Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE HUM DISTAL 5H LT 121MM

Facility

$4,842.05

Service Code	HCPCS C1713
Hospital Charge Code	270677669
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 5H RT 121MM

Facility

$4,842.05

Hospital Charge Code	270677665
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 5H RT 121MM

Facility

$4,842.05

Hospital Charge Code	270677665
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 6H LT 137MM

Facility

$4,993.45

Hospital Charge Code	270677634
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 6H LT 137MM

Facility

$4,993.45

Hospital Charge Code	270677634
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 6H RT 137MM

Facility

$4,993.45

Hospital Charge Code	270677631
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 6H RT 137MM

Facility

$4,993.45

Hospital Charge Code	270677631
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 7H LT 127MM

Facility

$4,842.05

Hospital Charge Code	270677640
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 7H LT 127MM

Facility

$4,842.05

Hospital Charge Code	270677640
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 7H LT 147MM

Facility

$4,842.05

Hospital Charge Code	270677670
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 7H LT 147MM

Facility

$4,842.05

Hospital Charge Code	270677670
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 7H RT 127MM

Facility

$4,842.05

Hospital Charge Code	270677637
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 7H RT 127MM

Facility

$4,842.05

Hospital Charge Code	270677637
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 7H RT 147MM

Facility

$4,842.05

Hospital Charge Code	270677666
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 7H RT 147MM

Facility

$4,842.05

Hospital Charge Code	270677666
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 9H LT 153MM

Facility

$4,842.05

Hospital Charge Code	270677641
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 9H LT 153MM

Facility

$4,842.05

Hospital Charge Code	270677641
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 9H RT 153MM

Facility

$4,842.05

Hospital Charge Code	270677638
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 9H RT 153MM

Facility

$4,842.05

Hospital Charge Code	270677638
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 RH RT 111MM

Facility

$4,993.45

Hospital Charge Code	270677630
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 RH RT 111MM

Facility

$4,993.45

Hospital Charge Code	270677630
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 HUMERAL PROXIMAL R 4H 9m

Facility

$6,865.00

Hospital Charge Code	270669241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.75
Max. Negotiated Rate	$1,661.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75

PLATE HUMERAL PROXIMAL R 4H 9m

Facility

$6,865.00

Hospital Charge Code	270669241
Hospital Revenue Code	278
Min. Negotiated Rate	$194.97
Max. Negotiated Rate	$3,432.50
Rate for Payer: Aetna Commercial	$2,608.70
Rate for Payer: Aetna Medicare Advantage	$2,059.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,750.58
Rate for Payer: Cigna Commercial	$3,432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75
Rate for Payer: UnitedHealthcare Community & State	$216.93
Rate for Payer: Wellpoint Medicaid Managed Care	$194.97

PLATE HUM PROX HI RT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270697450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.25
Max. Negotiated Rate	$1,716.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25

PLATE HUM PROX HI RT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270697450
Hospital Revenue Code	278
Min. Negotiated Rate	$201.50
Max. Negotiated Rate	$3,547.50
Rate for Payer: Aetna Commercial	$2,696.10
Rate for Payer: Aetna Medicare Advantage	$2,128.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,809.22
Rate for Payer: Cigna Commercial	$3,547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25
Rate for Payer: UnitedHealthcare Community & State	$224.20
Rate for Payer: Wellpoint Medicaid Managed Care	$201.50

Know your out-of-pocket cost for care.

All Charges