Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE HOOK METARARSAL LONG RT

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695549
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

PLATE HOOK SCREW CANN 4.0X36MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697015
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

PLATE HOOK SCREW CANN 4.0X36MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697015
Hospital Revenue Code	278
Min. Negotiated Rate	$48.99
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$655.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Community & State	$54.51
Rate for Payer: Wellpoint Medicaid Managed Care	$48.99

PLATE HOOK SM ORTLOC SYS

Facility

$6,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270701132
Hospital Revenue Code	278
Min. Negotiated Rate	$193.69
Max. Negotiated Rate	$3,410.00
Rate for Payer: Aetna Commercial	$2,591.60
Rate for Payer: Aetna Medicare Advantage	$2,046.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.10
Rate for Payer: Cigna Commercial	$3,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00
Rate for Payer: UnitedHealthcare Community & State	$215.51
Rate for Payer: Wellpoint Medicaid Managed Care	$193.69

PLATE HOOK SM ORTLOC SYS

Facility

$6,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270701132
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.00
Max. Negotiated Rate	$1,650.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00

PLATE HUM DISTAL 1H LT 69MM

Facility

$5,049.05

Service Code	HCPCS C1713
Hospital Charge Code	270676865
Hospital Revenue Code	278
Min. Negotiated Rate	$757.36
Max. Negotiated Rate	$1,221.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,009.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,221.87
Rate for Payer: Qualcare PPO/HMO/WC	$757.36

PLATE HUM DISTAL 1H LT 69MM

Facility

$4,842.05

Hospital Charge Code	270677667
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$1,171.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

PLATE HUM DISTAL 1H LT 69MM

Facility

$4,842.05

Hospital Charge Code	270677667
Hospital Revenue Code	278
Min. Negotiated Rate	$137.51
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31
Rate for Payer: UnitedHealthcare Community & State	$153.01
Rate for Payer: Wellpoint Medicaid Managed Care	$137.51

PLATE HUM DISTAL 1H LT 69MM

Facility

$5,049.05

Service Code	HCPCS C1713
Hospital Charge Code	270676865
Hospital Revenue Code	278
Min. Negotiated Rate	$143.39
Max. Negotiated Rate	$2,524.53
Rate for Payer: Aetna Commercial	$1,918.64
Rate for Payer: Aetna Medicare Advantage	$1,514.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,009.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,287.51
Rate for Payer: Cigna Commercial	$2,524.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,221.87
Rate for Payer: Qualcare PPO/HMO/WC	$757.36
Rate for Payer: UnitedHealthcare Community & State	$159.55
Rate for Payer: Wellpoint Medicaid Managed Care	$143.39

PLATE HUM DISTAL 1H LT 72MM

Facility

$4,993.05

Service Code	HCPCS C1713
Hospital Charge Code	270676238
Hospital Revenue Code	278
Min. Negotiated Rate	$748.96
Max. Negotiated Rate	$1,208.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.32
Rate for Payer: Qualcare PPO/HMO/WC	$748.96

PLATE HUM DISTAL 1H LT 72MM

Facility

$4,993.05

Service Code	HCPCS C1713
Hospital Charge Code	270676238
Hospital Revenue Code	278
Min. Negotiated Rate	$141.80
Max. Negotiated Rate	$2,496.53
Rate for Payer: Aetna Commercial	$1,897.36
Rate for Payer: Aetna Medicare Advantage	$1,497.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.23
Rate for Payer: Cigna Commercial	$2,496.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.32
Rate for Payer: Qualcare PPO/HMO/WC	$748.96
Rate for Payer: UnitedHealthcare Community & State	$157.78
Rate for Payer: Wellpoint Medicaid Managed Care	$141.80

PLATE HUM DISTAL 1H LT 72MM ST

Facility

$5,197.40

Service Code	HCPCS C1713
Hospital Charge Code	270676910
Hospital Revenue Code	278
Min. Negotiated Rate	$779.61
Max. Negotiated Rate	$1,257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.77
Rate for Payer: Qualcare PPO/HMO/WC	$779.61

PLATE HUM DISTAL 1H LT 72MM ST

Facility

$5,197.40

Service Code	HCPCS C1713
Hospital Charge Code	270676910
Hospital Revenue Code	278
Min. Negotiated Rate	$147.61
Max. Negotiated Rate	$2,598.70
Rate for Payer: Aetna Commercial	$1,975.01
Rate for Payer: Aetna Medicare Advantage	$1,559.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.34
Rate for Payer: Cigna Commercial	$2,598.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.77
Rate for Payer: Qualcare PPO/HMO/WC	$779.61
Rate for Payer: UnitedHealthcare Community & State	$164.24
Rate for Payer: Wellpoint Medicaid Managed Care	$147.61

PLATE HUM DISTAL 1H RT 69MM

Facility

$4,842.05

Hospital Charge Code	270677663
Hospital Revenue Code	278
Min. Negotiated Rate	$137.51
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31
Rate for Payer: UnitedHealthcare Community & State	$153.01
Rate for Payer: Wellpoint Medicaid Managed Care	$137.51

PLATE HUM DISTAL 1H RT 69MM

Facility

$4,842.05

Hospital Charge Code	270677663
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$1,171.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

PLATE HUM DISTAL 1H RT 72MM

Facility

$4,993.45

Hospital Charge Code	270677628
Hospital Revenue Code	278
Min. Negotiated Rate	$141.81
Max. Negotiated Rate	$2,496.72
Rate for Payer: Aetna Commercial	$1,897.51
Rate for Payer: Aetna Medicare Advantage	$1,498.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.33
Rate for Payer: Cigna Commercial	$2,496.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: Qualcare PPO/HMO/WC	$749.02
Rate for Payer: UnitedHealthcare Community & State	$157.79
Rate for Payer: Wellpoint Medicaid Managed Care	$141.81

PLATE HUM DISTAL 1H RT 72MM

Facility

$4,993.45

Hospital Charge Code	270677628
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$1,208.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: Qualcare PPO/HMO/WC	$749.02

PLATE HUM DISTAL 1H RT 72MM ST

Facility

$5,197.40

Service Code	HCPCS C1713
Hospital Charge Code	270678412
Hospital Revenue Code	278
Min. Negotiated Rate	$779.61
Max. Negotiated Rate	$1,257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.77
Rate for Payer: Qualcare PPO/HMO/WC	$779.61

PLATE HUM DISTAL 1H RT 72MM ST

Facility

$5,197.40

Service Code	HCPCS C1713
Hospital Charge Code	270678412
Hospital Revenue Code	278
Min. Negotiated Rate	$147.61
Max. Negotiated Rate	$2,598.70
Rate for Payer: Aetna Commercial	$1,975.01
Rate for Payer: Aetna Medicare Advantage	$1,559.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.34
Rate for Payer: Cigna Commercial	$2,598.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.77
Rate for Payer: Qualcare PPO/HMO/WC	$779.61
Rate for Payer: UnitedHealthcare Community & State	$164.24
Rate for Payer: Wellpoint Medicaid Managed Care	$147.61

PLATE HUM DISTAL 2H LT 82MM

Facility

$4,842.05

Hospital Charge Code	270677668
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$1,171.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

PLATE HUM DISTAL 2H LT 82MM

Facility

$4,842.05

Hospital Charge Code	270677668
Hospital Revenue Code	278
Min. Negotiated Rate	$137.51
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,839.98
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31
Rate for Payer: UnitedHealthcare Community & State	$153.01
Rate for Payer: Wellpoint Medicaid Managed Care	$137.51

PLATE HUM DISTAL 2H LT 82MM ST

Facility

$5,200.50

Service Code	HCPCS C1713
Hospital Charge Code	270684231
Hospital Revenue Code	278
Min. Negotiated Rate	$780.08
Max. Negotiated Rate	$1,258.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.52
Rate for Payer: Qualcare PPO/HMO/WC	$780.08

PLATE HUM DISTAL 2H LT 82MM ST

Facility

$5,200.50

Service Code	HCPCS C1713
Hospital Charge Code	270684231
Hospital Revenue Code	278
Min. Negotiated Rate	$147.69
Max. Negotiated Rate	$2,600.25
Rate for Payer: Aetna Commercial	$1,976.19
Rate for Payer: Aetna Medicare Advantage	$1,560.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.13
Rate for Payer: Cigna Commercial	$2,600.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.52
Rate for Payer: Qualcare PPO/HMO/WC	$780.08
Rate for Payer: UnitedHealthcare Community & State	$164.34
Rate for Payer: Wellpoint Medicaid Managed Care	$147.69

PLATE HUM DISTAL 2H LT 85MM

Facility

$4,993.45

Hospital Charge Code	270677632
Hospital Revenue Code	278
Min. Negotiated Rate	$141.81
Max. Negotiated Rate	$2,496.72
Rate for Payer: Aetna Commercial	$1,897.51
Rate for Payer: Aetna Medicare Advantage	$1,498.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.33
Rate for Payer: Cigna Commercial	$2,496.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: Qualcare PPO/HMO/WC	$749.02
Rate for Payer: UnitedHealthcare Community & State	$157.79
Rate for Payer: Wellpoint Medicaid Managed Care	$141.81

PLATE HUM DISTAL 2H LT 85MM

Facility

$4,993.45

Hospital Charge Code	270677632
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$1,208.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: Qualcare PPO/HMO/WC	$749.02

Know your out-of-pocket cost for care.

All Charges