Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ORTHO 6 CALC SLIDE

Facility

$7,490.00

Hospital Charge Code	270677101
Hospital Revenue Code	278
Min. Negotiated Rate	$212.72
Max. Negotiated Rate	$3,745.00
Rate for Payer: Aetna Commercial	$2,846.20
Rate for Payer: Aetna Medicare Advantage	$2,247.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,909.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,909.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,498.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,909.95
Rate for Payer: Cigna Commercial	$3,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,812.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,123.50
Rate for Payer: UnitedHealthcare Community & State	$236.68
Rate for Payer: Wellpoint Medicaid Managed Care	$212.72

PLATE ORTHOLOC 3DI TIBIA SM

Facility

$7,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270700813
Hospital Revenue Code	278
Min. Negotiated Rate	$211.15
Max. Negotiated Rate	$3,717.50
Rate for Payer: Aetna Commercial	$2,825.30
Rate for Payer: Aetna Medicare Advantage	$2,230.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,895.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,895.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,487.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,895.92
Rate for Payer: Cigna Commercial	$3,717.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,799.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,115.25
Rate for Payer: UnitedHealthcare Community & State	$234.95
Rate for Payer: Wellpoint Medicaid Managed Care	$211.15

PLATE ORTHOLOC 3DI TIBIA SM

Facility

$7,435.00

Service Code	HCPCS C1713
Hospital Charge Code	270700813
Hospital Revenue Code	278
Min. Negotiated Rate	$1,115.25
Max. Negotiated Rate	$1,799.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,487.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,799.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,115.25

PLATE ORTHOLOC LG LP HOOK 3DI

Facility

$13,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270700519
Hospital Revenue Code	278
Min. Negotiated Rate	$2,036.25
Max. Negotiated Rate	$3,285.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,285.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,036.25

PLATE ORTHOLOC LG LP HOOK 3DI

Facility

$13,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270700519
Hospital Revenue Code	278
Min. Negotiated Rate	$385.53
Max. Negotiated Rate	$6,787.50
Rate for Payer: Aetna Commercial	$5,158.50
Rate for Payer: Aetna Medicare Advantage	$4,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,461.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,461.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,715.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,461.62
Rate for Payer: Cigna Commercial	$6,787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,285.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,036.25
Rate for Payer: UnitedHealthcare Community & State	$428.97
Rate for Payer: Wellpoint Medicaid Managed Care	$385.53

PLATE PHERES LEUKOREDUCE IRRAD

Facility

$7,142.26

Service Code	HCPCS P9037
Hospital Charge Code	3101515
Hospital Revenue Code	390
Min. Negotiated Rate	$202.84
Max. Negotiated Rate	$2,870.95
Rate for Payer: Aetna Commercial	$2,152.72
Rate for Payer: Aetna Medicare Advantage	$2,564.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,870.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,870.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$791.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,870.95
Rate for Payer: Cigna Commercial	$1,586.44
Rate for Payer: Cigna Medicare Advantage	$791.44
Rate for Payer: Clover Medicare Advantage	$751.87
Rate for Payer: EmblemHealth Commercial	$2,374.32
Rate for Payer: Humana Medicare Advantage	$815.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$791.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,856.99
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,071.34
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$225.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$791.44
Rate for Payer: Wellcare Medicare Advantage	$791.44
Rate for Payer: Wellpoint Medicaid Managed Care	$202.84

PLATE PHERES LEUKOREDUCE IRRAD

Facility

$7,142.26

Service Code	HCPCS P9037
Hospital Charge Code	3101515
Hospital Revenue Code	390
Min. Negotiated Rate	$1,071.34
Max. Negotiated Rate	$1,071.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,071.34

PLATE PIA 4H NO WEDGE 16MM

Facility

$5,200.00

Hospital Charge Code	270660761
Hospital Revenue Code	278
Min. Negotiated Rate	$147.68
Max. Negotiated Rate	$2,600.00
Rate for Payer: Aetna Commercial	$1,976.00
Rate for Payer: Aetna Medicare Advantage	$1,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,326.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,326.00
Rate for Payer: Cigna Commercial	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00
Rate for Payer: UnitedHealthcare Community & State	$164.32
Rate for Payer: Wellpoint Medicaid Managed Care	$147.68

PLATE PIA 4H NO WEDGE 16MM

Facility

$5,200.00

Hospital Charge Code	270660761
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$1,258.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.40
Rate for Payer: Qualcare PPO/HMO/WC	$780.00

PLATE PLANTAR 2.7MM

Facility

$8,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696039
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

PLATE PLANTAR 2.7MM

Facility

$8,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696039
Hospital Revenue Code	278
Min. Negotiated Rate	$254.89
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$3,410.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Community & State	$283.61
Rate for Payer: Wellpoint Medicaid Managed Care	$254.89

PLATE PLANTAR GRAVITY PLANTAR

Facility

$7,431.00

Service Code	HCPCS C1713
Hospital Charge Code	270701068
Hospital Revenue Code	278
Min. Negotiated Rate	$1,114.65
Max. Negotiated Rate	$1,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,486.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,798.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,114.65

PLATE PLANTAR GRAVITY PLANTAR

Facility

$7,431.00

Service Code	HCPCS C1713
Hospital Charge Code	270701068
Hospital Revenue Code	278
Min. Negotiated Rate	$211.04
Max. Negotiated Rate	$3,715.50
Rate for Payer: Aetna Commercial	$2,823.78
Rate for Payer: Aetna Medicare Advantage	$2,229.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,894.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,894.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,486.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,894.90
Rate for Payer: Cigna Commercial	$3,715.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,798.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,114.65
Rate for Payer: UnitedHealthcare Community & State	$234.82
Rate for Payer: Wellpoint Medicaid Managed Care	$211.04

PLATE PLANTAR LAPIDUS RIGHT

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270676694
Hospital Revenue Code	278
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,840.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Community & State	$236.21
Rate for Payer: Wellpoint Medicaid Managed Care	$212.29

PLATE PLANTAR LAPIDUS RIGHT

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270676694
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

PLATE POR FLARED 8MMX34MM

Facility

$25,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270692941
Hospital Revenue Code	278
Min. Negotiated Rate	$3,765.00
Max. Negotiated Rate	$6,074.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,074.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,765.00

PLATE POR FLARED 8MMX34MM

Facility

$25,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270692941
Hospital Revenue Code	278
Min. Negotiated Rate	$712.84
Max. Negotiated Rate	$12,550.00
Rate for Payer: Aetna Commercial	$9,538.00
Rate for Payer: Aetna Medicare Advantage	$7,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,400.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,400.50
Rate for Payer: Cigna Commercial	$12,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,074.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,765.00
Rate for Payer: UnitedHealthcare Community & State	$793.16
Rate for Payer: Wellpoint Medicaid Managed Care	$712.84

PLATE POW 3.0 MM LOCKING

Facility

$3,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270684783
Hospital Revenue Code	278
Min. Negotiated Rate	$109.34
Max. Negotiated Rate	$1,925.00
Rate for Payer: Aetna Commercial	$1,463.00
Rate for Payer: Aetna Medicare Advantage	$1,155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$981.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$981.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$981.75
Rate for Payer: Cigna Commercial	$1,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50
Rate for Payer: UnitedHealthcare Community & State	$121.66
Rate for Payer: Wellpoint Medicaid Managed Care	$109.34

PLATE POW 3.0 MM LOCKING

Facility

$3,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270684783
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

PLATE POW LOCKING

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684632
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 POW LOCKING

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684632
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 POW LOCKING TI

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674082
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 POW LOCKING TI

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674082
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 PREBENT RIGHT 17 HOLE

Facility

$11,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270690138
Hospital Revenue Code	278
Min. Negotiated Rate	$1,779.00
Max. Negotiated Rate	$2,870.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,870.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,779.00

PLATE PREBENT RIGHT 17 HOLE

Facility

$11,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270690138
Hospital Revenue Code	278
Min. Negotiated Rate	$336.82
Max. Negotiated Rate	$5,930.00
Rate for Payer: Aetna Commercial	$4,506.80
Rate for Payer: Aetna Medicare Advantage	$3,558.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,024.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,024.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,372.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,024.30
Rate for Payer: Cigna Commercial	$5,930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,870.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,779.00
Rate for Payer: UnitedHealthcare Community & State	$374.78
Rate for Payer: Wellpoint Medicaid Managed Care	$336.82

Know your out-of-pocket cost for care.

All Charges