Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE MEDIAL HOOK LOCK SS 3H

Facility

$4,125.00

Hospital Charge Code	270671901
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

PLATE MEDIAL HOOK LOCK SS 5H

Facility

$4,125.00

Hospital Charge Code	270656471
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

PLATE MEDIAL HOOK LOCK SS 5H

Facility

$4,125.00

Hospital Charge Code	270656471
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

PLATE MEDIAL HOOK LOCK SS 7H

Facility

$4,500.00

Hospital Charge Code	270671902
Hospital Revenue Code	278
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$142.20
Rate for Payer: Wellpoint Medicaid Managed Care	$127.80

PLATE MEDIAL HOOK LOCK SS 7H

Facility

$4,500.00

Hospital Charge Code	270671902
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PLATE MEDIAL TIBIA 6H LT 142MM

Facility

$5,931.00

Hospital Charge Code	270675505
Hospital Revenue Code	278
Min. Negotiated Rate	$889.65
Max. Negotiated Rate	$1,435.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,186.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,435.30
Rate for Payer: Qualcare PPO/HMO/WC	$889.65

PLATE MEDIAL TIBIA 6H LT 142MM

Facility

$5,931.00

Hospital Charge Code	270675505
Hospital Revenue Code	278
Min. Negotiated Rate	$168.44
Max. Negotiated Rate	$2,965.50
Rate for Payer: Aetna Commercial	$2,253.78
Rate for Payer: Aetna Medicare Advantage	$1,779.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,512.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,512.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,186.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,512.40
Rate for Payer: Cigna Commercial	$2,965.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,435.30
Rate for Payer: Qualcare PPO/HMO/WC	$889.65
Rate for Payer: UnitedHealthcare Community & State	$187.42
Rate for Payer: Wellpoint Medicaid Managed Care	$168.44

PLATE MESH 2.4/2.7MM 12 HOLE

Facility

$7,953.40

Service Code	HCPCS C1713
Hospital Charge Code	270689659
Hospital Revenue Code	278
Min. Negotiated Rate	$225.88
Max. Negotiated Rate	$3,976.70
Rate for Payer: Aetna Commercial	$3,022.29
Rate for Payer: Aetna Medicare Advantage	$2,386.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,028.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,028.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,028.12
Rate for Payer: Cigna Commercial	$3,976.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,193.01
Rate for Payer: UnitedHealthcare Community & State	$251.33
Rate for Payer: Wellpoint Medicaid Managed Care	$225.88

PLATE MESH 2.4/2.7MM 12 HOLE

Facility

$7,953.40

Service Code	HCPCS C1713
Hospital Charge Code	270689659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,193.01
Max. Negotiated Rate	$1,924.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,193.01

PLATE METAPH 3.5x125MM 10HOLE

Facility

$4,172.55

Service Code	HCPCS C1713
Hospital Charge Code	270680766
Hospital Revenue Code	278
Min. Negotiated Rate	$625.88
Max. Negotiated Rate	$1,009.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.76
Rate for Payer: Qualcare PPO/HMO/WC	$625.88

PLATE METAPH 3.5x125MM 10HOLE

Facility

$4,172.55

Service Code	HCPCS C1713
Hospital Charge Code	270680766
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$2,086.28
Rate for Payer: Aetna Commercial	$1,585.57
Rate for Payer: Aetna Medicare Advantage	$1,251.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$834.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,064.00
Rate for Payer: Cigna Commercial	$2,086.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,009.76
Rate for Payer: Qualcare PPO/HMO/WC	$625.88
Rate for Payer: UnitedHealthcare Community & State	$131.85
Rate for Payer: Wellpoint Medicaid Managed Care	$118.50

PLATE METAPH 3.5x125MM 8HOLE

Facility

$3,804.00

Service Code	HCPCS C1713
Hospital Charge Code	270660388
Hospital Revenue Code	278
Min. Negotiated Rate	$108.03
Max. Negotiated Rate	$1,902.00
Rate for Payer: Aetna Commercial	$1,445.52
Rate for Payer: Aetna Medicare Advantage	$1,141.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$970.02
Rate for Payer: Cigna Commercial	$1,902.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: Qualcare PPO/HMO/WC	$570.60
Rate for Payer: UnitedHealthcare Community & State	$120.21
Rate for Payer: Wellpoint Medicaid Managed Care	$108.03

PLATE METAPH 3.5x125MM 8HOLE

Facility

$3,804.00

Service Code	HCPCS C1713
Hospital Charge Code	270660388
Hospital Revenue Code	278
Min. Negotiated Rate	$570.60
Max. Negotiated Rate	$920.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: Qualcare PPO/HMO/WC	$570.60

PLATE METAPH 3.5x190MM 12HOLE

Facility

$5,474.25

Service Code	HCPCS C1713
Hospital Charge Code	270684226
Hospital Revenue Code	278
Min. Negotiated Rate	$821.14
Max. Negotiated Rate	$1,324.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.77
Rate for Payer: Qualcare PPO/HMO/WC	$821.14

PLATE METAPH 3.5x190MM 12HOLE

Facility

$5,474.25

Service Code	HCPCS C1713
Hospital Charge Code	270684226
Hospital Revenue Code	278
Min. Negotiated Rate	$155.47
Max. Negotiated Rate	$2,737.12
Rate for Payer: Aetna Commercial	$2,080.22
Rate for Payer: Aetna Medicare Advantage	$1,642.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,395.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,395.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,395.93
Rate for Payer: Cigna Commercial	$2,737.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.77
Rate for Payer: Qualcare PPO/HMO/WC	$821.14
Rate for Payer: UnitedHealthcare Community & State	$172.99
Rate for Payer: Wellpoint Medicaid Managed Care	$155.47

PLATE METAPHY 4/5 HOLES 136MM

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270660391
Hospital Revenue Code	278
Min. Negotiated Rate	$580.05
Max. Negotiated Rate	$935.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: Qualcare PPO/HMO/WC	$580.05

PLATE METAPHY 4/5 HOLES 136MM

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270660391
Hospital Revenue Code	278
Min. Negotiated Rate	$109.82
Max. Negotiated Rate	$1,933.50
Rate for Payer: Aetna Commercial	$1,469.46
Rate for Payer: Aetna Medicare Advantage	$1,160.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.09
Rate for Payer: Cigna Commercial	$1,933.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: Qualcare PPO/HMO/WC	$580.05
Rate for Payer: UnitedHealthcare Community & State	$122.20
Rate for Payer: Wellpoint Medicaid Managed Care	$109.82

PLATE METAPHYS 4.5/3.5 118mm

Facility

$3,804.00

Hospital Charge Code	270669252
Hospital Revenue Code	278
Min. Negotiated Rate	$570.60
Max. Negotiated Rate	$920.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: Qualcare PPO/HMO/WC	$570.60

PLATE METAPHYS 4.5/3.5 118mm

Facility

$3,804.00

Hospital Charge Code	270669252
Hospital Revenue Code	278
Min. Negotiated Rate	$108.03
Max. Negotiated Rate	$1,902.00
Rate for Payer: Aetna Commercial	$1,445.52
Rate for Payer: Aetna Medicare Advantage	$1,141.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$970.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$760.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$970.02
Rate for Payer: Cigna Commercial	$1,902.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$920.57
Rate for Payer: Qualcare PPO/HMO/WC	$570.60
Rate for Payer: UnitedHealthcare Community & State	$120.21
Rate for Payer: Wellpoint Medicaid Managed Care	$108.03

PLATE METAPHYS 4.5/3.5 190mm

Facility

$5,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270669505
Hospital Revenue Code	278
Min. Negotiated Rate	$146.54
Max. Negotiated Rate	$2,580.00
Rate for Payer: Aetna Commercial	$1,960.80
Rate for Payer: Aetna Medicare Advantage	$1,548.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,315.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,315.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,032.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,315.80
Rate for Payer: Cigna Commercial	$2,580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,248.72
Rate for Payer: Qualcare PPO/HMO/WC	$774.00
Rate for Payer: UnitedHealthcare Community & State	$163.06
Rate for Payer: Wellpoint Medicaid Managed Care	$146.54

PLATE METAPHYS 4.5/3.5 190mm

Facility

$5,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270669505
Hospital Revenue Code	278
Min. Negotiated Rate	$774.00
Max. Negotiated Rate	$1,248.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,032.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,248.72
Rate for Payer: Qualcare PPO/HMO/WC	$774.00

PLATE METAPHYSEAL 4.5/3.5 11H

Facility

$3,996.00

Service Code	HCPCS C1713
Hospital Charge Code	270674861
Hospital Revenue Code	278
Min. Negotiated Rate	$599.40
Max. Negotiated Rate	$967.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$967.03
Rate for Payer: Qualcare PPO/HMO/WC	$599.40

PLATE METAPHYSEAL 4.5/3.5 11H

Facility

$3,996.00

Service Code	HCPCS C1713
Hospital Charge Code	270674861
Hospital Revenue Code	278
Min. Negotiated Rate	$113.49
Max. Negotiated Rate	$1,998.00
Rate for Payer: Aetna Commercial	$1,518.48
Rate for Payer: Aetna Medicare Advantage	$1,198.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$799.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,018.98
Rate for Payer: Cigna Commercial	$1,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$967.03
Rate for Payer: Qualcare PPO/HMO/WC	$599.40
Rate for Payer: UnitedHealthcare Community & State	$126.27
Rate for Payer: Wellpoint Medicaid Managed Care	$113.49

PLATE METAPHYSEAL 4.5MM 10H

Facility

$12,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270700091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,817.25
Max. Negotiated Rate	$2,931.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,423.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,931.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,817.25

PLATE METAPHYSEAL 4.5MM 10H

Facility

$12,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270700091
Hospital Revenue Code	278
Min. Negotiated Rate	$344.07
Max. Negotiated Rate	$6,057.50
Rate for Payer: Aetna Commercial	$4,603.70
Rate for Payer: Aetna Medicare Advantage	$3,634.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,089.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,089.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,089.32
Rate for Payer: Cigna Commercial	$6,057.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,931.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,817.25
Rate for Payer: UnitedHealthcare Community & State	$382.83
Rate for Payer: Wellpoint Medicaid Managed Care	$344.07

Know your out-of-pocket cost for care.

All Charges