Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VA LKG CLC 2.7x70MM LTST

Facility

$4,712.25

Hospital Charge Code	270678308
Hospital Revenue Code	278
Min. Negotiated Rate	$706.84
Max. Negotiated Rate	$1,140.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.36
Rate for Payer: Qualcare PPO/HMO/WC	$706.84

PLATE VARIAX COMPR STR 8H102MM

Facility

$4,555.35

Service Code	HCPCS C1713
Hospital Charge Code	270692172
Hospital Revenue Code	278
Min. Negotiated Rate	$129.37
Max. Negotiated Rate	$2,277.68
Rate for Payer: Aetna Commercial	$1,731.03
Rate for Payer: Aetna Medicare Advantage	$1,366.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$911.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,161.61
Rate for Payer: Cigna Commercial	$2,277.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.39
Rate for Payer: Qualcare PPO/HMO/WC	$683.30
Rate for Payer: UnitedHealthcare Community & State	$143.95
Rate for Payer: Wellpoint Medicaid Managed Care	$129.37

PLATE VARIAX COMPR STR 8H102MM

Facility

$4,555.35

Service Code	HCPCS C1713
Hospital Charge Code	270692172
Hospital Revenue Code	278
Min. Negotiated Rate	$683.30
Max. Negotiated Rate	$1,102.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$911.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.39
Rate for Payer: Qualcare PPO/HMO/WC	$683.30

PLATE VARIAX FIBULA 5 HOLES

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270667255
Hospital Revenue Code	278
Min. Negotiated Rate	$686.25
Max. Negotiated Rate	$1,107.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,107.15
Rate for Payer: Qualcare PPO/HMO/WC	$686.25

PLATE VARIAX FIBULA 5 HOLES

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270667255
Hospital Revenue Code	278
Min. Negotiated Rate	$129.93
Max. Negotiated Rate	$2,287.50
Rate for Payer: Aetna Commercial	$1,738.50
Rate for Payer: Aetna Medicare Advantage	$1,372.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,166.62
Rate for Payer: Cigna Commercial	$2,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,107.15
Rate for Payer: Qualcare PPO/HMO/WC	$686.25
Rate for Payer: UnitedHealthcare Community & State	$144.57
Rate for Payer: Wellpoint Medicaid Managed Care	$129.93

PLATE VDF 6 HOLE

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664947
Hospital Revenue Code	278
Min. Negotiated Rate	$134.76
Max. Negotiated Rate	$2,372.50
Rate for Payer: Aetna Commercial	$1,803.10
Rate for Payer: Aetna Medicare Advantage	$1,423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,209.97
Rate for Payer: Cigna Commercial	$2,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: Qualcare PPO/HMO/WC	$711.75
Rate for Payer: UnitedHealthcare Community & State	$149.94
Rate for Payer: Wellpoint Medicaid Managed Care	$134.76

PLATE VDF 6 HOLE

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664947
Hospital Revenue Code	278
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$1,148.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: Qualcare PPO/HMO/WC	$711.75

PLATE VDF 9 HOLES 149mm

Facility

$5,155.00

Hospital Charge Code	270665756
Hospital Revenue Code	278
Min. Negotiated Rate	$773.25
Max. Negotiated Rate	$1,247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,031.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,247.51
Rate for Payer: Qualcare PPO/HMO/WC	$773.25

PLATE VDF 9 HOLES 149mm

Facility

$5,155.00

Hospital Charge Code	270665756
Hospital Revenue Code	278
Min. Negotiated Rate	$146.40
Max. Negotiated Rate	$2,577.50
Rate for Payer: Aetna Commercial	$1,958.90
Rate for Payer: Aetna Medicare Advantage	$1,546.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,314.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,314.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,031.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,314.53
Rate for Payer: Cigna Commercial	$2,577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,247.51
Rate for Payer: Qualcare PPO/HMO/WC	$773.25
Rate for Payer: UnitedHealthcare Community & State	$162.90
Rate for Payer: Wellpoint Medicaid Managed Care	$146.40

PLATE VDR 4HOLE

Facility

$9,075.00

Hospital Charge Code	270703377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

PLATE VDR 4HOLE

Facility

$9,075.00

Hospital Charge Code	270703377
Hospital Revenue Code	278
Min. Negotiated Rate	$257.73
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$286.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.73

PLATE VDR RT NARROW

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270647991
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

PLATE VDR RT NARROW

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270647991
Hospital Revenue Code	278
Min. Negotiated Rate	$161.03
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$2,154.60
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: Qualcare PPO/HMO/WC	$850.50
Rate for Payer: UnitedHealthcare Community & State	$179.17
Rate for Payer: Wellpoint Medicaid Managed Care	$161.03

PLATE VERSA FX 4H 86MM 135 ANG

Facility

$2,126.25

Hospital Charge Code	270673058
Hospital Revenue Code	278
Min. Negotiated Rate	$318.94
Max. Negotiated Rate	$514.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.55
Rate for Payer: Qualcare PPO/HMO/WC	$318.94

PLATE VERSA FX 4H 86MM 135 ANG

Facility

$2,126.25

Hospital Charge Code	270673058
Hospital Revenue Code	278
Min. Negotiated Rate	$60.39
Max. Negotiated Rate	$1,063.12
Rate for Payer: Aetna Commercial	$807.98
Rate for Payer: Aetna Medicare Advantage	$637.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$542.19
Rate for Payer: Cigna Commercial	$1,063.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.55
Rate for Payer: Qualcare PPO/HMO/WC	$318.94
Rate for Payer: UnitedHealthcare Community & State	$67.19
Rate for Payer: Wellpoint Medicaid Managed Care	$60.39

PLATE VHS 6HOLE KEYLESS 200306

Facility

$422.00

Hospital Charge Code	270635311
Hospital Revenue Code	278
Min. Negotiated Rate	$63.30
Max. Negotiated Rate	$102.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.12
Rate for Payer: Qualcare PPO/HMO/WC	$63.30

PLATE VHS 6HOLE KEYLESS 200306

Facility

$422.00

Hospital Charge Code	270635311
Hospital Revenue Code	278
Min. Negotiated Rate	$11.98
Max. Negotiated Rate	$211.00
Rate for Payer: Aetna Commercial	$160.36
Rate for Payer: Aetna Medicare Advantage	$126.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.61
Rate for Payer: Cigna Commercial	$211.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.12
Rate for Payer: Qualcare PPO/HMO/WC	$63.30
Rate for Payer: UnitedHealthcare Community & State	$13.34
Rate for Payer: Wellpoint Medicaid Managed Care	$11.98

PLATE VOLAR DIST RADIUS 3H/LF

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678459
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 VOLAR DIST RADIUS 3H/LF

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678459
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 VOLAR DR L54 4 HOLE

Facility

$9,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705669
Hospital Revenue Code	278
Min. Negotiated Rate	$257.73
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$3,448.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
Rate for Payer: UnitedHealthcare Community & State	$286.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.73

PLATE VOLAR DR L54 4 HOLE

Facility

$9,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705669
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

PLATE VOLAR RADIUS 3H L STD

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270661791
Hospital Revenue Code	278
Min. Negotiated Rate	$127.09
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,700.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25
Rate for Payer: UnitedHealthcare Community & State	$141.41
Rate for Payer: Wellpoint Medicaid Managed Care	$127.09

PLATE VOLAR RADIUS 3H L STD

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270661791
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE WAISTED COMPR 10H 136MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270671803
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED COMPR 10H 136MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270671803
Hospital Revenue Code	278
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$499.70
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25
Rate for Payer: UnitedHealthcare Community & State	$41.55
Rate for Payer: Wellpoint Medicaid Managed Care	$37.35

Know your out-of-pocket cost for care.

All Charges