Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LUMBAR LATERAL 15MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695245
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

PLATE LUMBAR LATERAL 15MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695245
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

PLATEMATRIXNEUROCRANIAL12MM2H

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695476
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

PLATEMATRIXNEUROCRANIAL12MM2H

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695476
Hospital Revenue Code	278
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$17.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

PLATE MATRIXNEURO DBL Y 18MM6H

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270695275
Hospital Revenue Code	278
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$496.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

PLATE MATRIXNEURO DBL Y 18MM6H

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270695275
Hospital Revenue Code	278
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$779.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Community & State	$64.78
Rate for Payer: Wellpoint Medicaid Managed Care	$58.22

PLATE MATRIXNEURO TI STR 4H

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270698656
Hospital Revenue Code	278
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$262.20
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50
Rate for Payer: UnitedHealthcare Community & State	$21.80
Rate for Payer: Wellpoint Medicaid Managed Care	$19.60

PLATE MATRIXNEURO TI STR 4H

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270698656
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$166.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

PLATE MAXFORCE MTP 0-0 RT

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698095
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PLATE MAXFORCE MTP 0-0 RT

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698095
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

PLATE MAXFORCE MTP 6-5 LEFT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694413
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

PLATE MAXFORCE MTP 6-5 LEFT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694413
Hospital Revenue Code	278
Min. Negotiated Rate	$283.29
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$3,790.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25
Rate for Payer: UnitedHealthcare Community & State	$315.21
Rate for Payer: Wellpoint Medicaid Managed Care	$283.29

PLATE MAXFRAME FOOT 150MM

Facility

$7,015.65

Hospital Charge Code	270693737
Hospital Revenue Code	272
Min. Negotiated Rate	$1,052.35
Max. Negotiated Rate	$1,052.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.35

PLATE MAXFRAME FOOT 150MM

Facility

$7,015.65

Hospital Charge Code	270693737
Hospital Revenue Code	272
Min. Negotiated Rate	$199.24
Max. Negotiated Rate	$3,507.82
Rate for Payer: Aetna Commercial	$2,665.95
Rate for Payer: Aetna Medicare Advantage	$2,104.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,788.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,788.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,788.99
Rate for Payer: Cigna Commercial	$3,507.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,824.07
Rate for Payer: Oxford Commercial	$1,403.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.35
Rate for Payer: UnitedHealthcare Commercial	$1,403.13
Rate for Payer: UnitedHealthcare Community & State	$221.69
Rate for Payer: Wellpoint Medicaid Managed Care	$199.24

PLATE MC5 RIGHT 5 HOLE

Facility

$3,680.00

Hospital Charge Code	270669579
Hospital Revenue Code	278
Min. Negotiated Rate	$552.00
Max. Negotiated Rate	$890.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$736.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$890.56
Rate for Payer: Qualcare PPO/HMO/WC	$552.00

PLATE MC5 RIGHT 5 HOLE

Facility

$3,680.00

Hospital Charge Code	270669579
Hospital Revenue Code	278
Min. Negotiated Rate	$104.51
Max. Negotiated Rate	$1,840.00
Rate for Payer: Aetna Commercial	$1,398.40
Rate for Payer: Aetna Medicare Advantage	$1,104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$938.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$938.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$736.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$938.40
Rate for Payer: Cigna Commercial	$1,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$890.56
Rate for Payer: Qualcare PPO/HMO/WC	$552.00
Rate for Payer: UnitedHealthcare Community & State	$116.29
Rate for Payer: Wellpoint Medicaid Managed Care	$104.51

PLATE MED CALCANEUS

Facility

$3,094.30

Service Code	HCPCS C1713
Hospital Charge Code	270703985
Hospital Revenue Code	278
Min. Negotiated Rate	$87.88
Max. Negotiated Rate	$1,547.15
Rate for Payer: Aetna Commercial	$1,175.83
Rate for Payer: Aetna Medicare Advantage	$928.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$789.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$789.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$618.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$789.05
Rate for Payer: Cigna Commercial	$1,547.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$748.82
Rate for Payer: Qualcare PPO/HMO/WC	$464.14
Rate for Payer: UnitedHealthcare Community & State	$97.78
Rate for Payer: Wellpoint Medicaid Managed Care	$87.88

PLATE MED CALCANEUS

Facility

$3,094.30

Service Code	HCPCS C1713
Hospital Charge Code	270703985
Hospital Revenue Code	278
Min. Negotiated Rate	$464.14
Max. Negotiated Rate	$748.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$618.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$748.82
Rate for Payer: Qualcare PPO/HMO/WC	$464.14

PLATE MEDIAL 12 HOLES LF 198MM

Facility

$11,065.00

Hospital Charge Code	270670936
Hospital Revenue Code	278
Min. Negotiated Rate	$1,659.75
Max. Negotiated Rate	$2,677.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,677.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.75

PLATE MEDIAL 12 HOLES LF 198MM

Facility

$11,065.00

Hospital Charge Code	270670936
Hospital Revenue Code	278
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$5,532.50
Rate for Payer: Aetna Commercial	$4,204.70
Rate for Payer: Aetna Medicare Advantage	$3,319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,821.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,821.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,821.57
Rate for Payer: Cigna Commercial	$5,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,677.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.75
Rate for Payer: UnitedHealthcare Community & State	$349.65
Rate for Payer: Wellpoint Medicaid Managed Care	$314.25

PLATE MEDIAL 4 HOLE 92MM

Facility

$7,995.00

Hospital Charge Code	270670987
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 MEDIAL 4 HOLE 92MM

Facility

$7,995.00

Hospital Charge Code	270670987
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 MEDIAL COLM FUS 95MM RT

Facility

$5,871.00

Service Code	HCPCS C1713
Hospital Charge Code	270674858
Hospital Revenue Code	278
Min. Negotiated Rate	$166.74
Max. Negotiated Rate	$2,935.50
Rate for Payer: Aetna Commercial	$2,230.98
Rate for Payer: Aetna Medicare Advantage	$1,761.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,497.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,497.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,174.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,497.11
Rate for Payer: Cigna Commercial	$2,935.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,420.78
Rate for Payer: Qualcare PPO/HMO/WC	$880.65
Rate for Payer: UnitedHealthcare Community & State	$185.52
Rate for Payer: Wellpoint Medicaid Managed Care	$166.74

PLATE MEDIAL COLM FUS 95MM RT

Facility

$5,871.00

Service Code	HCPCS C1713
Hospital Charge Code	270674858
Hospital Revenue Code	278
Min. Negotiated Rate	$880.65
Max. Negotiated Rate	$1,420.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,174.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,420.78
Rate for Payer: Qualcare PPO/HMO/WC	$880.65

PLATE MEDIAL HOOK LOCK SS 3H

Facility

$4,125.00

Hospital Charge Code	270671901
Hospital Revenue Code	278
Min. Negotiated Rate	$117.15
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75
Rate for Payer: UnitedHealthcare Community & State	$130.35
Rate for Payer: Wellpoint Medicaid Managed Care	$117.15

Know your out-of-pocket cost for care.

All Charges