Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP TIBIA 4H/L 93MM STER

Facility

$6,039.00

Hospital Charge Code	270675550
Hospital Revenue Code	278
Min. Negotiated Rate	$171.51
Max. Negotiated Rate	$3,019.50
Rate for Payer: Aetna Commercial	$2,294.82
Rate for Payer: Aetna Medicare Advantage	$1,811.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,539.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,539.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,539.94
Rate for Payer: Cigna Commercial	$3,019.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.44
Rate for Payer: Qualcare PPO/HMO/WC	$905.85
Rate for Payer: UnitedHealthcare Community & State	$190.83
Rate for Payer: Wellpoint Medicaid Managed Care	$171.51

PLATE LCP TIBIAL 3.5MM 6H119MM

Facility

$8,300.20

Service Code	HCPCS C1713
Hospital Charge Code	270695644
Hospital Revenue Code	278
Min. Negotiated Rate	$235.73
Max. Negotiated Rate	$4,150.10
Rate for Payer: Aetna Commercial	$3,154.08
Rate for Payer: Aetna Medicare Advantage	$2,490.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,116.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,116.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,660.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,116.55
Rate for Payer: Cigna Commercial	$4,150.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.03
Rate for Payer: UnitedHealthcare Community & State	$262.29
Rate for Payer: Wellpoint Medicaid Managed Care	$235.73

PLATE LCP TIBIAL 3.5MM 6H119MM

Facility

$8,300.20

Service Code	HCPCS C1713
Hospital Charge Code	270695644
Hospital Revenue Code	278
Min. Negotiated Rate	$1,245.03
Max. Negotiated Rate	$2,008.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,660.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.03

PLATE LCP TITA 3.5x190m 14HOLE

Facility

$5,475.00

Hospital Charge Code	270667948
Hospital Revenue Code	272
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$2,080.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,423.50
Rate for Payer: Oxford Commercial	$1,095.00
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Commercial	$1,095.00
Rate for Payer: UnitedHealthcare Community & State	$173.01
Rate for Payer: Wellpoint Medicaid Managed Care	$155.49

PLATE LCP TITA 3.5x190m 14HOLE

Facility

$5,475.00

Hospital Charge Code	270667948
Hospital Revenue Code	272
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$821.25
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

PLATE LCP VOLAR 2.4MM 9H/5H

Facility

$3,667.85

Service Code	HCPCS C1713
Hospital Charge Code	270641160
Hospital Revenue Code	278
Min. Negotiated Rate	$550.18
Max. Negotiated Rate	$887.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.62
Rate for Payer: Qualcare PPO/HMO/WC	$550.18

PLATE LCP VOLAR 2.4MM 9H/5H

Facility

$3,667.85

Service Code	HCPCS C1713
Hospital Charge Code	270641160
Hospital Revenue Code	278
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$1,833.92
Rate for Payer: Aetna Commercial	$1,393.78
Rate for Payer: Aetna Medicare Advantage	$1,100.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.30
Rate for Payer: Cigna Commercial	$1,833.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.62
Rate for Payer: Qualcare PPO/HMO/WC	$550.18
Rate for Payer: UnitedHealthcare Community & State	$115.90
Rate for Payer: Wellpoint Medicaid Managed Care	$104.17

PLATE LCP X-ART 6H 3.5MM LT

Facility

$5,939.00

Service Code	HCPCS C1713
Hospital Charge Code	270643583
Hospital Revenue Code	278
Min. Negotiated Rate	$168.67
Max. Negotiated Rate	$2,969.50
Rate for Payer: Aetna Commercial	$2,256.82
Rate for Payer: Aetna Medicare Advantage	$1,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,514.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,514.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,187.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,514.44
Rate for Payer: Cigna Commercial	$2,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.24
Rate for Payer: Qualcare PPO/HMO/WC	$890.85
Rate for Payer: UnitedHealthcare Community & State	$187.67
Rate for Payer: Wellpoint Medicaid Managed Care	$168.67

PLATE LCP X-ART 6H 3.5MM LT

Facility

$5,939.00

Service Code	HCPCS C1713
Hospital Charge Code	270643583
Hospital Revenue Code	278
Min. Negotiated Rate	$890.85
Max. Negotiated Rate	$1,437.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,187.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.24
Rate for Payer: Qualcare PPO/HMO/WC	$890.85

PLATE LCP X-ART 6H 3.5MM RT ST

Facility

$6,146.00

Service Code	HCPCS C1713
Hospital Charge Code	270678905
Hospital Revenue Code	278
Min. Negotiated Rate	$921.90
Max. Negotiated Rate	$1,487.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,487.33
Rate for Payer: Qualcare PPO/HMO/WC	$921.90

PLATE LCP X-ART 6H 3.5MM RT ST

Facility

$6,146.00

Service Code	HCPCS C1713
Hospital Charge Code	270678905
Hospital Revenue Code	278
Min. Negotiated Rate	$174.55
Max. Negotiated Rate	$3,073.00
Rate for Payer: Aetna Commercial	$2,335.48
Rate for Payer: Aetna Medicare Advantage	$1,843.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,567.23
Rate for Payer: Cigna Commercial	$3,073.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,487.33
Rate for Payer: Qualcare PPO/HMO/WC	$921.90
Rate for Payer: UnitedHealthcare Community & State	$194.21
Rate for Payer: Wellpoint Medicaid Managed Care	$174.55

PLATE LCP X-ART 8H 3.5MM LT ST

Facility

$6,510.65

Service Code	HCPCS C1713
Hospital Charge Code	270675067
Hospital Revenue Code	278
Min. Negotiated Rate	$976.60
Max. Negotiated Rate	$1,575.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,302.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,575.58
Rate for Payer: Qualcare PPO/HMO/WC	$976.60

PLATE LCP X-ART 8H 3.5MM LT ST

Facility

$6,510.65

Service Code	HCPCS C1713
Hospital Charge Code	270675067
Hospital Revenue Code	278
Min. Negotiated Rate	$184.90
Max. Negotiated Rate	$3,255.32
Rate for Payer: Aetna Commercial	$2,474.05
Rate for Payer: Aetna Medicare Advantage	$1,953.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,660.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,660.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,302.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,660.22
Rate for Payer: Cigna Commercial	$3,255.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,575.58
Rate for Payer: Qualcare PPO/HMO/WC	$976.60
Rate for Payer: UnitedHealthcare Community & State	$205.74
Rate for Payer: Wellpoint Medicaid Managed Care	$184.90

PLATE LEFT FIBULAR 11 HOLE CLU

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701204
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 LEFT FIBULAR 11 HOLE CLU

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701204
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 LEFT STANDARD LONG VD

Facility

$5,920.00

Hospital Charge Code	270665498
Hospital Revenue Code	278
Min. Negotiated Rate	$168.13
Max. Negotiated Rate	$2,960.00
Rate for Payer: Aetna Commercial	$2,249.60
Rate for Payer: Aetna Medicare Advantage	$1,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,509.60
Rate for Payer: Cigna Commercial	$2,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: Qualcare PPO/HMO/WC	$888.00
Rate for Payer: UnitedHealthcare Community & State	$187.07
Rate for Payer: Wellpoint Medicaid Managed Care	$168.13

PLATE LEFT STANDARD LONG VD

Facility

$5,920.00

Hospital Charge Code	270665498
Hospital Revenue Code	278
Min. Negotiated Rate	$888.00
Max. Negotiated Rate	$1,432.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: Qualcare PPO/HMO/WC	$888.00

PLATE LEFT SUPPER 5 HOLE SUPER

Facility

$4,746.60

Service Code	HCPCS C1713
Hospital Charge Code	270690572
Hospital Revenue Code	278
Min. Negotiated Rate	$711.99
Max. Negotiated Rate	$1,148.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.68
Rate for Payer: Qualcare PPO/HMO/WC	$711.99

PLATE LEFT SUPPER 5 HOLE SUPER

Facility

$4,746.60

Service Code	HCPCS C1713
Hospital Charge Code	270690572
Hospital Revenue Code	278
Min. Negotiated Rate	$134.80
Max. Negotiated Rate	$2,373.30
Rate for Payer: Aetna Commercial	$1,803.71
Rate for Payer: Aetna Medicare Advantage	$1,423.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,210.38
Rate for Payer: Cigna Commercial	$2,373.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.68
Rate for Payer: Qualcare PPO/HMO/WC	$711.99
Rate for Payer: UnitedHealthcare Community & State	$149.99
Rate for Payer: Wellpoint Medicaid Managed Care	$134.80

PLATE LEFT T-SHAPED 5-HOLE

Facility

$6,337.45

Hospital Charge Code	270657183
Hospital Revenue Code	278
Min. Negotiated Rate	$950.62
Max. Negotiated Rate	$1,533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,267.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,533.66
Rate for Payer: Qualcare PPO/HMO/WC	$950.62

PLATE LEFT T-SHAPED 5-HOLE

Facility

$6,337.45

Hospital Charge Code	270657183
Hospital Revenue Code	278
Min. Negotiated Rate	$179.98
Max. Negotiated Rate	$3,168.72
Rate for Payer: Aetna Commercial	$2,408.23
Rate for Payer: Aetna Medicare Advantage	$1,901.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,616.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,616.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,267.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,616.05
Rate for Payer: Cigna Commercial	$3,168.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,533.66
Rate for Payer: Qualcare PPO/HMO/WC	$950.62
Rate for Payer: UnitedHealthcare Community & State	$200.26
Rate for Payer: Wellpoint Medicaid Managed Care	$179.98

PLATE LEFT VOLAR NARROW DISTAL

Facility

$4,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270647778
Hospital Revenue Code	278
Min. Negotiated Rate	$132.91
Max. Negotiated Rate	$2,340.00
Rate for Payer: Aetna Commercial	$1,778.40
Rate for Payer: Aetna Medicare Advantage	$1,404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,193.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,193.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,193.40
Rate for Payer: Cigna Commercial	$2,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$702.00
Rate for Payer: UnitedHealthcare Community & State	$147.89
Rate for Payer: Wellpoint Medicaid Managed Care	$132.91

PLATE LEFT VOLAR NARROW DISTAL

Facility

$4,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270647778
Hospital Revenue Code	278
Min. Negotiated Rate	$702.00
Max. Negotiated Rate	$1,132.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$936.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$702.00

PLATELET AB,HEPARIN IND

Facility

$390.00

Service Code	HCPCS 86022
Hospital Charge Code	39900189
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET AB,HEPARIN IND

Facility

$390.00

Service Code	HCPCS 86022
Hospital Charge Code	39900189
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$59.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.64
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$18.37
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Medicare Advantage	$18.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Know your out-of-pocket cost for care.

All Charges