Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TITAN STR 1.5mm 20HOLE

Facility

$1,022.80

Service Code	HCPCS C1713
Hospital Charge Code	270604091
Hospital Revenue Code	278
Min. Negotiated Rate	$29.05
Max. Negotiated Rate	$511.40
Rate for Payer: Aetna Commercial	$388.66
Rate for Payer: Aetna Medicare Advantage	$306.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.81
Rate for Payer: Cigna Commercial	$511.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.52
Rate for Payer: Qualcare PPO/HMO/WC	$153.42
Rate for Payer: UnitedHealthcare Community & State	$32.32
Rate for Payer: Wellpoint Medicaid Managed Care	$29.05

PLATE TITAN STR 1.5mm 20HOLE

Facility

$1,022.80

Service Code	HCPCS C1713
Hospital Charge Code	270604091
Hospital Revenue Code	278
Min. Negotiated Rate	$153.42
Max. Negotiated Rate	$247.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.52
Rate for Payer: Qualcare PPO/HMO/WC	$153.42

PLATE TITAN STR 2.0mm 20HOLE

Facility

$1,072.25

Service Code	HCPCS C1713
Hospital Charge Code	270603535
Hospital Revenue Code	278
Min. Negotiated Rate	$160.84
Max. Negotiated Rate	$259.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.48
Rate for Payer: Qualcare PPO/HMO/WC	$160.84

PLATE TITAN STR 2.0mm 20HOLE

Facility

$1,072.25

Service Code	HCPCS C1713
Hospital Charge Code	270603535
Hospital Revenue Code	278
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$536.12
Rate for Payer: Aetna Commercial	$407.45
Rate for Payer: Aetna Medicare Advantage	$321.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.42
Rate for Payer: Cigna Commercial	$536.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.48
Rate for Payer: Qualcare PPO/HMO/WC	$160.84
Rate for Payer: UnitedHealthcare Community & State	$33.88
Rate for Payer: Wellpoint Medicaid Managed Care	$30.45

PLATE T LCP 2.0MM 3HOLE/7HOLE

Facility

$1,788.00

Service Code	HCPCS C1713
Hospital Charge Code	270676476
Hospital Revenue Code	278
Min. Negotiated Rate	$50.78
Max. Negotiated Rate	$894.00
Rate for Payer: Aetna Commercial	$679.44
Rate for Payer: Aetna Medicare Advantage	$536.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.94
Rate for Payer: Cigna Commercial	$894.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.70
Rate for Payer: Qualcare PPO/HMO/WC	$268.20
Rate for Payer: UnitedHealthcare Community & State	$56.50
Rate for Payer: Wellpoint Medicaid Managed Care	$50.78

PLATE T LCP 2.0MM 3HOLE/7HOLE

Facility

$1,788.00

Service Code	HCPCS C1713
Hospital Charge Code	270676476
Hospital Revenue Code	278
Min. Negotiated Rate	$268.20
Max. Negotiated Rate	$432.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$357.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.70
Rate for Payer: Qualcare PPO/HMO/WC	$268.20

PLATE TM RVS SHOULDER 20MM

Facility

$18,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270695306
Hospital Revenue Code	278
Min. Negotiated Rate	$531.08
Max. Negotiated Rate	$9,350.00
Rate for Payer: Aetna Commercial	$7,106.00
Rate for Payer: Aetna Medicare Advantage	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,768.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,768.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,740.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,768.50
Rate for Payer: Cigna Commercial	$9,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,525.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,805.00
Rate for Payer: UnitedHealthcare Community & State	$590.92
Rate for Payer: Wellpoint Medicaid Managed Care	$531.08

PLATE TM RVS SHOULDER 20MM

Facility

$18,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270695306
Hospital Revenue Code	278
Min. Negotiated Rate	$2,805.00
Max. Negotiated Rate	$4,525.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,525.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,805.00

PLATE T NARROW 7 HOLE 2.3x15MM

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270657974
Hospital Revenue Code	278
Min. Negotiated Rate	$95.85
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,282.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25
Rate for Payer: UnitedHealthcare Community & State	$106.65
Rate for Payer: Wellpoint Medicaid Managed Care	$95.85

PLATE T NARROW 7 HOLE 2.3x15MM

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270657974
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

PLATE TRACK LAPIPLASTY 2.2MM

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270698029
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

PLATE TRACK LAPIPLASTY 2.2MM

Facility

$2,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270698029
Hospital Revenue Code	278
Min. Negotiated Rate	$77.39
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$1,035.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: Qualcare PPO/HMO/WC	$408.75
Rate for Payer: UnitedHealthcare Community & State	$86.11
Rate for Payer: Wellpoint Medicaid Managed Care	$77.39

PLATE, TTC TORNIER

Facility

$6,375.00

Hospital Charge Code	270339514
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

PLATE, TTC TORNIER

Facility

$6,375.00

Hospital Charge Code	270339514
Hospital Revenue Code	278
Min. Negotiated Rate	$181.05
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$2,422.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25
Rate for Payer: UnitedHealthcare Community & State	$201.45
Rate for Payer: Wellpoint Medicaid Managed Care	$181.05

PLATE TUB 3DI 10H 124MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700624
Hospital Revenue Code	278
Min. Negotiated Rate	$213.98
Max. Negotiated Rate	$3,767.22
Rate for Payer: Aetna Commercial	$2,863.09
Rate for Payer: Aetna Medicare Advantage	$2,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,921.28
Rate for Payer: Cigna Commercial	$3,767.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17
Rate for Payer: UnitedHealthcare Community & State	$238.09
Rate for Payer: Wellpoint Medicaid Managed Care	$213.98

PLATE TUB 3DI 10H 124MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700624
Hospital Revenue Code	278
Min. Negotiated Rate	$1,130.17
Max. Negotiated Rate	$1,823.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17

PLATE TUB 5 HOLE DELTA ORTLOC

Facility

$1,809.00

Service Code	HCPCS C1713
Hospital Charge Code	270704108
Hospital Revenue Code	278
Min. Negotiated Rate	$51.38
Max. Negotiated Rate	$904.50
Rate for Payer: Aetna Commercial	$687.42
Rate for Payer: Aetna Medicare Advantage	$542.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.30
Rate for Payer: Cigna Commercial	$904.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.78
Rate for Payer: Qualcare PPO/HMO/WC	$271.35
Rate for Payer: UnitedHealthcare Community & State	$57.16
Rate for Payer: Wellpoint Medicaid Managed Care	$51.38

PLATE TUB 5 HOLE DELTA ORTLOC

Facility

$1,809.00

Service Code	HCPCS C1713
Hospital Charge Code	270704108
Hospital Revenue Code	278
Min. Negotiated Rate	$271.35
Max. Negotiated Rate	$437.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.78
Rate for Payer: Qualcare PPO/HMO/WC	$271.35

PLATE TUB 8HOLE 95MM

Facility

$2,166.40

Service Code	HCPCS C1713
Hospital Charge Code	270696914
Hospital Revenue Code	278
Min. Negotiated Rate	$324.96
Max. Negotiated Rate	$524.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$524.27
Rate for Payer: Qualcare PPO/HMO/WC	$324.96

PLATE TUB 8HOLE 95MM

Facility

$2,166.40

Service Code	HCPCS C1713
Hospital Charge Code	270696914
Hospital Revenue Code	278
Min. Negotiated Rate	$61.53
Max. Negotiated Rate	$1,083.20
Rate for Payer: Aetna Commercial	$823.23
Rate for Payer: Aetna Medicare Advantage	$649.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$552.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$552.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$433.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$552.43
Rate for Payer: Cigna Commercial	$1,083.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$524.27
Rate for Payer: Qualcare PPO/HMO/WC	$324.96
Rate for Payer: UnitedHealthcare Community & State	$68.46
Rate for Payer: Wellpoint Medicaid Managed Care	$61.53

PLATE TUBULAR 100DEG 5H 61MM

Facility

$575.00

Hospital Charge Code	270676098
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

PLATE TUBULAR 100DEG 5H 61MM

Facility

$575.00

Hospital Charge Code	270676098
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

PLATE TUBULAR 3.5mm 100 DEGREE

Facility

$605.00

Service Code	HCPCS C1713
Hospital Charge Code	270672328
Hospital Revenue Code	278
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$146.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.41
Rate for Payer: Qualcare PPO/HMO/WC	$90.75

PLATE TUBULAR 3.5mm 100 DEGREE

Facility

$605.00

Service Code	HCPCS C1713
Hospital Charge Code	270672328
Hospital Revenue Code	278
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$302.50
Rate for Payer: Aetna Commercial	$229.90
Rate for Payer: Aetna Medicare Advantage	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.28
Rate for Payer: Cigna Commercial	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.41
Rate for Payer: Qualcare PPO/HMO/WC	$90.75
Rate for Payer: UnitedHealthcare Community & State	$19.12
Rate for Payer: Wellpoint Medicaid Managed Care	$17.18

PLATE TWO HOLE SS

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686189
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Know your out-of-pocket cost for care.

All Charges