Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATELONG FOOT MAX 180 MM ALUM

Facility

$8,157.00

Hospital Charge Code	270681230
Hospital Revenue Code	272
Min. Negotiated Rate	$231.66
Max. Negotiated Rate	$4,078.50
Rate for Payer: Aetna Commercial	$3,099.66
Rate for Payer: Aetna Medicare Advantage	$2,447.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,080.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,080.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,080.03
Rate for Payer: Cigna Commercial	$4,078.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,120.82
Rate for Payer: Oxford Commercial	$1,631.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.55
Rate for Payer: UnitedHealthcare Commercial	$1,631.40
Rate for Payer: UnitedHealthcare Community & State	$257.76
Rate for Payer: Wellpoint Medicaid Managed Care	$231.66

PLATELONG FOOT MAX 180 MM ALUM

Facility

$8,157.00

Hospital Charge Code	270681230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,223.55
Max. Negotiated Rate	$1,223.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.55

PLATELONG MAXFRAME 150MM

Facility

$6,933.00

Hospital Charge Code	270681231
Hospital Revenue Code	272
Min. Negotiated Rate	$196.90
Max. Negotiated Rate	$3,466.50
Rate for Payer: Aetna Commercial	$2,634.54
Rate for Payer: Aetna Medicare Advantage	$2,079.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,767.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,767.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,767.91
Rate for Payer: Cigna Commercial	$3,466.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,802.58
Rate for Payer: Oxford Commercial	$1,386.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.95
Rate for Payer: UnitedHealthcare Commercial	$1,386.60
Rate for Payer: UnitedHealthcare Community & State	$219.08
Rate for Payer: Wellpoint Medicaid Managed Care	$196.90

PLATELONG MAXFRAME 150MM

Facility

$6,933.00

Hospital Charge Code	270681231
Hospital Revenue Code	272
Min. Negotiated Rate	$1,039.95
Max. Negotiated Rate	$1,039.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.95

PLATE LONG ROI-C FOR H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE LONG ROI-C FOR H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678667
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

PLATE LORDOTIC 10X28X11MM ST

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692443
Hospital Revenue Code	278
Min. Negotiated Rate	$687.28
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$764.72
Rate for Payer: Wellpoint Medicaid Managed Care	$687.28

PLATE LORDOTIC 10X28X11MM ST

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDOTIC 10X29X9MM COAL

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692450
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDOTIC 10X29X9MM COAL

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692450
Hospital Revenue Code	278
Min. Negotiated Rate	$687.28
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$9,196.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00
Rate for Payer: UnitedHealthcare Community & State	$764.72
Rate for Payer: Wellpoint Medicaid Managed Care	$687.28

PLATE LORDTIC 28 MM

Facility

$6,590.00

Service Code	HCPCS C1889
Hospital Charge Code	270690569
Hospital Revenue Code	278
Min. Negotiated Rate	$988.50
Max. Negotiated Rate	$1,594.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,318.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,594.78
Rate for Payer: Qualcare PPO/HMO/WC	$988.50

PLATE LORDTIC 28 MM

Facility

$6,590.00

Service Code	HCPCS C1889
Hospital Charge Code	270690569
Hospital Revenue Code	278
Min. Negotiated Rate	$187.16
Max. Negotiated Rate	$3,295.00
Rate for Payer: Aetna Commercial	$2,504.20
Rate for Payer: Aetna Medicare Advantage	$1,977.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.45
Rate for Payer: Cigna Commercial	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,594.78
Rate for Payer: Qualcare PPO/HMO/WC	$988.50
Rate for Payer: UnitedHealthcare Community & State	$208.24
Rate for Payer: Wellpoint Medicaid Managed Care	$187.16

PLATE LORDTIC 30MM

Facility

$6,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270690567
Hospital Revenue Code	278
Min. Negotiated Rate	$187.44
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$208.56
Rate for Payer: Wellpoint Medicaid Managed Care	$187.44

PLATE LORDTIC 30MM

Facility

$6,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270690567
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

PLATE LOW PRO 2 HOLE 15MM

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270704118
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

PLATE LOW PRO 2 HOLE 15MM

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270704118
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PLATE LOW PROFILE COTTON 6MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270674305
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE LOW PROFILE COTTON 6MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270674305
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

PLATE LOW PROFILE LAPIDUS 4 HO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685384
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

PLATE LOW PROFILE LAPIDUS 4 HO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685384
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE LUMBAR 24MM

Facility

$40,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697266
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$9,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

PLATE LUMBAR 24MM

Facility

$40,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697266
Hospital Revenue Code	278
Min. Negotiated Rate	$1,157.30
Max. Negotiated Rate	$20,375.00
Rate for Payer: Aetna Commercial	$15,485.00
Rate for Payer: Aetna Medicare Advantage	$12,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,391.25
Rate for Payer: Cigna Commercial	$20,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50
Rate for Payer: UnitedHealthcare Community & State	$1,287.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,157.30

PLATE LUMBAR LAT 2 SCR 17MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695203
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

PLATE LUMBAR LAT 2 SCR 17MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695203
Hospital Revenue Code	278
Min. Negotiated Rate	$589.30
Max. Negotiated Rate	$10,375.00
Rate for Payer: Aetna Commercial	$7,885.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$10,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50
Rate for Payer: UnitedHealthcare Community & State	$655.70
Rate for Payer: Wellpoint Medicaid Managed Care	$589.30

Know your out-of-pocket cost for care.

All Charges