Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE STR 2.0x23MM 4HOLE

Facility

$258.00

Service Code	HCPCS C1713
Hospital Charge Code	270604328
Hospital Revenue Code	278
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$62.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

PLATE STR 2.0x29MM 5HOLE

Facility

$276.55

Service Code	HCPCS C1713
Hospital Charge Code	270651724
Hospital Revenue Code	278
Min. Negotiated Rate	$41.48
Max. Negotiated Rate	$66.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.93
Rate for Payer: Qualcare PPO/HMO/WC	$41.48

PLATE STR 2.0x29MM 5HOLE

Facility

$276.55

Service Code	HCPCS C1713
Hospital Charge Code	270651724
Hospital Revenue Code	278
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$138.28
Rate for Payer: Aetna Commercial	$105.09
Rate for Payer: Aetna Medicare Advantage	$82.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.52
Rate for Payer: Cigna Commercial	$138.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.93
Rate for Payer: Qualcare PPO/HMO/WC	$41.48
Rate for Payer: UnitedHealthcare Community & State	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$7.85

PLATE STR 6 HOLE 2.0MM STERILE

Facility

$2,542.95

Service Code	HCPCS C1713
Hospital Charge Code	270686759
Hospital Revenue Code	278
Min. Negotiated Rate	$381.44
Max. Negotiated Rate	$615.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.39
Rate for Payer: Qualcare PPO/HMO/WC	$381.44

PLATE STR 6 HOLE 2.0MM STERILE

Facility

$2,542.95

Service Code	HCPCS C1713
Hospital Charge Code	270686759
Hospital Revenue Code	278
Min. Negotiated Rate	$72.22
Max. Negotiated Rate	$1,271.47
Rate for Payer: Aetna Commercial	$966.32
Rate for Payer: Aetna Medicare Advantage	$762.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$648.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$648.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$648.45
Rate for Payer: Cigna Commercial	$1,271.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.39
Rate for Payer: Qualcare PPO/HMO/WC	$381.44
Rate for Payer: UnitedHealthcare Community & State	$80.36
Rate for Payer: Wellpoint Medicaid Managed Care	$72.22

PLATE STRAIGHT 1.5MM 12HOLE

Facility

$1,053.70

Service Code	HCPCS C1713
Hospital Charge Code	270654814
Hospital Revenue Code	278
Min. Negotiated Rate	$29.93
Max. Negotiated Rate	$526.85
Rate for Payer: Aetna Commercial	$400.41
Rate for Payer: Aetna Medicare Advantage	$316.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.69
Rate for Payer: Cigna Commercial	$526.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.06
Rate for Payer: UnitedHealthcare Community & State	$33.30
Rate for Payer: Wellpoint Medicaid Managed Care	$29.93

PLATE STRAIGHT 1.5MM 12HOLE

Facility

$1,053.70

Service Code	HCPCS C1713
Hospital Charge Code	270654814
Hospital Revenue Code	278
Min. Negotiated Rate	$158.06
Max. Negotiated Rate	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.06

PLATE STRAIGHT 1.5MM 6HOLE

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270654812
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

PLATE STRAIGHT 1.5MM 6HOLE

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270654812
Hospital Revenue Code	278
Min. Negotiated Rate	$23.69
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$317.03
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14
Rate for Payer: UnitedHealthcare Community & State	$26.36
Rate for Payer: Wellpoint Medicaid Managed Care	$23.69

PLATE STRAIGHT 2.0MM 12HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654825
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

PLATE STRAIGHT 2.0MM 12HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654825
Hospital Revenue Code	278
Min. Negotiated Rate	$31.15
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$416.84
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54
Rate for Payer: UnitedHealthcare Community & State	$34.66
Rate for Payer: Wellpoint Medicaid Managed Care	$31.15

PLATE STRAIGHT 2.0MM 6HOLE

Facility

$945.30

Service Code	HCPCS C1713
Hospital Charge Code	270654824
Hospital Revenue Code	278
Min. Negotiated Rate	$141.79
Max. Negotiated Rate	$228.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.76
Rate for Payer: Qualcare PPO/HMO/WC	$141.79

PLATE STRAIGHT 2.0MM 6HOLE

Facility

$945.30

Service Code	HCPCS C1713
Hospital Charge Code	270654824
Hospital Revenue Code	278
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$472.65
Rate for Payer: Aetna Commercial	$359.21
Rate for Payer: Aetna Medicare Advantage	$283.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.05
Rate for Payer: Cigna Commercial	$472.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.76
Rate for Payer: Qualcare PPO/HMO/WC	$141.79
Rate for Payer: UnitedHealthcare Community & State	$29.87
Rate for Payer: Wellpoint Medicaid Managed Care	$26.85

PLATE STRAIGHT 2.4MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694872
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE STRAIGHT 2.4MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694872
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

PLATE STRAIGHT 6 HOLE

Facility

$75.00

Service Code	HCPCS C1713
Hospital Charge Code	270698544
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PLATE STRAIGHT 6 HOLE

Facility

$75.00

Service Code	HCPCS C1713
Hospital Charge Code	270698544
Hospital Revenue Code	278
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

PLATE STRAIGHT 6HOLE 2.0MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694674
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE STRAIGHT 6HOLE 2.0MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694674
Hospital Revenue Code	278
Min. Negotiated Rate	$112.89
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Community & State	$125.61
Rate for Payer: Wellpoint Medicaid Managed Care	$112.89

PLATE STRAIGHT 8 HOLE W / COMP

Facility

$4,111.25

Service Code	HCPCS C1713
Hospital Charge Code	270701753
Hospital Revenue Code	278
Min. Negotiated Rate	$616.69
Max. Negotiated Rate	$994.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$994.92
Rate for Payer: Qualcare PPO/HMO/WC	$616.69

PLATE STRAIGHT 8 HOLE W / COMP

Facility

$4,111.25

Service Code	HCPCS C1713
Hospital Charge Code	270701753
Hospital Revenue Code	278
Min. Negotiated Rate	$116.76
Max. Negotiated Rate	$2,055.62
Rate for Payer: Aetna Commercial	$1,562.28
Rate for Payer: Aetna Medicare Advantage	$1,233.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,048.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,048.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$822.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,048.37
Rate for Payer: Cigna Commercial	$2,055.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$994.92
Rate for Payer: Qualcare PPO/HMO/WC	$616.69
Rate for Payer: UnitedHealthcare Community & State	$129.92
Rate for Payer: Wellpoint Medicaid Managed Care	$116.76

PLATE STRA TUB 8 HOLE

Facility

$2,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270701131
Hospital Revenue Code	278
Min. Negotiated Rate	$73.41
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$982.30
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.57
Rate for Payer: Qualcare PPO/HMO/WC	$387.75
Rate for Payer: UnitedHealthcare Community & State	$81.69
Rate for Payer: Wellpoint Medicaid Managed Care	$73.41

PLATE STRA TUB 8 HOLE

Facility

$2,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270701131
Hospital Revenue Code	278
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$625.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.57
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

PLATE STRM STRAIGHT 6HOLE

Facility

$5,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270694321
Hospital Revenue Code	278
Min. Negotiated Rate	$828.75
Max. Negotiated Rate	$1,337.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.05
Rate for Payer: Qualcare PPO/HMO/WC	$828.75

PLATE STRM STRAIGHT 6HOLE

Facility

$5,525.00

Service Code	HCPCS C1713
Hospital Charge Code	270694321
Hospital Revenue Code	278
Min. Negotiated Rate	$156.91
Max. Negotiated Rate	$2,762.50
Rate for Payer: Aetna Commercial	$2,099.50
Rate for Payer: Aetna Medicare Advantage	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,408.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,408.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,408.88
Rate for Payer: Cigna Commercial	$2,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,337.05
Rate for Payer: Qualcare PPO/HMO/WC	$828.75
Rate for Payer: UnitedHealthcare Community & State	$174.59
Rate for Payer: Wellpoint Medicaid Managed Care	$156.91

Know your out-of-pocket cost for care.

All Charges