Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LK ANT CALCA 2.7X56MML

Facility

$4,492.00

Service Code	HCPCS C1713
Hospital Charge Code	270693304
Hospital Revenue Code	278
Min. Negotiated Rate	$127.57
Max. Negotiated Rate	$2,246.00
Rate for Payer: Aetna Commercial	$1,706.96
Rate for Payer: Aetna Medicare Advantage	$1,347.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$898.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,145.46
Rate for Payer: Cigna Commercial	$2,246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.06
Rate for Payer: Qualcare PPO/HMO/WC	$673.80
Rate for Payer: UnitedHealthcare Community & State	$141.95
Rate for Payer: Wellpoint Medicaid Managed Care	$127.57

PLATE LK ANT CALCA 2.7X56MML

Facility

$4,492.00

Service Code	HCPCS C1713
Hospital Charge Code	270693304
Hospital Revenue Code	278
Min. Negotiated Rate	$673.80
Max. Negotiated Rate	$1,087.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$898.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.06
Rate for Payer: Qualcare PPO/HMO/WC	$673.80

PLATE LKG PAT SS 3H SM 2.7 VA

Facility

$10,419.75

Service Code	HCPCS C1713
Hospital Charge Code	270694962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.96
Max. Negotiated Rate	$2,521.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,083.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,521.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,562.96

PLATE LKG PAT SS 3H SM 2.7 VA

Facility

$10,419.75

Service Code	HCPCS C1713
Hospital Charge Code	270694962
Hospital Revenue Code	278
Min. Negotiated Rate	$295.92
Max. Negotiated Rate	$5,209.88
Rate for Payer: Aetna Commercial	$3,959.51
Rate for Payer: Aetna Medicare Advantage	$3,125.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,657.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,657.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,083.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,657.04
Rate for Payer: Cigna Commercial	$5,209.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,521.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,562.96
Rate for Payer: UnitedHealthcare Community & State	$329.26
Rate for Payer: Wellpoint Medicaid Managed Care	$295.92

PLATE LKG SPINAL LP PROLINK

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698824
Hospital Revenue Code	278
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

PLATE LKG SPINAL LP PROLINK

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698824
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

PLATE LOCKING 10 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688224
Hospital Revenue Code	278
Min. Negotiated Rate	$110.05
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,472.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Community & State	$122.45
Rate for Payer: Wellpoint Medicaid Managed Care	$110.05

PLATE LOCKING 10 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688224
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

PLATE LOCKING DISTAL TI 5 HOLE

Facility

$3,500.00

Hospital Charge Code	270693453
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$110.60
Rate for Payer: Wellpoint Medicaid Managed Care	$99.40

PLATE LOCKING DISTAL TI 5 HOLE

Facility

$3,500.00

Hospital Charge Code	270693453
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LOCKING STRAIGHT SS 10H

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270667332
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

PLATE LOCKING STRAIGHT SS 10H

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270667332
Hospital Revenue Code	278
Min. Negotiated Rate	$84.49
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$1,130.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Community & State	$94.01
Rate for Payer: Wellpoint Medicaid Managed Care	$84.49

PLATE LOCKING STRAIGHT SS 12H

Facility

$3,475.00

Hospital Charge Code	270671900
Hospital Revenue Code	278
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$109.81
Rate for Payer: Wellpoint Medicaid Managed Care	$98.69

PLATE LOCKING STRAIGHT SS 12H

Facility

$3,475.00

Hospital Charge Code	270671900
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

PLATE LOCKING STRAIGHT SS 4H

Facility

$2,250.00

Hospital Charge Code	270671896
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

PLATE LOCKING STRAIGHT SS 4H

Facility

$2,250.00

Hospital Charge Code	270671896
Hospital Revenue Code	278
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

PLATE LOCKING STRAIGHT SS 6H

Facility

$2,375.00

Hospital Charge Code	270671897
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

PLATE LOCKING STRAIGHT SS 6H

Facility

$2,375.00

Hospital Charge Code	270671897
Hospital Revenue Code	278
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

PLATE LOCKING STRAIGHT SS 7H

Facility

$2,625.00

Hospital Charge Code	270671898
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PLATE LOCKING STRAIGHT SS 7H

Facility

$2,625.00

Hospital Charge Code	270671898
Hospital Revenue Code	278
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Community & State	$82.95
Rate for Payer: Wellpoint Medicaid Managed Care	$74.55

PLATE LOCKING STRAIGHT SS 8H

Facility

$2,750.00

Hospital Charge Code	270671899
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

PLATE LOCKING STRAIGHT SS 8H

Facility

$2,750.00

Hospital Charge Code	270671899
Hospital Revenue Code	278
Min. Negotiated Rate	$78.10
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$1,045.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50
Rate for Payer: UnitedHealthcare Community & State	$86.90
Rate for Payer: Wellpoint Medicaid Managed Care	$78.10

PLATE LOCKING TUBUL 3RD TI 4H

Facility

$1,150.00

Hospital Charge Code	270702504
Hospital Revenue Code	278
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$437.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$32.66

PLATE LOCKING TUBUL 3RD TI 4H

Facility

$1,150.00

Hospital Charge Code	270702504
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

PLATE LOCK LAT HOOK TI 3H

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696717
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

Know your out-of-pocket cost for care.

All Charges