Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE GORILLA MTP MED RT 5D

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270700642
Hospital Revenue Code	278
Min. Negotiated Rate	$184.71
Max. Negotiated Rate	$3,251.88
Rate for Payer: Aetna Commercial	$2,471.43
Rate for Payer: Aetna Medicare Advantage	$1,951.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,658.46
Rate for Payer: Cigna Commercial	$3,251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56
Rate for Payer: UnitedHealthcare Community & State	$205.52
Rate for Payer: Wellpoint Medicaid Managed Care	$184.71

PLATE GORILLA MTP MED RT 5D

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270700642
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$1,573.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

PLATE GRIDLOCK VLC 2HOLE

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680717
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE GRIDLOCK VLC 2HOLE

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680717
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

PLATE GRIP THROC. MED 200MM

Facility

$13,012.00

Hospital Charge Code	270670738
Hospital Revenue Code	272
Min. Negotiated Rate	$1,951.80
Max. Negotiated Rate	$1,951.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80

PLATE GRIP THROC. MED 200MM

Facility

$13,012.00

Hospital Charge Code	270670738
Hospital Revenue Code	272
Min. Negotiated Rate	$369.54
Max. Negotiated Rate	$6,506.00
Rate for Payer: Aetna Commercial	$4,944.56
Rate for Payer: Aetna Medicare Advantage	$3,903.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,318.06
Rate for Payer: Cigna Commercial	$6,506.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,383.12
Rate for Payer: Oxford Commercial	$2,602.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80
Rate for Payer: UnitedHealthcare Commercial	$2,602.40
Rate for Payer: UnitedHealthcare Community & State	$411.18
Rate for Payer: Wellpoint Medicaid Managed Care	$369.54

PLATE GRUVE 20MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699044
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

PLATE GRUVE 20MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699044
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE HA REMOVABLE END 12

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692076
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 HA REMOVABLE END 12

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692076
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 HELIX R, 40MM 2 LEVEL

Facility

$8,545.00

Hospital Charge Code	270667692
Hospital Revenue Code	278
Min. Negotiated Rate	$242.68
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$270.02
Rate for Payer: Wellpoint Medicaid Managed Care	$242.68

PLATE HELIX R, 40MM 2 LEVEL

Facility

$8,545.00

Hospital Charge Code	270667692
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE HELIX R, 44MM 2-LEVEL

Facility

$8,545.00

Hospital Charge Code	270666087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE HELIX R, 44MM 2-LEVEL

Facility

$8,545.00

Hospital Charge Code	270666087
Hospital Revenue Code	278
Min. Negotiated Rate	$242.68
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$3,247.10
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75
Rate for Payer: UnitedHealthcare Community & State	$270.02
Rate for Payer: Wellpoint Medicaid Managed Care	$242.68

PLATE HOLDING TAC

Facility

$350.00

Hospital Charge Code	270669668
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

PLATE HOLDING TAC

Facility

$350.00

Hospital Charge Code	270669668
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PLATE HOLE 13 ANATOMIC LEFT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701531
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 HOLE 13 ANATOMIC LEFT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701531
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 HOOK 3 HOLE 3.5MM LCP

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270683790
Hospital Revenue Code	278
Min. Negotiated Rate	$67.52
Max. Negotiated Rate	$1,188.75
Rate for Payer: Aetna Commercial	$903.45
Rate for Payer: Aetna Medicare Advantage	$713.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.26
Rate for Payer: Cigna Commercial	$1,188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62
Rate for Payer: UnitedHealthcare Community & State	$75.13
Rate for Payer: Wellpoint Medicaid Managed Care	$67.52

PLATE HOOK 3 HOLE 3.5MM LCP

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270683790
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$575.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE HOOK LG 3DI 70MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,130.17
Max. Negotiated Rate	$1,823.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17

PLATE HOOK LG 3DI 70MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700376
Hospital Revenue Code	278
Min. Negotiated Rate	$213.98
Max. Negotiated Rate	$3,767.22
Rate for Payer: Aetna Commercial	$2,863.09
Rate for Payer: Aetna Medicare Advantage	$2,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,921.28
Rate for Payer: Cigna Commercial	$3,767.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17
Rate for Payer: UnitedHealthcare Community & State	$238.09
Rate for Payer: Wellpoint Medicaid Managed Care	$213.98

PLATE HOOK LOCK TI 3 HOLE

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692862
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATE HOOK LOCK TI 3 HOLE

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692862
Hospital Revenue Code	278
Min. Negotiated Rate	$131.35
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,757.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75
Rate for Payer: UnitedHealthcare Community & State	$146.15
Rate for Payer: Wellpoint Medicaid Managed Care	$131.35

PLATE HOOK METARARSAL LONG RT

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695549
Hospital Revenue Code	278
Min. Negotiated Rate	$181.05
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$201.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.05

Know your out-of-pocket cost for care.

All Charges