Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

T-PLATE 4HOLE 84MM

Facility

$1,248.35

Service Code	HCPCS C1713
Hospital Charge Code	270652907
Hospital Revenue Code	278
Min. Negotiated Rate	$35.45
Max. Negotiated Rate	$624.17
Rate for Payer: Aetna Commercial	$474.37
Rate for Payer: Aetna Medicare Advantage	$374.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.33
Rate for Payer: Cigna Commercial	$624.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.10
Rate for Payer: Qualcare PPO/HMO/WC	$187.25
Rate for Payer: UnitedHealthcare Community & State	$39.45
Rate for Payer: Wellpoint Medicaid Managed Care	$35.45

T-PLATE 4HOLE 84MM

Facility

$1,248.35

Service Code	HCPCS C1713
Hospital Charge Code	270652907
Hospital Revenue Code	278
Min. Negotiated Rate	$187.25
Max. Negotiated Rate	$302.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.10
Rate for Payer: Qualcare PPO/HMO/WC	$187.25

T-PLATE 4 HOLES

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270670803
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

T-PLATE 4 HOLES

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270670803
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

T-PLATE 5H RS

Facility

$5,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692249
Hospital Revenue Code	278
Min. Negotiated Rate	$159.04
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$2,128.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00
Rate for Payer: UnitedHealthcare Community & State	$176.96
Rate for Payer: Wellpoint Medicaid Managed Care	$159.04

T-PLATE 5H RS

Facility

$5,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270692249
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

T-PLATE LCP 2.0MM 2HOLE/9HOLE

Facility

$1,788.00

Service Code	HCPCS C1713
Hospital Charge Code	270659769
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

T-PLATE LCP 2.0MM 2HOLE/9HOLE

Facility

$1,788.00

Service Code	HCPCS C1713
Hospital Charge Code	270659769
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

T-PLATE LCP 2.4MM 3HOLE/7HOLE

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270676530
Hospital Revenue Code	278
Min. Negotiated Rate	$458.87
Max. Negotiated Rate	$740.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: Qualcare PPO/HMO/WC	$458.87

T-PLATE LCP 2.4MM 3HOLE/7HOLE

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270676530
Hospital Revenue Code	278
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,529.55
Rate for Payer: Aetna Commercial	$1,162.46
Rate for Payer: Aetna Medicare Advantage	$917.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.07
Rate for Payer: Cigna Commercial	$1,529.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: Qualcare PPO/HMO/WC	$458.87
Rate for Payer: UnitedHealthcare Community & State	$96.67
Rate for Payer: Wellpoint Medicaid Managed Care	$86.88

T-PLATE LCP 2 HOLE 2.7MM

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270678174
Hospital Revenue Code	278
Min. Negotiated Rate	$458.87
Max. Negotiated Rate	$740.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: Qualcare PPO/HMO/WC	$458.87

T-PLATE LCP 2 HOLE 2.7MM

Facility

$3,059.10

Service Code	HCPCS C1713
Hospital Charge Code	270678174
Hospital Revenue Code	278
Min. Negotiated Rate	$86.88
Max. Negotiated Rate	$1,529.55
Rate for Payer: Aetna Commercial	$1,162.46
Rate for Payer: Aetna Medicare Advantage	$917.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.07
Rate for Payer: Cigna Commercial	$1,529.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.30
Rate for Payer: Qualcare PPO/HMO/WC	$458.87
Rate for Payer: UnitedHealthcare Community & State	$96.67
Rate for Payer: Wellpoint Medicaid Managed Care	$86.88

T-PLATE LCP 3.5x52MM 3H/3H RT

Facility

$1,546.80

Service Code	HCPCS C1713
Hospital Charge Code	270656698
Hospital Revenue Code	278
Min. Negotiated Rate	$232.02
Max. Negotiated Rate	$374.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.33
Rate for Payer: Qualcare PPO/HMO/WC	$232.02

T-PLATE LCP 3.5x52MM 3H/3H RT

Facility

$1,546.80

Service Code	HCPCS C1713
Hospital Charge Code	270656698
Hospital Revenue Code	278
Min. Negotiated Rate	$43.93
Max. Negotiated Rate	$773.40
Rate for Payer: Aetna Commercial	$587.78
Rate for Payer: Aetna Medicare Advantage	$464.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.43
Rate for Payer: Cigna Commercial	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$374.33
Rate for Payer: Qualcare PPO/HMO/WC	$232.02
Rate for Payer: UnitedHealthcare Community & State	$48.88
Rate for Payer: Wellpoint Medicaid Managed Care	$43.93

T-PLATE LCP 3.5x56MM 4H/4H RT

Facility

$1,384.30

Hospital Charge Code	270675318
Hospital Revenue Code	278
Min. Negotiated Rate	$207.65
Max. Negotiated Rate	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.00
Rate for Payer: Qualcare PPO/HMO/WC	$207.65

T-PLATE LCP 3.5x56MM 4H/4H RT

Facility

$1,384.30

Hospital Charge Code	270675318
Hospital Revenue Code	278
Min. Negotiated Rate	$39.31
Max. Negotiated Rate	$692.15
Rate for Payer: Aetna Commercial	$526.03
Rate for Payer: Aetna Medicare Advantage	$415.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.00
Rate for Payer: Cigna Commercial	$692.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.00
Rate for Payer: Qualcare PPO/HMO/WC	$207.65
Rate for Payer: UnitedHealthcare Community & State	$43.74
Rate for Payer: Wellpoint Medicaid Managed Care	$39.31

T-PLATE LCP 3.5x63MM 3H/4H RT

Facility

$1,569.70

Hospital Charge Code	270656699
Hospital Revenue Code	278
Min. Negotiated Rate	$44.58
Max. Negotiated Rate	$784.85
Rate for Payer: Aetna Commercial	$596.49
Rate for Payer: Aetna Medicare Advantage	$470.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.27
Rate for Payer: Cigna Commercial	$784.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.87
Rate for Payer: Qualcare PPO/HMO/WC	$235.46
Rate for Payer: UnitedHealthcare Community & State	$49.60
Rate for Payer: Wellpoint Medicaid Managed Care	$44.58

T-PLATE LCP 3.5x63MM 3H/4H RT

Facility

$1,569.70

Hospital Charge Code	270656699
Hospital Revenue Code	278
Min. Negotiated Rate	$235.46
Max. Negotiated Rate	$379.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$313.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$379.87
Rate for Payer: Qualcare PPO/HMO/WC	$235.46

T-PLATE LCP 3.5x78MM 4H/6H RT

Facility

$1,773.65

Hospital Charge Code	270656700
Hospital Revenue Code	278
Min. Negotiated Rate	$266.05
Max. Negotiated Rate	$429.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.22
Rate for Payer: Qualcare PPO/HMO/WC	$266.05

T-PLATE LCP 3.5x78MM 4H/6H RT

Facility

$1,773.65

Hospital Charge Code	270656700
Hospital Revenue Code	278
Min. Negotiated Rate	$50.37
Max. Negotiated Rate	$886.83
Rate for Payer: Aetna Commercial	$673.99
Rate for Payer: Aetna Medicare Advantage	$532.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.28
Rate for Payer: Cigna Commercial	$886.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.22
Rate for Payer: Qualcare PPO/HMO/WC	$266.05
Rate for Payer: UnitedHealthcare Community & State	$56.05
Rate for Payer: Wellpoint Medicaid Managed Care	$50.37

T-PLATE LCP 4.5x147MM 8HOLE

Facility

$3,411.35

Hospital Charge Code	270666772
Hospital Revenue Code	278
Min. Negotiated Rate	$511.70
Max. Negotiated Rate	$825.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.55
Rate for Payer: Qualcare PPO/HMO/WC	$511.70

T-PLATE LCP 4.5x147MM 8HOLE

Facility

$3,411.35

Hospital Charge Code	270666772
Hospital Revenue Code	278
Min. Negotiated Rate	$96.88
Max. Negotiated Rate	$1,705.67
Rate for Payer: Aetna Commercial	$1,296.31
Rate for Payer: Aetna Medicare Advantage	$1,023.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$869.89
Rate for Payer: Cigna Commercial	$1,705.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.55
Rate for Payer: Qualcare PPO/HMO/WC	$511.70
Rate for Payer: UnitedHealthcare Community & State	$107.80
Rate for Payer: Wellpoint Medicaid Managed Care	$96.88

T-PLATE LCP 4.5x83MM 4HOLE

Facility

$2,577.05

Hospital Charge Code	270671990
Hospital Revenue Code	278
Min. Negotiated Rate	$73.19
Max. Negotiated Rate	$1,288.53
Rate for Payer: Aetna Commercial	$979.28
Rate for Payer: Aetna Medicare Advantage	$773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.15
Rate for Payer: Cigna Commercial	$1,288.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.65
Rate for Payer: Qualcare PPO/HMO/WC	$386.56
Rate for Payer: UnitedHealthcare Community & State	$81.43
Rate for Payer: Wellpoint Medicaid Managed Care	$73.19

T-PLATE LCP 4.5x83MM 4HOLE

Facility

$2,577.05

Hospital Charge Code	270671990
Hospital Revenue Code	278
Min. Negotiated Rate	$386.56
Max. Negotiated Rate	$623.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$623.65
Rate for Payer: Qualcare PPO/HMO/WC	$386.56

T-PLATE LKG NARROW 5H 34MM

Facility

$4,565.20

Service Code	HCPCS C1713
Hospital Charge Code	270700479
Hospital Revenue Code	278
Min. Negotiated Rate	$129.65
Max. Negotiated Rate	$2,282.60
Rate for Payer: Aetna Commercial	$1,734.78
Rate for Payer: Aetna Medicare Advantage	$1,369.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,164.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,164.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$913.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,164.13
Rate for Payer: Cigna Commercial	$2,282.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,104.78
Rate for Payer: Qualcare PPO/HMO/WC	$684.78
Rate for Payer: UnitedHealthcare Community & State	$144.26
Rate for Payer: Wellpoint Medicaid Managed Care	$129.65

Know your out-of-pocket cost for care.

All Charges