Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATETIB3.5MMVA-LCP4H87MMRT

Facility

$8,831.20

Service Code	HCPCS C1713
Hospital Charge Code	270697561
Hospital Revenue Code	278
Min. Negotiated Rate	$250.81
Max. Negotiated Rate	$4,415.60
Rate for Payer: Aetna Commercial	$3,355.86
Rate for Payer: Aetna Medicare Advantage	$2,649.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,251.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,251.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,766.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,251.96
Rate for Payer: Cigna Commercial	$4,415.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,137.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,324.68
Rate for Payer: UnitedHealthcare Community & State	$279.07
Rate for Payer: Wellpoint Medicaid Managed Care	$250.81

PLATETIB3.5MMVA-LCP4H87MMRT

Facility

$8,831.20

Service Code	HCPCS C1713
Hospital Charge Code	270697561
Hospital Revenue Code	278
Min. Negotiated Rate	$1,324.68
Max. Negotiated Rate	$2,137.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,766.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,137.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,324.68

PLATE TIBIA 10 HOLE DISTAL

Facility

$712.40

Service Code	HCPCS C1713
Hospital Charge Code	270689576
Hospital Revenue Code	278
Min. Negotiated Rate	$20.23
Max. Negotiated Rate	$356.20
Rate for Payer: Aetna Commercial	$270.71
Rate for Payer: Aetna Medicare Advantage	$213.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.66
Rate for Payer: Cigna Commercial	$356.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.40
Rate for Payer: Qualcare PPO/HMO/WC	$106.86
Rate for Payer: UnitedHealthcare Community & State	$22.51
Rate for Payer: Wellpoint Medicaid Managed Care	$20.23

PLATE TIBIA 10 HOLE DISTAL

Facility

$712.40

Service Code	HCPCS C1713
Hospital Charge Code	270689576
Hospital Revenue Code	278
Min. Negotiated Rate	$106.86
Max. Negotiated Rate	$172.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.40
Rate for Payer: Qualcare PPO/HMO/WC	$106.86

PLATE TIBIA 12 HOLES 250MM

Facility

$6,549.00

Hospital Charge Code	270670452
Hospital Revenue Code	278
Min. Negotiated Rate	$982.35
Max. Negotiated Rate	$1,584.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,309.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,584.86
Rate for Payer: Qualcare PPO/HMO/WC	$982.35

PLATE TIBIA 12 HOLES 250MM

Facility

$6,549.00

Hospital Charge Code	270670452
Hospital Revenue Code	278
Min. Negotiated Rate	$185.99
Max. Negotiated Rate	$3,274.50
Rate for Payer: Aetna Commercial	$2,488.62
Rate for Payer: Aetna Medicare Advantage	$1,964.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,669.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,669.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,309.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,669.99
Rate for Payer: Cigna Commercial	$3,274.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,584.86
Rate for Payer: Qualcare PPO/HMO/WC	$982.35
Rate for Payer: UnitedHealthcare Community & State	$206.95
Rate for Payer: Wellpoint Medicaid Managed Care	$185.99

PLATE TIBIA 3.5MM 6H RT

Facility

$4,937.80

Service Code	HCPCS C1713
Hospital Charge Code	270651725
Hospital Revenue Code	278
Min. Negotiated Rate	$140.23
Max. Negotiated Rate	$2,468.90
Rate for Payer: Aetna Commercial	$1,876.36
Rate for Payer: Aetna Medicare Advantage	$1,481.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.14
Rate for Payer: Cigna Commercial	$2,468.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.95
Rate for Payer: Qualcare PPO/HMO/WC	$740.67
Rate for Payer: UnitedHealthcare Community & State	$156.03
Rate for Payer: Wellpoint Medicaid Managed Care	$140.23

PLATE TIBIA 3.5MM 6H RT

Facility

$4,937.80

Service Code	HCPCS C1713
Hospital Charge Code	270651725
Hospital Revenue Code	278
Min. Negotiated Rate	$740.67
Max. Negotiated Rate	$1,194.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.95
Rate for Payer: Qualcare PPO/HMO/WC	$740.67

PLATE TIBIA 3.5MM 8H RT

Facility

$5,098.50

Service Code	HCPCS C1713
Hospital Charge Code	270651849
Hospital Revenue Code	278
Min. Negotiated Rate	$144.80
Max. Negotiated Rate	$2,549.25
Rate for Payer: Aetna Commercial	$1,937.43
Rate for Payer: Aetna Medicare Advantage	$1,529.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.12
Rate for Payer: Cigna Commercial	$2,549.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: Qualcare PPO/HMO/WC	$764.77
Rate for Payer: UnitedHealthcare Community & State	$161.11
Rate for Payer: Wellpoint Medicaid Managed Care	$144.80

PLATE TIBIA 3.5MM 8H RT

Facility

$5,098.50

Service Code	HCPCS C1713
Hospital Charge Code	270651849
Hospital Revenue Code	278
Min. Negotiated Rate	$764.77
Max. Negotiated Rate	$1,233.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: Qualcare PPO/HMO/WC	$764.77

PLATE TIBIA 4.5MM 4H LT

Facility

$6,037.85

Service Code	HCPCS C1713
Hospital Charge Code	270637030
Hospital Revenue Code	278
Min. Negotiated Rate	$171.47
Max. Negotiated Rate	$3,018.93
Rate for Payer: Aetna Commercial	$2,294.38
Rate for Payer: Aetna Medicare Advantage	$1,811.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,539.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,539.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,539.65
Rate for Payer: Cigna Commercial	$3,018.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.16
Rate for Payer: Qualcare PPO/HMO/WC	$905.68
Rate for Payer: UnitedHealthcare Community & State	$190.80
Rate for Payer: Wellpoint Medicaid Managed Care	$171.47

PLATE TIBIA 4.5MM 4H LT

Facility

$6,037.85

Service Code	HCPCS C1713
Hospital Charge Code	270637030
Hospital Revenue Code	278
Min. Negotiated Rate	$905.68
Max. Negotiated Rate	$1,461.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.16
Rate for Payer: Qualcare PPO/HMO/WC	$905.68

PLATE TIBIA 4.5MM 8H LT ST

Facility

$5,280.80

Service Code	HCPCS C1713
Hospital Charge Code	270646083
Hospital Revenue Code	278
Min. Negotiated Rate	$149.97
Max. Negotiated Rate	$2,640.40
Rate for Payer: Aetna Commercial	$2,006.70
Rate for Payer: Aetna Medicare Advantage	$1,584.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.60
Rate for Payer: Cigna Commercial	$2,640.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.95
Rate for Payer: Qualcare PPO/HMO/WC	$792.12
Rate for Payer: UnitedHealthcare Community & State	$166.87
Rate for Payer: Wellpoint Medicaid Managed Care	$149.97

PLATE TIBIA 4.5MM 8H LT ST

Facility

$5,280.80

Service Code	HCPCS C1713
Hospital Charge Code	270646083
Hospital Revenue Code	278
Min. Negotiated Rate	$792.12
Max. Negotiated Rate	$1,277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.95
Rate for Payer: Qualcare PPO/HMO/WC	$792.12

PLATE TIBIA 4.5MM 8H RT

Facility

$6,183.10

Service Code	HCPCS C1713
Hospital Charge Code	270628206
Hospital Revenue Code	278
Min. Negotiated Rate	$175.60
Max. Negotiated Rate	$3,091.55
Rate for Payer: Aetna Commercial	$2,349.58
Rate for Payer: Aetna Medicare Advantage	$1,854.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,576.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,576.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,576.69
Rate for Payer: Cigna Commercial	$3,091.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,496.31
Rate for Payer: Qualcare PPO/HMO/WC	$927.47
Rate for Payer: UnitedHealthcare Community & State	$195.39
Rate for Payer: Wellpoint Medicaid Managed Care	$175.60

PLATE TIBIA 4.5MM 8H RT

Facility

$6,183.10

Service Code	HCPCS C1713
Hospital Charge Code	270628206
Hospital Revenue Code	278
Min. Negotiated Rate	$927.47
Max. Negotiated Rate	$1,496.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,496.31
Rate for Payer: Qualcare PPO/HMO/WC	$927.47

PLATE TIBIA 4.5x226MM 12H RT

Facility

$6,322.15

Hospital Charge Code	270661909
Hospital Revenue Code	278
Min. Negotiated Rate	$179.55
Max. Negotiated Rate	$3,161.07
Rate for Payer: Aetna Commercial	$2,402.42
Rate for Payer: Aetna Medicare Advantage	$1,896.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,612.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,612.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,264.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,612.15
Rate for Payer: Cigna Commercial	$3,161.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.96
Rate for Payer: Qualcare PPO/HMO/WC	$948.32
Rate for Payer: UnitedHealthcare Community & State	$199.78
Rate for Payer: Wellpoint Medicaid Managed Care	$179.55

PLATE TIBIA 4.5x226MM 12H RT

Facility

$6,322.15

Hospital Charge Code	270661909
Hospital Revenue Code	278
Min. Negotiated Rate	$948.32
Max. Negotiated Rate	$1,529.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,264.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.96
Rate for Payer: Qualcare PPO/HMO/WC	$948.32

PLATE TIBIA 4.5x262MM 14H LT

Facility

$6,390.10

Hospital Charge Code	270661914
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$1,546.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x262MM 14H LT

Facility

$6,390.10

Hospital Charge Code	270661914
Hospital Revenue Code	278
Min. Negotiated Rate	$181.48
Max. Negotiated Rate	$3,195.05
Rate for Payer: Aetna Commercial	$2,428.24
Rate for Payer: Aetna Medicare Advantage	$1,917.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,629.48
Rate for Payer: Cigna Commercial	$3,195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51
Rate for Payer: UnitedHealthcare Community & State	$201.93
Rate for Payer: Wellpoint Medicaid Managed Care	$181.48

PLATE TIBIA 4.5x262MM 14H RT

Facility

$6,390.10

Hospital Charge Code	270661911
Hospital Revenue Code	278
Min. Negotiated Rate	$181.48
Max. Negotiated Rate	$3,195.05
Rate for Payer: Aetna Commercial	$2,428.24
Rate for Payer: Aetna Medicare Advantage	$1,917.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,629.48
Rate for Payer: Cigna Commercial	$3,195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51
Rate for Payer: UnitedHealthcare Community & State	$201.93
Rate for Payer: Wellpoint Medicaid Managed Care	$181.48

PLATE TIBIA 4.5x262MM 14H RT

Facility

$6,390.10

Hospital Charge Code	270661911
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$1,546.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x82MM 4H LT ST

Facility

$6,244.90

Hospital Charge Code	270665855
Hospital Revenue Code	278
Min. Negotiated Rate	$936.74
Max. Negotiated Rate	$1,511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,248.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.27
Rate for Payer: Qualcare PPO/HMO/WC	$936.74

PLATE TIBIA 4.5x82MM 4H LT ST

Facility

$6,244.90

Hospital Charge Code	270665855
Hospital Revenue Code	278
Min. Negotiated Rate	$177.36
Max. Negotiated Rate	$3,122.45
Rate for Payer: Aetna Commercial	$2,373.06
Rate for Payer: Aetna Medicare Advantage	$1,873.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,592.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,592.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,248.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,592.45
Rate for Payer: Cigna Commercial	$3,122.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.27
Rate for Payer: Qualcare PPO/HMO/WC	$936.74
Rate for Payer: UnitedHealthcare Community & State	$197.34
Rate for Payer: Wellpoint Medicaid Managed Care	$177.36

PLATE TIBIA 6HOLE 123MM LEFT

Facility

$9,671.00

Service Code	HCPCS C1713
Hospital Charge Code	270675653
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.65
Max. Negotiated Rate	$2,340.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.65

Know your out-of-pocket cost for care.

All Charges