Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE PYRENEES LVL 5 100MM

Facility

$9,315.00

Hospital Charge Code	270670327
Hospital Revenue Code	278
Min. Negotiated Rate	$264.55
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$294.35
Rate for Payer: Wellpoint Medicaid Managed Care	$264.55

PLATE PYRENEES LVL 5 100MM

Facility

$9,315.00

Hospital Charge Code	270670327
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 105MM

Facility

$9,315.00

Hospital Charge Code	270670328
Hospital Revenue Code	278
Min. Negotiated Rate	$264.55
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$294.35
Rate for Payer: Wellpoint Medicaid Managed Care	$264.55

PLATE PYRENEES LVL 5 105MM

Facility

$9,315.00

Hospital Charge Code	270670328
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 110MM

Facility

$9,315.00

Hospital Charge Code	270670329
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENEES LVL 5 110MM

Facility

$9,315.00

Hospital Charge Code	270670329
Hospital Revenue Code	278
Min. Negotiated Rate	$264.55
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$294.35
Rate for Payer: Wellpoint Medicaid Managed Care	$264.55

PLATE PYRENEES LVL 5 95MM

Facility

$9,315.00

Hospital Charge Code	270670330
Hospital Revenue Code	278
Min. Negotiated Rate	$264.55
Max. Negotiated Rate	$4,657.50
Rate for Payer: Aetna Commercial	$3,539.70
Rate for Payer: Aetna Medicare Advantage	$2,794.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,375.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,375.32
Rate for Payer: Cigna Commercial	$4,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25
Rate for Payer: UnitedHealthcare Community & State	$294.35
Rate for Payer: Wellpoint Medicaid Managed Care	$264.55

PLATE PYRENEES LVL 5 95MM

Facility

$9,315.00

Hospital Charge Code	270670330
Hospital Revenue Code	278
Min. Negotiated Rate	$1,397.25
Max. Negotiated Rate	$2,254.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,863.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,254.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,397.25

PLATE PYRENESS LVL 2 44MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670299
Hospital Revenue Code	278
Min. Negotiated Rate	$1,041.00
Max. Negotiated Rate	$1,679.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00

PLATE PYRENESS LVL 2 44MM

Facility

$6,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270670299
Hospital Revenue Code	278
Min. Negotiated Rate	$197.10
Max. Negotiated Rate	$3,470.00
Rate for Payer: Aetna Commercial	$2,637.20
Rate for Payer: Aetna Medicare Advantage	$2,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,769.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,769.70
Rate for Payer: Cigna Commercial	$3,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,679.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,041.00
Rate for Payer: UnitedHealthcare Community & State	$219.30
Rate for Payer: Wellpoint Medicaid Managed Care	$197.10

PLATE QTR TUBULAR 3HOLE 23MM

Facility

$333.70

Service Code	HCPCS C1713
Hospital Charge Code	270604316
Hospital Revenue Code	278
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$166.85
Rate for Payer: Aetna Commercial	$126.81
Rate for Payer: Aetna Medicare Advantage	$100.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.09
Rate for Payer: Cigna Commercial	$166.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.76
Rate for Payer: Qualcare PPO/HMO/WC	$50.05
Rate for Payer: UnitedHealthcare Community & State	$10.54
Rate for Payer: Wellpoint Medicaid Managed Care	$9.48

PLATE QTR TUBULAR 3HOLE 23MM

Facility

$333.70

Service Code	HCPCS C1713
Hospital Charge Code	270604316
Hospital Revenue Code	278
Min. Negotiated Rate	$50.05
Max. Negotiated Rate	$80.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.76
Rate for Payer: Qualcare PPO/HMO/WC	$50.05

PLATE QTR TUBULAR 4HOLE 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270651853
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$131.10
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Community & State	$10.90
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

PLATE QTR TUBULAR 4HOLE 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270651853
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PLATE QTR TUBULAR 5HOLE 39MM

Facility

$377.00

Service Code	HCPCS C1713
Hospital Charge Code	270651854
Hospital Revenue Code	278
Min. Negotiated Rate	$56.55
Max. Negotiated Rate	$91.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.55

PLATE QTR TUBULAR 5HOLE 39MM

Facility

$377.00

Service Code	HCPCS C1713
Hospital Charge Code	270651854
Hospital Revenue Code	278
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$188.50
Rate for Payer: Aetna Commercial	$143.26
Rate for Payer: Aetna Medicare Advantage	$113.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.14
Rate for Payer: Cigna Commercial	$188.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.23
Rate for Payer: Qualcare PPO/HMO/WC	$56.55
Rate for Payer: UnitedHealthcare Community & State	$11.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.71

PLATE QTR TUBULAR 6HOLE 47MM

Facility

$407.90

Service Code	HCPCS C1713
Hospital Charge Code	270604319
Hospital Revenue Code	278
Min. Negotiated Rate	$11.58
Max. Negotiated Rate	$203.95
Rate for Payer: Aetna Commercial	$155.00
Rate for Payer: Aetna Medicare Advantage	$122.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.01
Rate for Payer: Cigna Commercial	$203.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.71
Rate for Payer: Qualcare PPO/HMO/WC	$61.19
Rate for Payer: UnitedHealthcare Community & State	$12.89
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

PLATE QTR TUBULAR 6HOLE 47MM

Facility

$407.90

Service Code	HCPCS C1713
Hospital Charge Code	270604319
Hospital Revenue Code	278
Min. Negotiated Rate	$61.19
Max. Negotiated Rate	$98.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.71
Rate for Payer: Qualcare PPO/HMO/WC	$61.19

PLATE QTR TUBULAR 7HOLE 55MM

Facility

$435.70

Service Code	HCPCS C1713
Hospital Charge Code	270604320
Hospital Revenue Code	278
Min. Negotiated Rate	$12.37
Max. Negotiated Rate	$217.85
Rate for Payer: Aetna Commercial	$165.57
Rate for Payer: Aetna Medicare Advantage	$130.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.10
Rate for Payer: Cigna Commercial	$217.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.44
Rate for Payer: Qualcare PPO/HMO/WC	$65.36
Rate for Payer: UnitedHealthcare Community & State	$13.77
Rate for Payer: Wellpoint Medicaid Managed Care	$12.37

PLATE QTR TUBULAR 7HOLE 55MM

Facility

$435.70

Service Code	HCPCS C1713
Hospital Charge Code	270604320
Hospital Revenue Code	278
Min. Negotiated Rate	$65.36
Max. Negotiated Rate	$105.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.44
Rate for Payer: Qualcare PPO/HMO/WC	$65.36

PLATE QTR TUBULAR 8HOLE 63MM

Facility

$448.05

Service Code	HCPCS C1713
Hospital Charge Code	270651855
Hospital Revenue Code	278
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$224.03
Rate for Payer: Aetna Commercial	$170.26
Rate for Payer: Aetna Medicare Advantage	$134.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.25
Rate for Payer: Cigna Commercial	$224.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.43
Rate for Payer: Qualcare PPO/HMO/WC	$67.21
Rate for Payer: UnitedHealthcare Community & State	$14.16
Rate for Payer: Wellpoint Medicaid Managed Care	$12.72

PLATE QTR TUBULAR 8HOLE 63MM

Facility

$448.05

Service Code	HCPCS C1713
Hospital Charge Code	270651855
Hospital Revenue Code	278
Min. Negotiated Rate	$67.21
Max. Negotiated Rate	$108.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.43
Rate for Payer: Qualcare PPO/HMO/WC	$67.21

PLATE QUARTER-TUBULAR 3 HOLE

Facility

$333.00

Hospital Charge Code	270656726
Hospital Revenue Code	278
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$126.54
Rate for Payer: Aetna Medicare Advantage	$99.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.92
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.59
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Community & State	$10.52
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

PLATE QUARTER-TUBULAR 3 HOLE

Facility

$333.00

Hospital Charge Code	270656726
Hospital Revenue Code	278
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$80.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.59
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

PLATE QUARTER-TUBULAR 8 HOLE

Facility

$453.00

Hospital Charge Code	270657224
Hospital Revenue Code	278
Min. Negotiated Rate	$12.87
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$172.14
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.63
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Community & State	$14.31
Rate for Payer: Wellpoint Medicaid Managed Care	$12.87

Know your out-of-pocket cost for care.

All Charges