Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LATERAL TIBIA 2H 95MM RT

Facility

$13,170.00

Service Code	HCPCS C1713
Hospital Charge Code	270673957
Hospital Revenue Code	278
Min. Negotiated Rate	$374.03
Max. Negotiated Rate	$6,585.00
Rate for Payer: Aetna Commercial	$5,004.60
Rate for Payer: Aetna Medicare Advantage	$3,951.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,358.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,358.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,634.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,358.35
Rate for Payer: Cigna Commercial	$6,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,187.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,975.50
Rate for Payer: UnitedHealthcare Community & State	$416.17
Rate for Payer: Wellpoint Medicaid Managed Care	$374.03

PLATE LATFIB ORTHOLOC RT 101MM

Facility

$7,977.50

Service Code	HCPCS C1713
Hospital Charge Code	270699444
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.62
Max. Negotiated Rate	$1,930.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,930.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.62

PLATE LATFIB ORTHOLOC RT 101MM

Facility

$7,977.50

Service Code	HCPCS C1713
Hospital Charge Code	270699444
Hospital Revenue Code	278
Min. Negotiated Rate	$226.56
Max. Negotiated Rate	$3,988.75
Rate for Payer: Aetna Commercial	$3,031.45
Rate for Payer: Aetna Medicare Advantage	$2,393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,034.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,034.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,034.26
Rate for Payer: Cigna Commercial	$3,988.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,930.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.62
Rate for Payer: UnitedHealthcare Community & State	$252.09
Rate for Payer: Wellpoint Medicaid Managed Care	$226.56

PLATE LAT POST LF 4 HOLE 105MM

Facility

$7,995.00

Hospital Charge Code	270670991
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$1,934.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

PLATE LAT POST LF 4 HOLE 105MM

Facility

$7,995.00

Hospital Charge Code	270670991
Hospital Revenue Code	278
Min. Negotiated Rate	$227.06
Max. Negotiated Rate	$3,997.50
Rate for Payer: Aetna Commercial	$3,038.10
Rate for Payer: Aetna Medicare Advantage	$2,398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,038.72
Rate for Payer: Cigna Commercial	$3,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25
Rate for Payer: UnitedHealthcare Community & State	$252.64
Rate for Payer: Wellpoint Medicaid Managed Care	$227.06

PLATE L-BUTTRESS 85MM 4H RT

Facility

$1,714.95

Service Code	HCPCS C1713
Hospital Charge Code	270652579
Hospital Revenue Code	278
Min. Negotiated Rate	$257.24
Max. Negotiated Rate	$415.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.02
Rate for Payer: Qualcare PPO/HMO/WC	$257.24

PLATE L-BUTTRESS 85MM 4H RT

Facility

$1,714.95

Service Code	HCPCS C1713
Hospital Charge Code	270652579
Hospital Revenue Code	278
Min. Negotiated Rate	$48.70
Max. Negotiated Rate	$857.48
Rate for Payer: Aetna Commercial	$651.68
Rate for Payer: Aetna Medicare Advantage	$514.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.31
Rate for Payer: Cigna Commercial	$857.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.02
Rate for Payer: Qualcare PPO/HMO/WC	$257.24
Rate for Payer: UnitedHealthcare Community & State	$54.19
Rate for Payer: Wellpoint Medicaid Managed Care	$48.70

PLATE LC-DCP 2.0MM 4HOLE 27MM

Facility

$896.10

Service Code	HCPCS C1713
Hospital Charge Code	270654841
Hospital Revenue Code	278
Min. Negotiated Rate	$134.41
Max. Negotiated Rate	$216.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.86
Rate for Payer: Qualcare PPO/HMO/WC	$134.41

PLATE LC-DCP 2.0MM 4HOLE 27MM

Facility

$896.10

Service Code	HCPCS C1713
Hospital Charge Code	270654841
Hospital Revenue Code	278
Min. Negotiated Rate	$25.45
Max. Negotiated Rate	$448.05
Rate for Payer: Aetna Commercial	$340.52
Rate for Payer: Aetna Medicare Advantage	$268.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.51
Rate for Payer: Cigna Commercial	$448.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.86
Rate for Payer: Qualcare PPO/HMO/WC	$134.41
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$25.45

PLATE LC-DCP 2.0MM 6HOLE 39MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270654843
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

PLATE LC-DCP 2.0MM 6HOLE 39MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270654843
Hospital Revenue Code	278
Min. Negotiated Rate	$29.84
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$399.23
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59
Rate for Payer: UnitedHealthcare Community & State	$33.20
Rate for Payer: Wellpoint Medicaid Managed Care	$29.84

PLATE LC-DCP 2.0MM 8HOLE 68MM

Facility

$1,205.10

Service Code	HCPCS C1713
Hospital Charge Code	270654856
Hospital Revenue Code	278
Min. Negotiated Rate	$34.22
Max. Negotiated Rate	$602.55
Rate for Payer: Aetna Commercial	$457.94
Rate for Payer: Aetna Medicare Advantage	$361.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.30
Rate for Payer: Cigna Commercial	$602.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.63
Rate for Payer: Qualcare PPO/HMO/WC	$180.76
Rate for Payer: UnitedHealthcare Community & State	$38.08
Rate for Payer: Wellpoint Medicaid Managed Care	$34.22

PLATE LC-DCP 2.0MM 8HOLE 68MM

Facility

$1,205.10

Service Code	HCPCS C1713
Hospital Charge Code	270654856
Hospital Revenue Code	278
Min. Negotiated Rate	$180.76
Max. Negotiated Rate	$291.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.63
Rate for Payer: Qualcare PPO/HMO/WC	$180.76

PLATE LC-DCP 2.4MM 4 HOLE

Facility

$1,242.20

Service Code	HCPCS C1713
Hospital Charge Code	270654867
Hospital Revenue Code	278
Min. Negotiated Rate	$186.33
Max. Negotiated Rate	$300.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.61
Rate for Payer: Qualcare PPO/HMO/WC	$186.33

PLATE LC-DCP 2.4MM 4 HOLE

Facility

$1,242.20

Service Code	HCPCS C1713
Hospital Charge Code	270654867
Hospital Revenue Code	278
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$621.10
Rate for Payer: Aetna Commercial	$472.04
Rate for Payer: Aetna Medicare Advantage	$372.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.76
Rate for Payer: Cigna Commercial	$621.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.61
Rate for Payer: Qualcare PPO/HMO/WC	$186.33
Rate for Payer: UnitedHealthcare Community & State	$39.25
Rate for Payer: Wellpoint Medicaid Managed Care	$35.28

PLATE LC-DCP 2.4MM 6 HOLE

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270654869
Hospital Revenue Code	278
Min. Negotiated Rate	$39.84
Max. Negotiated Rate	$701.42
Rate for Payer: Aetna Commercial	$533.08
Rate for Payer: Aetna Medicare Advantage	$420.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.73
Rate for Payer: Cigna Commercial	$701.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43
Rate for Payer: UnitedHealthcare Community & State	$44.33
Rate for Payer: Wellpoint Medicaid Managed Care	$39.84

PLATE LC-DCP 2.4MM 6 HOLE

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270654869
Hospital Revenue Code	278
Min. Negotiated Rate	$210.43
Max. Negotiated Rate	$339.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43

PLATE LC-DCP 2.4MM 8 HOLE

Facility

$1,514.10

Service Code	HCPCS C1713
Hospital Charge Code	270654870
Hospital Revenue Code	278
Min. Negotiated Rate	$227.12
Max. Negotiated Rate	$366.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.41
Rate for Payer: Qualcare PPO/HMO/WC	$227.12

PLATE LC-DCP 2.4MM 8 HOLE

Facility

$1,514.10

Service Code	HCPCS C1713
Hospital Charge Code	270654870
Hospital Revenue Code	278
Min. Negotiated Rate	$43.00
Max. Negotiated Rate	$757.05
Rate for Payer: Aetna Commercial	$575.36
Rate for Payer: Aetna Medicare Advantage	$454.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.10
Rate for Payer: Cigna Commercial	$757.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.41
Rate for Payer: Qualcare PPO/HMO/WC	$227.12
Rate for Payer: UnitedHealthcare Community & State	$47.85
Rate for Payer: Wellpoint Medicaid Managed Care	$43.00

PLATE LC-DCP 3.5x103MM 8HOLE

Facility

$700.20

Service Code	HCPCS C1713
Hospital Charge Code	270601897
Hospital Revenue Code	278
Min. Negotiated Rate	$19.89
Max. Negotiated Rate	$350.10
Rate for Payer: Aetna Commercial	$266.08
Rate for Payer: Aetna Medicare Advantage	$210.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.55
Rate for Payer: Cigna Commercial	$350.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.45
Rate for Payer: Qualcare PPO/HMO/WC	$105.03
Rate for Payer: UnitedHealthcare Community & State	$22.13
Rate for Payer: Wellpoint Medicaid Managed Care	$19.89

PLATE LC-DCP 3.5x103MM 8HOLE

Facility

$700.20

Service Code	HCPCS C1713
Hospital Charge Code	270601897
Hospital Revenue Code	278
Min. Negotiated Rate	$105.03
Max. Negotiated Rate	$169.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.45
Rate for Payer: Qualcare PPO/HMO/WC	$105.03

PLATE LC-DCP 3.5x116MM 9HOLE

Facility

$710.70

Service Code	HCPCS C1713
Hospital Charge Code	270603344
Hospital Revenue Code	278
Min. Negotiated Rate	$106.61
Max. Negotiated Rate	$171.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.99
Rate for Payer: Qualcare PPO/HMO/WC	$106.61

PLATE LC-DCP 3.5x116MM 9HOLE

Facility

$710.70

Service Code	HCPCS C1713
Hospital Charge Code	270603344
Hospital Revenue Code	278
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$355.35
Rate for Payer: Aetna Commercial	$270.07
Rate for Payer: Aetna Medicare Advantage	$213.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.23
Rate for Payer: Cigna Commercial	$355.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.99
Rate for Payer: Qualcare PPO/HMO/WC	$106.61
Rate for Payer: UnitedHealthcare Community & State	$22.46
Rate for Payer: Wellpoint Medicaid Managed Care	$20.18

PLATE LC-DCP 3.5x64MM 5HOLE

Facility

$599.45

Service Code	HCPCS C1713
Hospital Charge Code	270630538
Hospital Revenue Code	278
Min. Negotiated Rate	$17.02
Max. Negotiated Rate	$299.73
Rate for Payer: Aetna Commercial	$227.79
Rate for Payer: Aetna Medicare Advantage	$179.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.86
Rate for Payer: Cigna Commercial	$299.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.07
Rate for Payer: Qualcare PPO/HMO/WC	$89.92
Rate for Payer: UnitedHealthcare Community & State	$18.94
Rate for Payer: Wellpoint Medicaid Managed Care	$17.02

PLATE LC-DCP 3.5x64MM 5HOLE

Facility

$599.45

Service Code	HCPCS C1713
Hospital Charge Code	270630538
Hospital Revenue Code	278
Min. Negotiated Rate	$89.92
Max. Negotiated Rate	$145.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.07
Rate for Payer: Qualcare PPO/HMO/WC	$89.92

Know your out-of-pocket cost for care.

All Charges