Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE MTP FUSN 2.4/2.7 LG STER

Facility

$4,409.45

Hospital Charge Code	270677976
Hospital Revenue Code	278
Min. Negotiated Rate	$661.42
Max. Negotiated Rate	$1,067.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: Qualcare PPO/HMO/WC	$661.42

PLATE MTP FUSN 2.4/2.7 LG STER

Facility

$4,409.45

Hospital Charge Code	270677976
Hospital Revenue Code	278
Min. Negotiated Rate	$125.23
Max. Negotiated Rate	$2,204.72
Rate for Payer: Aetna Commercial	$1,675.59
Rate for Payer: Aetna Medicare Advantage	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.41
Rate for Payer: Cigna Commercial	$2,204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: Qualcare PPO/HMO/WC	$661.42
Rate for Payer: UnitedHealthcare Community & State	$139.34
Rate for Payer: Wellpoint Medicaid Managed Care	$125.23

PLATE MTP FUSN 2.4/2.7mm 5DEG

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679436
Hospital Revenue Code	278
Min. Negotiated Rate	$125.23
Max. Negotiated Rate	$2,204.72
Rate for Payer: Aetna Commercial	$1,675.59
Rate for Payer: Aetna Medicare Advantage	$1,322.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,124.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,124.41
Rate for Payer: Cigna Commercial	$2,204.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: Qualcare PPO/HMO/WC	$661.42
Rate for Payer: UnitedHealthcare Community & State	$139.34
Rate for Payer: Wellpoint Medicaid Managed Care	$125.23

PLATE MTP FUSN 2.4/2.7mm 5DEG

Facility

$4,409.45

Service Code	HCPCS C1713
Hospital Charge Code	270679436
Hospital Revenue Code	278
Min. Negotiated Rate	$661.42
Max. Negotiated Rate	$1,067.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,067.09
Rate for Payer: Qualcare PPO/HMO/WC	$661.42

PLATE MTP FUSN SMALL LEFT 5

Facility

$4,668.60

Service Code	HCPCS C1713
Hospital Charge Code	270688734
Hospital Revenue Code	278
Min. Negotiated Rate	$700.29
Max. Negotiated Rate	$1,129.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.80
Rate for Payer: Qualcare PPO/HMO/WC	$700.29

PLATE MTP FUSN SMALL LEFT 5

Facility

$4,668.60

Service Code	HCPCS C1713
Hospital Charge Code	270688734
Hospital Revenue Code	278
Min. Negotiated Rate	$132.59
Max. Negotiated Rate	$2,334.30
Rate for Payer: Aetna Commercial	$1,774.07
Rate for Payer: Aetna Medicare Advantage	$1,400.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,190.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,190.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$933.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,190.49
Rate for Payer: Cigna Commercial	$2,334.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,129.80
Rate for Payer: Qualcare PPO/HMO/WC	$700.29
Rate for Payer: UnitedHealthcare Community & State	$147.53
Rate for Payer: Wellpoint Medicaid Managed Care	$132.59

PLATE MTP LONG TI 8H V1 RT

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270698992
Hospital Revenue Code	278
Min. Negotiated Rate	$496.29
Max. Negotiated Rate	$8,737.50
Rate for Payer: Aetna Commercial	$6,640.50
Rate for Payer: Aetna Medicare Advantage	$5,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,456.12
Rate for Payer: Cigna Commercial	$8,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25
Rate for Payer: UnitedHealthcare Community & State	$552.21
Rate for Payer: Wellpoint Medicaid Managed Care	$496.29

PLATE MTP LONG TI 8H V1 RT

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270698992
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$4,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

PLATE MTP LO-PRO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691058
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 MTP LO-PRO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691058
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 MTP V1 ANCHORAGE LT

Facility

$14,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270695700
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

PLATE MTP V1 ANCHORAGE LT

Facility

$14,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270695700
Hospital Revenue Code	278
Min. Negotiated Rate	$425.43
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$5,692.40
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00
Rate for Payer: UnitedHealthcare Community & State	$473.37
Rate for Payer: Wellpoint Medicaid Managed Care	$425.43

PLATE MTP V1 RIGHT

Facility

$10,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270673313
Hospital Revenue Code	278
Min. Negotiated Rate	$1,502.25
Max. Negotiated Rate	$2,423.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25

PLATE MTP V1 RIGHT

Facility

$10,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270673313
Hospital Revenue Code	278
Min. Negotiated Rate	$284.43
Max. Negotiated Rate	$5,007.50
Rate for Payer: Aetna Commercial	$3,805.70
Rate for Payer: Aetna Medicare Advantage	$3,004.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,553.82
Rate for Payer: Cigna Commercial	$5,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25
Rate for Payer: UnitedHealthcare Community & State	$316.47
Rate for Payer: Wellpoint Medicaid Managed Care	$284.43

PLATE MTP V` LONG 8 HOLE

Facility

$10,015.00

Hospital Charge Code	270669555
Hospital Revenue Code	278
Min. Negotiated Rate	$284.43
Max. Negotiated Rate	$5,007.50
Rate for Payer: Aetna Commercial	$3,805.70
Rate for Payer: Aetna Medicare Advantage	$3,004.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,553.82
Rate for Payer: Cigna Commercial	$5,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25
Rate for Payer: UnitedHealthcare Community & State	$316.47
Rate for Payer: Wellpoint Medicaid Managed Care	$284.43

PLATE MTP V` LONG 8 HOLE

Facility

$10,015.00

Hospital Charge Code	270669555
Hospital Revenue Code	278
Min. Negotiated Rate	$1,502.25
Max. Negotiated Rate	$2,423.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25

PLATE NARROW 16H 4.5x296MM

Facility

$3,417.00

Hospital Charge Code	270675500
Hospital Revenue Code	278
Min. Negotiated Rate	$512.55
Max. Negotiated Rate	$826.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.91
Rate for Payer: Qualcare PPO/HMO/WC	$512.55

PLATE NARROW 16H 4.5x296MM

Facility

$3,417.00

Hospital Charge Code	270675500
Hospital Revenue Code	278
Min. Negotiated Rate	$97.04
Max. Negotiated Rate	$1,708.50
Rate for Payer: Aetna Commercial	$1,298.46
Rate for Payer: Aetna Medicare Advantage	$1,025.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$871.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$871.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$871.34
Rate for Payer: Cigna Commercial	$1,708.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.91
Rate for Payer: Qualcare PPO/HMO/WC	$512.55
Rate for Payer: UnitedHealthcare Community & State	$107.98
Rate for Payer: Wellpoint Medicaid Managed Care	$97.04

PLATE NARROW 4H 4.5x80MM

Facility

$1,428.00

Hospital Charge Code	270675504
Hospital Revenue Code	278
Min. Negotiated Rate	$40.56
Max. Negotiated Rate	$714.00
Rate for Payer: Aetna Commercial	$542.64
Rate for Payer: Aetna Medicare Advantage	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.14
Rate for Payer: Cigna Commercial	$714.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.58
Rate for Payer: Qualcare PPO/HMO/WC	$214.20
Rate for Payer: UnitedHealthcare Community & State	$45.12
Rate for Payer: Wellpoint Medicaid Managed Care	$40.56

PLATE NARROW 4H 4.5x80MM

Facility

$1,428.00

Hospital Charge Code	270675504
Hospital Revenue Code	278
Min. Negotiated Rate	$214.20
Max. Negotiated Rate	$345.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.58
Rate for Payer: Qualcare PPO/HMO/WC	$214.20

PLATE NARROW LCP 8H/4.5x152MM

Facility

$2,100.60

Service Code	HCPCS C1713
Hospital Charge Code	270666770
Hospital Revenue Code	278
Min. Negotiated Rate	$315.09
Max. Negotiated Rate	$508.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.35
Rate for Payer: Qualcare PPO/HMO/WC	$315.09

PLATE NARROW LCP 8H/4.5x152MM

Facility

$2,100.60

Service Code	HCPCS C1713
Hospital Charge Code	270666770
Hospital Revenue Code	278
Min. Negotiated Rate	$59.66
Max. Negotiated Rate	$1,050.30
Rate for Payer: Aetna Commercial	$798.23
Rate for Payer: Aetna Medicare Advantage	$630.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.65
Rate for Payer: Cigna Commercial	$1,050.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.35
Rate for Payer: Qualcare PPO/HMO/WC	$315.09
Rate for Payer: UnitedHealthcare Community & State	$66.38
Rate for Payer: Wellpoint Medicaid Managed Care	$59.66

PLATE NARROW LOCK 6H 2X34MM

Facility

$4,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270700736
Hospital Revenue Code	278
Min. Negotiated Rate	$118.71
Max. Negotiated Rate	$2,090.00
Rate for Payer: Aetna Commercial	$1,588.40
Rate for Payer: Aetna Medicare Advantage	$1,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,065.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,065.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,065.90
Rate for Payer: Cigna Commercial	$2,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,011.56
Rate for Payer: Qualcare PPO/HMO/WC	$627.00
Rate for Payer: UnitedHealthcare Community & State	$132.09
Rate for Payer: Wellpoint Medicaid Managed Care	$118.71

PLATE NARROW LOCK 6H 2X34MM

Facility

$4,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270700736
Hospital Revenue Code	278
Min. Negotiated Rate	$627.00
Max. Negotiated Rate	$1,011.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$836.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,011.56
Rate for Payer: Qualcare PPO/HMO/WC	$627.00

PLATE NARROW LOCK 8H 2X46MM

Facility

$4,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270700737
Hospital Revenue Code	278
Min. Negotiated Rate	$118.71
Max. Negotiated Rate	$2,090.00
Rate for Payer: Aetna Commercial	$1,588.40
Rate for Payer: Aetna Medicare Advantage	$1,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,065.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,065.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,065.90
Rate for Payer: Cigna Commercial	$2,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,011.56
Rate for Payer: Qualcare PPO/HMO/WC	$627.00
Rate for Payer: UnitedHealthcare Community & State	$132.09
Rate for Payer: Wellpoint Medicaid Managed Care	$118.71

Know your out-of-pocket cost for care.

All Charges