Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CERVICAL 28 MM

Facility

$4,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270691988
Hospital Revenue Code	278
Min. Negotiated Rate	$742.50
Max. Negotiated Rate	$1,197.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: Qualcare PPO/HMO/WC	$742.50

PLATE CERVICAL 28 MM

Facility

$4,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270691988
Hospital Revenue Code	278
Min. Negotiated Rate	$140.58
Max. Negotiated Rate	$2,475.00
Rate for Payer: Aetna Commercial	$1,881.00
Rate for Payer: Aetna Medicare Advantage	$1,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,262.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,262.25
Rate for Payer: Cigna Commercial	$2,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,197.90
Rate for Payer: Qualcare PPO/HMO/WC	$742.50
Rate for Payer: UnitedHealthcare Community & State	$156.42
Rate for Payer: Wellpoint Medicaid Managed Care	$140.58

PLATE CERVICAL 2LEV 32MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694851
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

PLATE CERVICAL 2LEV 32MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695238
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

PLATE CERVICAL 2LEV 32MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695238
Hospital Revenue Code	278
Min. Negotiated Rate	$546.70
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$608.30
Rate for Payer: Wellpoint Medicaid Managed Care	$546.70

PLATE CERVICAL 2LEV 32MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694851
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE CERVICAL 2-LEVEL 24MM

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699098
Hospital Revenue Code	278
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

PLATE CERVICAL 2-LEVEL 24MM

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699098
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

PLATE CERVICAL 2 LEVEL 39MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270657677
Hospital Revenue Code	278
Min. Negotiated Rate	$340.80
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Community & State	$379.20
Rate for Payer: Wellpoint Medicaid Managed Care	$340.80

PLATE CERVICAL 2 LEVEL 39MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270657677
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

PLATE CERVICAL 2 LEVEL 42MM

Facility

$9,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270657672
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

PLATE CERVICAL 2 LEVEL 42MM

Facility

$9,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270657672
Hospital Revenue Code	278
Min. Negotiated Rate	$281.16
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$3,762.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00
Rate for Payer: UnitedHealthcare Community & State	$312.84
Rate for Payer: Wellpoint Medicaid Managed Care	$281.16

PLATE CERVICAL 2 LEVEL 45MM

Facility

$9,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270658057
Hospital Revenue Code	278
Min. Negotiated Rate	$281.16
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$3,762.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00
Rate for Payer: UnitedHealthcare Community & State	$312.84
Rate for Payer: Wellpoint Medicaid Managed Care	$281.16

PLATE CERVICAL 2 LEVEL 45MM

Facility

$9,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270658057
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

PLATE CERVICAL 2 LEVEL 48MM

Facility

$9,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270675718
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

PLATE CERVICAL 2 LEVEL 48MM

Facility

$9,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270675718
Hospital Revenue Code	278
Min. Negotiated Rate	$281.16
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$3,762.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00
Rate for Payer: UnitedHealthcare Community & State	$312.84
Rate for Payer: Wellpoint Medicaid Managed Care	$281.16

PLATE CERVICAL 36MM

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698922
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$4,052.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

PLATE CERVICAL 36MM

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698922
Hospital Revenue Code	278
Min. Negotiated Rate	$475.63
Max. Negotiated Rate	$8,373.75
Rate for Payer: Aetna Commercial	$6,364.05
Rate for Payer: Aetna Medicare Advantage	$5,024.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,270.61
Rate for Payer: Cigna Commercial	$8,373.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12
Rate for Payer: UnitedHealthcare Community & State	$529.22
Rate for Payer: Wellpoint Medicaid Managed Care	$475.63

PLATE CERVICAL 3LEV 48MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694465
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE CERVICAL 3LEV 48MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694465
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

PLATE CERVICAL 3-LEVEL 43MM

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698670
Hospital Revenue Code	278
Min. Negotiated Rate	$475.63
Max. Negotiated Rate	$8,373.75
Rate for Payer: Aetna Commercial	$6,364.05
Rate for Payer: Aetna Medicare Advantage	$5,024.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,270.61
Rate for Payer: Cigna Commercial	$8,373.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12
Rate for Payer: UnitedHealthcare Community & State	$529.22
Rate for Payer: Wellpoint Medicaid Managed Care	$475.63

PLATE CERVICAL 3-LEVEL 43MM

Facility

$16,747.50

Service Code	HCPCS C1713
Hospital Charge Code	270698670
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$4,052.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

PLATE CERVICAL 3LEVEL 45MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694687
Hospital Revenue Code	278
Min. Negotiated Rate	$489.90
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$6,555.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50
Rate for Payer: UnitedHealthcare Community & State	$545.10
Rate for Payer: Wellpoint Medicaid Managed Care	$489.90

PLATE CERVICAL 3LEVEL 45MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694687
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE CERVICAL 3 LEVEL 48MM

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270700539
Hospital Revenue Code	278
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$268.60
Rate for Payer: Wellpoint Medicaid Managed Care	$241.40

Know your out-of-pocket cost for care.

All Charges