Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE STR TUB 6 HOL ORTHOLOG

Facility

$12,510.00

Service Code	HCPCS C1713
Hospital Charge Code	270701111
Hospital Revenue Code	278
Min. Negotiated Rate	$1,876.50
Max. Negotiated Rate	$3,027.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,502.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,027.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,876.50

PLATE STR TUB 6 HOL ORTHOLOG

Facility

$12,510.00

Service Code	HCPCS C1713
Hospital Charge Code	270701111
Hospital Revenue Code	278
Min. Negotiated Rate	$355.28
Max. Negotiated Rate	$6,255.00
Rate for Payer: Aetna Commercial	$4,753.80
Rate for Payer: Aetna Medicare Advantage	$3,753.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,190.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,190.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,190.05
Rate for Payer: Cigna Commercial	$6,255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,027.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,876.50
Rate for Payer: UnitedHealthcare Community & State	$395.32
Rate for Payer: Wellpoint Medicaid Managed Care	$355.28

PLATE SUPPORT SINUS TARSI RT M

Facility

$5,981.25

Service Code	HCPCS C1713
Hospital Charge Code	270701521
Hospital Revenue Code	278
Min. Negotiated Rate	$169.87
Max. Negotiated Rate	$2,990.62
Rate for Payer: Aetna Commercial	$2,272.88
Rate for Payer: Aetna Medicare Advantage	$1,794.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,525.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,525.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,525.22
Rate for Payer: Cigna Commercial	$2,990.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.46
Rate for Payer: Qualcare PPO/HMO/WC	$897.19
Rate for Payer: UnitedHealthcare Community & State	$189.01
Rate for Payer: Wellpoint Medicaid Managed Care	$169.87

PLATE SUPPORT SINUS TARSI RT M

Facility

$5,981.25

Service Code	HCPCS C1713
Hospital Charge Code	270701521
Hospital Revenue Code	278
Min. Negotiated Rate	$897.19
Max. Negotiated Rate	$1,447.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.46
Rate for Payer: Qualcare PPO/HMO/WC	$897.19

PLATE SUPR MID CURV 10H 122MM

Facility

$8,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270673668
Hospital Revenue Code	278
Min. Negotiated Rate	$237.14
Max. Negotiated Rate	$4,175.00
Rate for Payer: Aetna Commercial	$3,173.00
Rate for Payer: Aetna Medicare Advantage	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,129.25
Rate for Payer: Cigna Commercial	$4,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50
Rate for Payer: UnitedHealthcare Community & State	$263.86
Rate for Payer: Wellpoint Medicaid Managed Care	$237.14

PLATE SUPR MID CURV 10H 122MM

Facility

$8,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270673668
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$2,020.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

PLATE SYN 1/3 TUB 8H 236108

Facility

$222.30

Service Code	HCPCS C1713
Hospital Charge Code	270607164
Hospital Revenue Code	278
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$111.15
Rate for Payer: Aetna Commercial	$84.47
Rate for Payer: Aetna Medicare Advantage	$66.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.69
Rate for Payer: Cigna Commercial	$111.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.80
Rate for Payer: Qualcare PPO/HMO/WC	$33.34
Rate for Payer: UnitedHealthcare Community & State	$7.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

PLATE SYN 1/3 TUB 8H 236108

Facility

$222.30

Service Code	HCPCS C1713
Hospital Charge Code	270607164
Hospital Revenue Code	278
Min. Negotiated Rate	$33.34
Max. Negotiated Rate	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.80
Rate for Payer: Qualcare PPO/HMO/WC	$33.34

PLATE SYN BROAD 9H 226.59

Facility

$1,027.25

Service Code	HCPCS C1713
Hospital Charge Code	270619713
Hospital Revenue Code	278
Min. Negotiated Rate	$154.09
Max. Negotiated Rate	$248.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.59
Rate for Payer: Qualcare PPO/HMO/WC	$154.09

PLATE SYN BROAD 9H 226.59

Facility

$1,027.25

Service Code	HCPCS C1713
Hospital Charge Code	270619713
Hospital Revenue Code	278
Min. Negotiated Rate	$29.17
Max. Negotiated Rate	$513.62
Rate for Payer: Aetna Commercial	$390.36
Rate for Payer: Aetna Medicare Advantage	$308.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.95
Rate for Payer: Cigna Commercial	$513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.59
Rate for Payer: Qualcare PPO/HMO/WC	$154.09
Rate for Payer: UnitedHealthcare Community & State	$32.46
Rate for Payer: Wellpoint Medicaid Managed Care	$29.17

PLATE SYNDE LAT RT101MM ORTLCK

Facility

$2,325.00

Hospital Charge Code	270701059
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

PLATE SYNDE LAT RT101MM ORTLCK

Facility

$2,325.00

Hospital Charge Code	270701059
Hospital Revenue Code	278
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$73.47
Rate for Payer: Wellpoint Medicaid Managed Care	$66.03

PLATE SYST PLANTAR PARATROOPER

Facility

$4,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700495
Hospital Revenue Code	278
Min. Negotiated Rate	$134.19
Max. Negotiated Rate	$2,362.50
Rate for Payer: Aetna Commercial	$1,795.50
Rate for Payer: Aetna Medicare Advantage	$1,417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,204.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,204.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,204.88
Rate for Payer: Cigna Commercial	$2,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.45
Rate for Payer: Qualcare PPO/HMO/WC	$708.75
Rate for Payer: UnitedHealthcare Community & State	$149.31
Rate for Payer: Wellpoint Medicaid Managed Care	$134.19

PLATE SYST PLANTAR PARATROOPER

Facility

$4,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700495
Hospital Revenue Code	278
Min. Negotiated Rate	$708.75
Max. Negotiated Rate	$1,143.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,143.45
Rate for Payer: Qualcare PPO/HMO/WC	$708.75

PLATE T 12 HOLES

Facility

$2,240.25

Service Code	HCPCS C1713
Hospital Charge Code	270680075
Hospital Revenue Code	278
Min. Negotiated Rate	$63.62
Max. Negotiated Rate	$1,120.12
Rate for Payer: Aetna Commercial	$851.29
Rate for Payer: Aetna Medicare Advantage	$672.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$448.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.26
Rate for Payer: Cigna Commercial	$1,120.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.14
Rate for Payer: Qualcare PPO/HMO/WC	$336.04
Rate for Payer: UnitedHealthcare Community & State	$70.79
Rate for Payer: Wellpoint Medicaid Managed Care	$63.62

PLATE T 12 HOLES

Facility

$2,240.25

Service Code	HCPCS C1713
Hospital Charge Code	270680075
Hospital Revenue Code	278
Min. Negotiated Rate	$336.04
Max. Negotiated Rate	$542.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$448.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.14
Rate for Payer: Qualcare PPO/HMO/WC	$336.04

PLATE T 2.0 MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689801
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 T 2.0 MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689801
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 T 8 HOLES/148MM

Facility

$2,020.85

Service Code	HCPCS C1713
Hospital Charge Code	270655717
Hospital Revenue Code	278
Min. Negotiated Rate	$303.13
Max. Negotiated Rate	$489.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.13

PLATE T 8 HOLES/148MM

Facility

$2,020.85

Service Code	HCPCS C1713
Hospital Charge Code	270655717
Hospital Revenue Code	278
Min. Negotiated Rate	$57.39
Max. Negotiated Rate	$1,010.42
Rate for Payer: Aetna Commercial	$767.92
Rate for Payer: Aetna Medicare Advantage	$606.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.32
Rate for Payer: Cigna Commercial	$1,010.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$489.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.13
Rate for Payer: UnitedHealthcare Community & State	$63.86
Rate for Payer: Wellpoint Medicaid Managed Care	$57.39

PLATE TACK

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270684668
Hospital Revenue Code	278
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$89.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

PLATE TACK

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270684668
Hospital Revenue Code	278
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.54
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Community & State	$11.69
Rate for Payer: Wellpoint Medicaid Managed Care	$10.51

PLATE TACK

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	270669449
Hospital Revenue Code	278
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

PLATE TACK

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	270669449
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$55.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

PLATE TARSI SUPPORT RT.MED

Facility

$5,981.25

Hospital Charge Code	270701494
Hospital Revenue Code	278
Min. Negotiated Rate	$897.19
Max. Negotiated Rate	$1,447.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,196.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,447.46
Rate for Payer: Qualcare PPO/HMO/WC	$897.19

Know your out-of-pocket cost for care.

All Charges