Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TARSI SUPPORT RT.MED

Facility

$5,981.25

Hospital Charge Code	270701494
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 TEMP P.H

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270683198
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 TEMP P.H

Facility

$370.00

Service Code	HCPCS C1713
Hospital Charge Code	270683198
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 T-FUSION 2.4/2.7MM SHRT

Facility

$3,956.10

Service Code	HCPCS C1713
Hospital Charge Code	270683197
Hospital Revenue Code	278
Min. Negotiated Rate	$112.35
Max. Negotiated Rate	$1,978.05
Rate for Payer: Aetna Commercial	$1,503.32
Rate for Payer: Aetna Medicare Advantage	$1,186.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.81
Rate for Payer: Cigna Commercial	$1,978.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.38
Rate for Payer: Qualcare PPO/HMO/WC	$593.41
Rate for Payer: UnitedHealthcare Community & State	$125.01
Rate for Payer: Wellpoint Medicaid Managed Care	$112.35

PLATE T-FUSION 2.4/2.7MM SHRT

Facility

$3,956.10

Service Code	HCPCS C1713
Hospital Charge Code	270683197
Hospital Revenue Code	278
Min. Negotiated Rate	$593.41
Max. Negotiated Rate	$957.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$791.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$957.38
Rate for Payer: Qualcare PPO/HMO/WC	$593.41

PLATE T-FUSION 2.4/2.7MM STD

Facility

$3,822.00

Service Code	HCPCS C1713
Hospital Charge Code	270677232
Hospital Revenue Code	278
Min. Negotiated Rate	$573.30
Max. Negotiated Rate	$924.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$764.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$924.92
Rate for Payer: Qualcare PPO/HMO/WC	$573.30

PLATE T-FUSION 2.4/2.7MM STD

Facility

$3,822.00

Service Code	HCPCS C1713
Hospital Charge Code	270677232
Hospital Revenue Code	278
Min. Negotiated Rate	$108.54
Max. Negotiated Rate	$1,911.00
Rate for Payer: Aetna Commercial	$1,452.36
Rate for Payer: Aetna Medicare Advantage	$1,146.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$974.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$974.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$764.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$974.61
Rate for Payer: Cigna Commercial	$1,911.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$924.92
Rate for Payer: Qualcare PPO/HMO/WC	$573.30
Rate for Payer: UnitedHealthcare Community & State	$120.78
Rate for Payer: Wellpoint Medicaid Managed Care	$108.54

PLATE TFUSION 2.4/2.7MM STD 2H

Facility

$3,729.65

Service Code	HCPCS C1713
Hospital Charge Code	270680182
Hospital Revenue Code	278
Min. Negotiated Rate	$559.45
Max. Negotiated Rate	$902.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: Qualcare PPO/HMO/WC	$559.45

PLATE TFUSION 2.4/2.7MM STD 2H

Facility

$3,729.65

Service Code	HCPCS C1713
Hospital Charge Code	270680182
Hospital Revenue Code	278
Min. Negotiated Rate	$105.92
Max. Negotiated Rate	$1,864.83
Rate for Payer: Aetna Commercial	$1,417.27
Rate for Payer: Aetna Medicare Advantage	$1,118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$951.06
Rate for Payer: Cigna Commercial	$1,864.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: Qualcare PPO/HMO/WC	$559.45
Rate for Payer: UnitedHealthcare Community & State	$117.86
Rate for Payer: Wellpoint Medicaid Managed Care	$105.92

PLATE THIRD TUBULAR LCK SS 10H

Facility

$1,400.00

Hospital Charge Code	270664484
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

PLATE THIRD TUBULAR LCK SS 10H

Facility

$1,400.00

Hospital Charge Code	270664484
Hospital Revenue Code	278
Min. Negotiated Rate	$39.76
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$532.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Community & State	$44.24
Rate for Payer: Wellpoint Medicaid Managed Care	$39.76

PLATE THIRD TUBULAR LCK SS 12H

Facility

$1,500.00

Hospital Charge Code	270671906
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

PLATE THIRD TUBULAR LCK SS 12H

Facility

$1,500.00

Hospital Charge Code	270671906
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

PLATE THIRD TUBULAR LKG TI 8H

Facility

$1,436.50

Service Code	HCPCS C1713
Hospital Charge Code	270699386
Hospital Revenue Code	278
Min. Negotiated Rate	$215.47
Max. Negotiated Rate	$347.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.63
Rate for Payer: Qualcare PPO/HMO/WC	$215.47

PLATE THIRD TUBULAR LKG TI 8H

Facility

$1,436.50

Service Code	HCPCS C1713
Hospital Charge Code	270699386
Hospital Revenue Code	278
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$718.25
Rate for Payer: Aetna Commercial	$545.87
Rate for Payer: Aetna Medicare Advantage	$430.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$287.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.31
Rate for Payer: Cigna Commercial	$718.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.63
Rate for Payer: Qualcare PPO/HMO/WC	$215.47
Rate for Payer: UnitedHealthcare Community & State	$45.39
Rate for Payer: Wellpoint Medicaid Managed Care	$40.80

PLATE THIRD TUBULAR LOCK SS 4H

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270671903
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

PLATE THIRD TUBULAR LOCK SS 4H

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270671903
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

PLATE THIRD TUBULAR LOCK SS 5H

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270671904
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

PLATE THIRD TUBULAR LOCK SS 5H

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270671904
Hospital Revenue Code	278
Min. Negotiated Rate	$33.37
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Community & State	$37.13
Rate for Payer: Wellpoint Medicaid Managed Care	$33.37

PLATE THIRD TUBULAR LOCK SS 6H

Facility

$1,200.00

Hospital Charge Code	270671905
Hospital Revenue Code	278
Min. Negotiated Rate	$34.08
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$37.92
Rate for Payer: Wellpoint Medicaid Managed Care	$34.08

PLATE THIRD TUBULAR LOCK SS 6H

Facility

$1,200.00

Hospital Charge Code	270671905
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

PLATE THIRD TUBULAR LOCK SS 7H

Facility

$1,275.00

Hospital Charge Code	270667560
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25

PLATE THIRD TUBULAR LOCK SS 7H

Facility

$1,275.00

Hospital Charge Code	270667560
Hospital Revenue Code	278
Min. Negotiated Rate	$36.21
Max. Negotiated Rate	$637.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.12
Rate for Payer: Cigna Commercial	$637.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.55
Rate for Payer: Qualcare PPO/HMO/WC	$191.25
Rate for Payer: UnitedHealthcare Community & State	$40.29
Rate for Payer: Wellpoint Medicaid Managed Care	$36.21

PLATE THIRD TUBULAR LOCK SS 8H

Facility

$1,325.00

Hospital Charge Code	270665076
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE THIRD TUBULAR LOCK SS 8H

Facility

$1,325.00

Hospital Charge Code	270665076
Hospital Revenue Code	278
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

Know your out-of-pocket cost for care.

All Charges