Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE NARROW LOCK 8H 2X46MM

Facility

$4,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270700737
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 VDR

Facility

$6,150.00

Hospital Charge Code	270665815
Hospital Revenue Code	278
Min. Negotiated Rate	$922.50
Max. Negotiated Rate	$1,488.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.30
Rate for Payer: Qualcare PPO/HMO/WC	$922.50

PLATE NARROW VDR

Facility

$6,150.00

Hospital Charge Code	270665815
Hospital Revenue Code	278
Min. Negotiated Rate	$174.66
Max. Negotiated Rate	$3,075.00
Rate for Payer: Aetna Commercial	$2,337.00
Rate for Payer: Aetna Medicare Advantage	$1,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,568.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,568.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,568.25
Rate for Payer: Cigna Commercial	$3,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.30
Rate for Payer: Qualcare PPO/HMO/WC	$922.50
Rate for Payer: UnitedHealthcare Community & State	$194.34
Rate for Payer: Wellpoint Medicaid Managed Care	$174.66

PLATE NATERIOE 2.7MM

Facility

$4,166.00

Service Code	HCPCS C1713
Hospital Charge Code	270682403
Hospital Revenue Code	278
Min. Negotiated Rate	$624.90
Max. Negotiated Rate	$1,008.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$833.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,008.17
Rate for Payer: Qualcare PPO/HMO/WC	$624.90

PLATE NATERIOE 2.7MM

Facility

$4,166.00

Service Code	HCPCS C1713
Hospital Charge Code	270682403
Hospital Revenue Code	278
Min. Negotiated Rate	$118.31
Max. Negotiated Rate	$2,083.00
Rate for Payer: Aetna Commercial	$1,583.08
Rate for Payer: Aetna Medicare Advantage	$1,249.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$833.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.33
Rate for Payer: Cigna Commercial	$2,083.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,008.17
Rate for Payer: Qualcare PPO/HMO/WC	$624.90
Rate for Payer: UnitedHealthcare Community & State	$131.65
Rate for Payer: Wellpoint Medicaid Managed Care	$118.31

PLATE NAVCULR 2.4X2.7MM VA-LCK

Facility

$5,133.65

Service Code	HCPCS C1713
Hospital Charge Code	270686482
Hospital Revenue Code	278
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$2,566.82
Rate for Payer: Aetna Commercial	$1,950.79
Rate for Payer: Aetna Medicare Advantage	$1,540.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,309.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,309.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,026.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,309.08
Rate for Payer: Cigna Commercial	$2,566.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.34
Rate for Payer: Qualcare PPO/HMO/WC	$770.05
Rate for Payer: UnitedHealthcare Community & State	$162.22
Rate for Payer: Wellpoint Medicaid Managed Care	$145.80

PLATE NAVCULR 2.4X2.7MM VA-LCK

Facility

$5,133.65

Service Code	HCPCS C1713
Hospital Charge Code	270686482
Hospital Revenue Code	278
Min. Negotiated Rate	$770.05
Max. Negotiated Rate	$1,242.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,026.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.34
Rate for Payer: Qualcare PPO/HMO/WC	$770.05

PLATE NCB PP DIST FEM 278MM

Facility

$13,074.90

Hospital Charge Code	270702816
Hospital Revenue Code	278
Min. Negotiated Rate	$1,961.23
Max. Negotiated Rate	$3,164.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,614.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,164.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.23

PLATE NCB PP DIST FEM 278MM

Facility

$13,074.90

Hospital Charge Code	270702816
Hospital Revenue Code	278
Min. Negotiated Rate	$371.33
Max. Negotiated Rate	$6,537.45
Rate for Payer: Aetna Commercial	$4,968.46
Rate for Payer: Aetna Medicare Advantage	$3,922.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,334.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,334.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,614.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,334.10
Rate for Payer: Cigna Commercial	$6,537.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,164.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.23
Rate for Payer: UnitedHealthcare Community & State	$413.17
Rate for Payer: Wellpoint Medicaid Managed Care	$371.33

PLATE NEURO BOX 4H 10x26MM

Facility

$1,460.00

Hospital Charge Code	270674575
Hospital Revenue Code	278
Min. Negotiated Rate	$41.46
Max. Negotiated Rate	$730.00
Rate for Payer: Aetna Commercial	$554.80
Rate for Payer: Aetna Medicare Advantage	$438.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$372.30
Rate for Payer: Cigna Commercial	$730.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.32
Rate for Payer: Qualcare PPO/HMO/WC	$219.00
Rate for Payer: UnitedHealthcare Community & State	$46.14
Rate for Payer: Wellpoint Medicaid Managed Care	$41.46

PLATE NEURO BOX 4H 10x26MM

Facility

$1,460.00

Hospital Charge Code	270674575
Hospital Revenue Code	278
Min. Negotiated Rate	$219.00
Max. Negotiated Rate	$353.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.32
Rate for Payer: Qualcare PPO/HMO/WC	$219.00

PLATE NEXGEN ANT CERV 3L 61MM

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270694744
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

PLATE NEXGEN ANT CERV 3L 61MM

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270694744
Hospital Revenue Code	278
Min. Negotiated Rate	$441.62
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$5,909.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50
Rate for Payer: UnitedHealthcare Community & State	$491.38
Rate for Payer: Wellpoint Medicaid Managed Care	$441.62

PLATE OC 31 MM

Facility

$15,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270687811
Hospital Revenue Code	278
Min. Negotiated Rate	$2,398.50
Max. Negotiated Rate	$3,869.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,198.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,869.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,398.50

PLATE OC 31 MM

Facility

$15,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270687811
Hospital Revenue Code	278
Min. Negotiated Rate	$454.12
Max. Negotiated Rate	$7,995.00
Rate for Payer: Aetna Commercial	$6,076.20
Rate for Payer: Aetna Medicare Advantage	$4,797.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,077.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,077.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,077.45
Rate for Payer: Cigna Commercial	$7,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,869.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,398.50
Rate for Payer: UnitedHealthcare Community & State	$505.28
Rate for Payer: Wellpoint Medicaid Managed Care	$454.12

PLATE OCCIPITAL SMALL

Facility

$21,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697874
Hospital Revenue Code	278
Min. Negotiated Rate	$3,296.25
Max. Negotiated Rate	$5,317.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,317.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,296.25

PLATE OCCIPITAL SMALL

Facility

$21,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697874
Hospital Revenue Code	278
Min. Negotiated Rate	$624.09
Max. Negotiated Rate	$10,987.50
Rate for Payer: Aetna Commercial	$8,350.50
Rate for Payer: Aetna Medicare Advantage	$6,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,603.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,603.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,603.62
Rate for Payer: Cigna Commercial	$10,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,317.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,296.25
Rate for Payer: UnitedHealthcare Community & State	$694.41
Rate for Payer: Wellpoint Medicaid Managed Care	$624.09

PLATE OCCIPTAL Y-SHAPE 40-50MM

Facility

$30,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270696791
Hospital Revenue Code	278
Min. Negotiated Rate	$863.36
Max. Negotiated Rate	$15,200.00
Rate for Payer: Aetna Commercial	$11,552.00
Rate for Payer: Aetna Medicare Advantage	$9,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,752.00
Rate for Payer: Cigna Commercial	$15,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,356.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,560.00
Rate for Payer: UnitedHealthcare Community & State	$960.64
Rate for Payer: Wellpoint Medicaid Managed Care	$863.36

PLATE OCCIPTAL Y-SHAPE 40-50MM

Facility

$30,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270696791
Hospital Revenue Code	278
Min. Negotiated Rate	$4,560.00
Max. Negotiated Rate	$7,356.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,356.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,560.00

PLATE OLECRANON

Facility

$15,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270705395
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.00
Max. Negotiated Rate	$3,780.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,780.04
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.00

PLATE OLECRANON

Facility

$15,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270705395
Hospital Revenue Code	278
Min. Negotiated Rate	$443.61
Max. Negotiated Rate	$7,810.00
Rate for Payer: Aetna Commercial	$5,935.60
Rate for Payer: Aetna Medicare Advantage	$4,686.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,983.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,983.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,983.10
Rate for Payer: Cigna Commercial	$7,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,780.04
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.00
Rate for Payer: UnitedHealthcare Community & State	$493.59
Rate for Payer: Wellpoint Medicaid Managed Care	$443.61

PLATE OLECRANON

Facility

$13,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270705394
Hospital Revenue Code	278
Min. Negotiated Rate	$369.91
Max. Negotiated Rate	$6,512.50
Rate for Payer: Aetna Commercial	$4,949.50
Rate for Payer: Aetna Medicare Advantage	$3,907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,321.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,321.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,321.38
Rate for Payer: Cigna Commercial	$6,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.75
Rate for Payer: UnitedHealthcare Community & State	$411.59
Rate for Payer: Wellpoint Medicaid Managed Care	$369.91

PLATE OLECRANON

Facility

$13,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270705394
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.75
Max. Negotiated Rate	$3,152.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.75

PLATE OLECRANON 10 HOLE

Facility

$6,770.00

Hospital Charge Code	270668017
Hospital Revenue Code	278
Min. Negotiated Rate	$192.27
Max. Negotiated Rate	$3,385.00
Rate for Payer: Aetna Commercial	$2,572.60
Rate for Payer: Aetna Medicare Advantage	$2,031.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,726.35
Rate for Payer: Cigna Commercial	$3,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.50
Rate for Payer: UnitedHealthcare Community & State	$213.93
Rate for Payer: Wellpoint Medicaid Managed Care	$192.27

PLATE OLECRANON 10 HOLE

Facility

$6,770.00

Hospital Charge Code	270668017
Hospital Revenue Code	278
Min. Negotiated Rate	$1,015.50
Max. Negotiated Rate	$1,638.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.50

Know your out-of-pocket cost for care.

All Charges