Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

T-PLATE 2.4MM 6 HOLE

Facility

$4,306.25

Service Code	HCPCS C1713
Hospital Charge Code	270700083
Hospital Revenue Code	278
Min. Negotiated Rate	$122.30
Max. Negotiated Rate	$2,153.12
Rate for Payer: Aetna Commercial	$1,636.38
Rate for Payer: Aetna Medicare Advantage	$1,291.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,098.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,098.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$861.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,098.09
Rate for Payer: Cigna Commercial	$2,153.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.11
Rate for Payer: Qualcare PPO/HMO/WC	$645.94
Rate for Payer: UnitedHealthcare Community & State	$136.08
Rate for Payer: Wellpoint Medicaid Managed Care	$122.30

T-PLATE 2H HEAD 8H SHAFT 53MM

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270653004
Hospital Revenue Code	278
Min. Negotiated Rate	$28.61
Max. Negotiated Rate	$503.68
Rate for Payer: Aetna Commercial	$382.79
Rate for Payer: Aetna Medicare Advantage	$302.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.87
Rate for Payer: Cigna Commercial	$503.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10
Rate for Payer: UnitedHealthcare Community & State	$31.83
Rate for Payer: Wellpoint Medicaid Managed Care	$28.61

T-PLATE 2H HEAD 8H SHAFT 53MM

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270653004
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$243.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

T-PLATE2 HOLE LCP 2.4MM 7HOLE

Facility

$3,150.85

Service Code	HCPCS C1713
Hospital Charge Code	270685438
Hospital Revenue Code	278
Min. Negotiated Rate	$472.63
Max. Negotiated Rate	$762.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.51
Rate for Payer: Qualcare PPO/HMO/WC	$472.63

T-PLATE2 HOLE LCP 2.4MM 7HOLE

Facility

$3,150.85

Service Code	HCPCS C1713
Hospital Charge Code	270685438
Hospital Revenue Code	278
Min. Negotiated Rate	$89.48
Max. Negotiated Rate	$1,575.42
Rate for Payer: Aetna Commercial	$1,197.32
Rate for Payer: Aetna Medicare Advantage	$945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.47
Rate for Payer: Cigna Commercial	$1,575.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.51
Rate for Payer: Qualcare PPO/HMO/WC	$472.63
Rate for Payer: UnitedHealthcare Community & State	$99.57
Rate for Payer: Wellpoint Medicaid Managed Care	$89.48

T-PLATE 3.5MM 3H/3H OBL ANG

Facility

$936.25

Service Code	HCPCS C1713
Hospital Charge Code	270603405
Hospital Revenue Code	278
Min. Negotiated Rate	$26.59
Max. Negotiated Rate	$468.12
Rate for Payer: Aetna Commercial	$355.77
Rate for Payer: Aetna Medicare Advantage	$280.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.74
Rate for Payer: Cigna Commercial	$468.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.57
Rate for Payer: Qualcare PPO/HMO/WC	$140.44
Rate for Payer: UnitedHealthcare Community & State	$29.59
Rate for Payer: Wellpoint Medicaid Managed Care	$26.59

T-PLATE 3.5MM 3H/3H OBL ANG

Facility

$936.25

Service Code	HCPCS C1713
Hospital Charge Code	270603405
Hospital Revenue Code	278
Min. Negotiated Rate	$140.44
Max. Negotiated Rate	$226.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.57
Rate for Payer: Qualcare PPO/HMO/WC	$140.44

T-PLATE 3.5MM 3H/3H RT ANG

Facility

$546.95

Service Code	HCPCS C1713
Hospital Charge Code	270603398
Hospital Revenue Code	278
Min. Negotiated Rate	$82.04
Max. Negotiated Rate	$132.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.36
Rate for Payer: Qualcare PPO/HMO/WC	$82.04

T-PLATE 3.5MM 3H/3H RT ANG

Facility

$546.95

Service Code	HCPCS C1713
Hospital Charge Code	270603398
Hospital Revenue Code	278
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$273.48
Rate for Payer: Aetna Commercial	$207.84
Rate for Payer: Aetna Medicare Advantage	$164.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.47
Rate for Payer: Cigna Commercial	$273.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.36
Rate for Payer: Qualcare PPO/HMO/WC	$82.04
Rate for Payer: UnitedHealthcare Community & State	$17.28
Rate for Payer: Wellpoint Medicaid Managed Care	$15.53

T-PLATE 3.5MM 3H/5H OBL ANG

Facility

$1,019.70

Service Code	HCPCS C1713
Hospital Charge Code	270603407
Hospital Revenue Code	278
Min. Negotiated Rate	$152.96
Max. Negotiated Rate	$246.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96

T-PLATE 3.5MM 3H/5H OBL ANG

Facility

$1,019.70

Service Code	HCPCS C1713
Hospital Charge Code	270603407
Hospital Revenue Code	278
Min. Negotiated Rate	$28.96
Max. Negotiated Rate	$509.85
Rate for Payer: Aetna Commercial	$387.49
Rate for Payer: Aetna Medicare Advantage	$305.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.02
Rate for Payer: Cigna Commercial	$509.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96
Rate for Payer: UnitedHealthcare Community & State	$32.22
Rate for Payer: Wellpoint Medicaid Managed Care	$28.96

T-PLATE 3.5MM 3H/5H RT ANG

Facility

$642.95

Service Code	HCPCS C1713
Hospital Charge Code	270601901
Hospital Revenue Code	278
Min. Negotiated Rate	$96.44
Max. Negotiated Rate	$155.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.59
Rate for Payer: Qualcare PPO/HMO/WC	$96.44

T-PLATE 3.5MM 3H/5H RT ANG

Facility

$642.95

Service Code	HCPCS C1713
Hospital Charge Code	270601901
Hospital Revenue Code	278
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$321.48
Rate for Payer: Aetna Commercial	$244.32
Rate for Payer: Aetna Medicare Advantage	$192.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.95
Rate for Payer: Cigna Commercial	$321.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.59
Rate for Payer: Qualcare PPO/HMO/WC	$96.44
Rate for Payer: UnitedHealthcare Community & State	$20.32
Rate for Payer: Wellpoint Medicaid Managed Care	$18.26

T-PLATE 3.5MM 4H/4H RT ANG

Facility

$565.45

Service Code	HCPCS C1713
Hospital Charge Code	270604310
Hospital Revenue Code	278
Min. Negotiated Rate	$84.82
Max. Negotiated Rate	$136.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.84
Rate for Payer: Qualcare PPO/HMO/WC	$84.82

T-PLATE 3.5MM 4H/4H RT ANG

Facility

$565.45

Service Code	HCPCS C1713
Hospital Charge Code	270604310
Hospital Revenue Code	278
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$282.73
Rate for Payer: Aetna Commercial	$214.87
Rate for Payer: Aetna Medicare Advantage	$169.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.19
Rate for Payer: Cigna Commercial	$282.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.84
Rate for Payer: Qualcare PPO/HMO/WC	$84.82
Rate for Payer: UnitedHealthcare Community & State	$17.87
Rate for Payer: Wellpoint Medicaid Managed Care	$16.06

T-PLATE 3 HOLE 2.7x32MM

Facility

$259.55

Service Code	HCPCS C1713
Hospital Charge Code	270604332
Hospital Revenue Code	278
Min. Negotiated Rate	$38.93
Max. Negotiated Rate	$62.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.81
Rate for Payer: Qualcare PPO/HMO/WC	$38.93

T-PLATE 3 HOLE 2.7x32MM

Facility

$259.55

Service Code	HCPCS C1713
Hospital Charge Code	270604332
Hospital Revenue Code	278
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$129.78
Rate for Payer: Aetna Commercial	$98.63
Rate for Payer: Aetna Medicare Advantage	$77.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.19
Rate for Payer: Cigna Commercial	$129.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.81
Rate for Payer: Qualcare PPO/HMO/WC	$38.93
Rate for Payer: UnitedHealthcare Community & State	$8.20
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

T-PLATE 3 HOLEx5 HOLE 67 mm

Facility

$1,523.35

Service Code	HCPCS C1713
Hospital Charge Code	270679622
Hospital Revenue Code	278
Min. Negotiated Rate	$228.50
Max. Negotiated Rate	$368.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.65
Rate for Payer: Qualcare PPO/HMO/WC	$228.50

T-PLATE 3 HOLEx5 HOLE 67 mm

Facility

$1,523.35

Service Code	HCPCS C1713
Hospital Charge Code	270679622
Hospital Revenue Code	278
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$761.67
Rate for Payer: Aetna Commercial	$578.87
Rate for Payer: Aetna Medicare Advantage	$457.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.45
Rate for Payer: Cigna Commercial	$761.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.65
Rate for Payer: Qualcare PPO/HMO/WC	$228.50
Rate for Payer: UnitedHealthcare Community & State	$48.14
Rate for Payer: Wellpoint Medicaid Managed Care	$43.26

T-PLATE 4 HOLE 20MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270665926
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

T-PLATE 4 HOLE 20MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270665926
Hospital Revenue Code	278
Min. Negotiated Rate	$247.51
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$3,311.70
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25
Rate for Payer: UnitedHealthcare Community & State	$275.39
Rate for Payer: Wellpoint Medicaid Managed Care	$247.51

T-PLATE 4 HOLE 25MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270673663
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

T-PLATE 4 HOLE 25MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270673663
Hospital Revenue Code	278
Min. Negotiated Rate	$247.51
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$3,311.70
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25
Rate for Payer: UnitedHealthcare Community & State	$275.39
Rate for Payer: Wellpoint Medicaid Managed Care	$247.51

T-PLATE 4 HOLE 30MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270671024
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

T-PLATE 4 HOLE 30MM CLAW II

Facility

$8,715.00

Hospital Charge Code	270671024
Hospital Revenue Code	278
Min. Negotiated Rate	$247.51
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$3,311.70
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25
Rate for Payer: UnitedHealthcare Community & State	$275.39
Rate for Payer: Wellpoint Medicaid Managed Care	$247.51

Know your out-of-pocket cost for care.

All Charges