Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE QUARTER-TUBULAR 8 HOLE

Facility

$453.00

Hospital Charge Code	270657224
Hospital Revenue Code	278
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$109.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.63
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

PLATE RADIUS LCP

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270687279
Hospital Revenue Code	278
Min. Negotiated Rate	$145.27
Max. Negotiated Rate	$2,557.50
Rate for Payer: Aetna Commercial	$1,943.70
Rate for Payer: Aetna Medicare Advantage	$1,534.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,304.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,304.33
Rate for Payer: Cigna Commercial	$2,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25
Rate for Payer: UnitedHealthcare Community & State	$161.63
Rate for Payer: Wellpoint Medicaid Managed Care	$145.27

PLATE RADIUS LCP

Facility

$5,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270687279
Hospital Revenue Code	278
Min. Negotiated Rate	$767.25
Max. Negotiated Rate	$1,237.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,023.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.83
Rate for Payer: Qualcare PPO/HMO/WC	$767.25

PLATE RECON 3.5mm 6 HOLE

Facility

$795.60

Hospital Charge Code	270671857
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$397.80
Rate for Payer: Aetna Commercial	$302.33
Rate for Payer: Aetna Medicare Advantage	$238.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.88
Rate for Payer: Cigna Commercial	$397.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.54
Rate for Payer: Qualcare PPO/HMO/WC	$119.34
Rate for Payer: UnitedHealthcare Community & State	$25.14
Rate for Payer: Wellpoint Medicaid Managed Care	$22.60

PLATE RECON 3.5mm 6 HOLE

Facility

$795.60

Hospital Charge Code	270671857
Hospital Revenue Code	278
Min. Negotiated Rate	$119.34
Max. Negotiated Rate	$192.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.54
Rate for Payer: Qualcare PPO/HMO/WC	$119.34

PLATE RECON 3.5x106MM 9HOLE

Facility

$1,881.80

Service Code	HCPCS C1713
Hospital Charge Code	270604373
Hospital Revenue Code	278
Min. Negotiated Rate	$53.44
Max. Negotiated Rate	$940.90
Rate for Payer: Aetna Commercial	$715.08
Rate for Payer: Aetna Medicare Advantage	$564.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.86
Rate for Payer: Cigna Commercial	$940.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.27
Rate for Payer: UnitedHealthcare Community & State	$59.46
Rate for Payer: Wellpoint Medicaid Managed Care	$53.44

PLATE RECON 3.5x106MM 9HOLE

Facility

$1,881.80

Service Code	HCPCS C1713
Hospital Charge Code	270604373
Hospital Revenue Code	278
Min. Negotiated Rate	$282.27
Max. Negotiated Rate	$455.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.40
Rate for Payer: Qualcare PPO/HMO/WC	$282.27

PLATE RECON 3.5x58MM 5HOLE

Facility

$1,464.65

Service Code	HCPCS C1713
Hospital Charge Code	270604369
Hospital Revenue Code	278
Min. Negotiated Rate	$41.60
Max. Negotiated Rate	$732.33
Rate for Payer: Aetna Commercial	$556.57
Rate for Payer: Aetna Medicare Advantage	$439.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.49
Rate for Payer: Cigna Commercial	$732.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.45
Rate for Payer: Qualcare PPO/HMO/WC	$219.70
Rate for Payer: UnitedHealthcare Community & State	$46.28
Rate for Payer: Wellpoint Medicaid Managed Care	$41.60

PLATE RECON 3.5x58MM 5HOLE

Facility

$1,464.65

Service Code	HCPCS C1713
Hospital Charge Code	270604369
Hospital Revenue Code	278
Min. Negotiated Rate	$219.70
Max. Negotiated Rate	$354.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.45
Rate for Payer: Qualcare PPO/HMO/WC	$219.70

PLATE RECONS 10 HOLES 4x120MM

Facility

$4,595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673000
Hospital Revenue Code	278
Min. Negotiated Rate	$130.50
Max. Negotiated Rate	$2,297.50
Rate for Payer: Aetna Commercial	$1,746.10
Rate for Payer: Aetna Medicare Advantage	$1,378.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,171.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,171.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$919.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,171.72
Rate for Payer: Cigna Commercial	$2,297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.99
Rate for Payer: Qualcare PPO/HMO/WC	$689.25
Rate for Payer: UnitedHealthcare Community & State	$145.20
Rate for Payer: Wellpoint Medicaid Managed Care	$130.50

PLATE RECONS 10 HOLES 4x120MM

Facility

$4,595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673000
Hospital Revenue Code	278
Min. Negotiated Rate	$689.25
Max. Negotiated Rate	$1,111.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$919.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.99
Rate for Payer: Qualcare PPO/HMO/WC	$689.25

PLATE REGATTA 14MM 2HOLE

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693475
Hospital Revenue Code	278
Min. Negotiated Rate	$603.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$8,075.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50
Rate for Payer: UnitedHealthcare Community & State	$671.50
Rate for Payer: Wellpoint Medicaid Managed Care	$603.50

PLATE REGATTA 14MM 2HOLE

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693475
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

PLATE REPLICATOR 1.5MM OFFSET

Facility

$5,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270670755
Hospital Revenue Code	278
Min. Negotiated Rate	$156.06
Max. Negotiated Rate	$2,747.50
Rate for Payer: Aetna Commercial	$2,088.10
Rate for Payer: Aetna Medicare Advantage	$1,648.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,401.22
Rate for Payer: Cigna Commercial	$2,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.79
Rate for Payer: Qualcare PPO/HMO/WC	$824.25
Rate for Payer: UnitedHealthcare Community & State	$173.64
Rate for Payer: Wellpoint Medicaid Managed Care	$156.06

PLATE REPLICATOR 1.5MM OFFSET

Facility

$5,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270670755
Hospital Revenue Code	278
Min. Negotiated Rate	$824.25
Max. Negotiated Rate	$1,329.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.79
Rate for Payer: Qualcare PPO/HMO/WC	$824.25

PLATE REPLICATOR 4.5MM OFFSET

Facility

$5,495.55

Hospital Charge Code	270669869
Hospital Revenue Code	278
Min. Negotiated Rate	$824.33
Max. Negotiated Rate	$1,329.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.92
Rate for Payer: Qualcare PPO/HMO/WC	$824.33

PLATE REPLICATOR 4.5MM OFFSET

Facility

$5,495.55

Hospital Charge Code	270669869
Hospital Revenue Code	278
Min. Negotiated Rate	$156.07
Max. Negotiated Rate	$2,747.78
Rate for Payer: Aetna Commercial	$2,088.31
Rate for Payer: Aetna Medicare Advantage	$1,648.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,401.37
Rate for Payer: Cigna Commercial	$2,747.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.92
Rate for Payer: Qualcare PPO/HMO/WC	$824.33
Rate for Payer: UnitedHealthcare Community & State	$173.66
Rate for Payer: Wellpoint Medicaid Managed Care	$156.07

PLATE RIGHT 4 HOLES OLECRANON

Facility

$7,995.00

Hospital Charge Code	270669709
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$1,934.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

PLATE RIGHT 4 HOLES OLECRANON

Facility

$7,995.00

Hospital Charge Code	270669709
Hospital Revenue Code	278
Min. Negotiated Rate	$227.06
Max. Negotiated Rate	$3,997.50
Rate for Payer: Aetna Commercial	$3,038.10
Rate for Payer: Aetna Medicare Advantage	$2,398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,038.72
Rate for Payer: Cigna Commercial	$3,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25
Rate for Payer: UnitedHealthcare Community & State	$252.64
Rate for Payer: Wellpoint Medicaid Managed Care	$227.06

PLATE RIGHT PRIMARY MPJ FUSION

Facility

$8,500.00

Hospital Charge Code	270669678
Hospital Revenue Code	278
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$268.60
Rate for Payer: Wellpoint Medicaid Managed Care	$241.40

PLATE RIGHT PRIMARY MPJ FUSION

Facility

$8,500.00

Hospital Charge Code	270669678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

PLATE RIGHT T

Facility

$5,865.00

Hospital Charge Code	270702598
Hospital Revenue Code	278
Min. Negotiated Rate	$879.75
Max. Negotiated Rate	$1,419.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,419.33
Rate for Payer: Qualcare PPO/HMO/WC	$879.75

PLATE RIGHT T

Facility

$5,865.00

Hospital Charge Code	270702598
Hospital Revenue Code	278
Min. Negotiated Rate	$166.57
Max. Negotiated Rate	$2,932.50
Rate for Payer: Aetna Commercial	$2,228.70
Rate for Payer: Aetna Medicare Advantage	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,495.58
Rate for Payer: Cigna Commercial	$2,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,419.33
Rate for Payer: Qualcare PPO/HMO/WC	$879.75
Rate for Payer: UnitedHealthcare Community & State	$185.33
Rate for Payer: Wellpoint Medicaid Managed Care	$166.57

PLATE ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270679749
Hospital Revenue Code	278
Min. Negotiated Rate	$331.33
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$4,433.33
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00
Rate for Payer: UnitedHealthcare Community & State	$368.67
Rate for Payer: Wellpoint Medicaid Managed Care	$331.33

PLATE ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270679749
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

Know your out-of-pocket cost for care.

All Charges