATE FUSION WRIST NEUTRAL

Facility

$11,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270691338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$2,803.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

PLATE GEMINUS HOOK

Facility

$2,275.00

Hospital Charge Code	270664439
Hospital Revenue Code	278
Min. Negotiated Rate	$64.61
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$864.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Qualcare PPO/HMO/WC	$341.25
Rate for Payer: UnitedHealthcare Community & State	$71.89
Rate for Payer: Wellpoint Medicaid Managed Care	$64.61

PLATE GEMINUS HOOK

Facility

$2,275.00

Hospital Charge Code	270664439
Hospital Revenue Code	278
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$550.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

PLATE GLENOID REVERSE SHOULDER

Facility

$7,952.40

Service Code	HCPCS C1713
Hospital Charge Code	270668552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.86
Max. Negotiated Rate	$1,924.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.86

PLATE GLENOID REVERSE SHOULDER

Facility

$7,952.40

Service Code	HCPCS C1713
Hospital Charge Code	270668552
Hospital Revenue Code	278
Min. Negotiated Rate	$225.85
Max. Negotiated Rate	$3,976.20
Rate for Payer: Aetna Commercial	$3,021.91
Rate for Payer: Aetna Medicare Advantage	$2,385.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.86
Rate for Payer: Cigna Commercial	$3,976.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.86
Rate for Payer: UnitedHealthcare Community & State	$251.30
Rate for Payer: Wellpoint Medicaid Managed Care	$225.85

Know your out-of-pocket cost for care.

All Charges