Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LC-DCP 3.5x77MM 6HOLE

Facility

$1,667.70

Service Code	HCPCS C1713
Hospital Charge Code	270601896
Hospital Revenue Code	278
Min. Negotiated Rate	$47.36
Max. Negotiated Rate	$833.85
Rate for Payer: Aetna Commercial	$633.73
Rate for Payer: Aetna Medicare Advantage	$500.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.26
Rate for Payer: Cigna Commercial	$833.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.58
Rate for Payer: Qualcare PPO/HMO/WC	$250.16
Rate for Payer: UnitedHealthcare Community & State	$52.70
Rate for Payer: Wellpoint Medicaid Managed Care	$47.36

PLATE LC-DCP 3.5x77MM 6HOLE

Facility

$1,667.70

Service Code	HCPCS C1713
Hospital Charge Code	270601896
Hospital Revenue Code	278
Min. Negotiated Rate	$250.16
Max. Negotiated Rate	$403.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.58
Rate for Payer: Qualcare PPO/HMO/WC	$250.16

PLATE LC-DCP 3.5x90MM 7HOLE

Facility

$665.15

Service Code	HCPCS C1713
Hospital Charge Code	270601895
Hospital Revenue Code	278
Min. Negotiated Rate	$99.77
Max. Negotiated Rate	$160.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.97
Rate for Payer: Qualcare PPO/HMO/WC	$99.77

PLATE LC-DCP 3.5x90MM 7HOLE

Facility

$665.15

Service Code	HCPCS C1713
Hospital Charge Code	270601895
Hospital Revenue Code	278
Min. Negotiated Rate	$18.89
Max. Negotiated Rate	$332.57
Rate for Payer: Aetna Commercial	$252.76
Rate for Payer: Aetna Medicare Advantage	$199.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.61
Rate for Payer: Cigna Commercial	$332.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.97
Rate for Payer: Qualcare PPO/HMO/WC	$99.77
Rate for Payer: UnitedHealthcare Community & State	$21.02
Rate for Payer: Wellpoint Medicaid Managed Care	$18.89

PLATE LC DCP 4HOLE 2.4mm 31mm

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270651720
Hospital Revenue Code	278
Min. Negotiated Rate	$210.43
Max. Negotiated Rate	$339.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43

PLATE LC DCP 4HOLE 2.4mm 31mm

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270651720
Hospital Revenue Code	278
Min. Negotiated Rate	$39.84
Max. Negotiated Rate	$701.42
Rate for Payer: Aetna Commercial	$533.08
Rate for Payer: Aetna Medicare Advantage	$420.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.73
Rate for Payer: Cigna Commercial	$701.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43
Rate for Payer: UnitedHealthcare Community & State	$44.33
Rate for Payer: Wellpoint Medicaid Managed Care	$39.84

PLATE LC DCP 6HOLE 2.4mm 47mm

Facility

$1,575.90

Service Code	HCPCS C1713
Hospital Charge Code	270651721
Hospital Revenue Code	278
Min. Negotiated Rate	$44.76
Max. Negotiated Rate	$787.95
Rate for Payer: Aetna Commercial	$598.84
Rate for Payer: Aetna Medicare Advantage	$472.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.85
Rate for Payer: Cigna Commercial	$787.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.37
Rate for Payer: Qualcare PPO/HMO/WC	$236.38
Rate for Payer: UnitedHealthcare Community & State	$49.80
Rate for Payer: Wellpoint Medicaid Managed Care	$44.76

PLATE LC DCP 6HOLE 2.4mm 47mm

Facility

$1,575.90

Service Code	HCPCS C1713
Hospital Charge Code	270651721
Hospital Revenue Code	278
Min. Negotiated Rate	$236.38
Max. Negotiated Rate	$381.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.37
Rate for Payer: Qualcare PPO/HMO/WC	$236.38

PLATE LC-DCP TITN 3.5MM 10H

Facility

$715.25

Service Code	HCPCS C1713
Hospital Charge Code	270603345
Hospital Revenue Code	278
Min. Negotiated Rate	$107.29
Max. Negotiated Rate	$173.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.09
Rate for Payer: Qualcare PPO/HMO/WC	$107.29

PLATE LC-DCP TITN 3.5MM 10H

Facility

$715.25

Service Code	HCPCS C1713
Hospital Charge Code	270603345
Hospital Revenue Code	278
Min. Negotiated Rate	$20.31
Max. Negotiated Rate	$357.62
Rate for Payer: Aetna Commercial	$271.80
Rate for Payer: Aetna Medicare Advantage	$214.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.39
Rate for Payer: Cigna Commercial	$357.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.09
Rate for Payer: Qualcare PPO/HMO/WC	$107.29
Rate for Payer: UnitedHealthcare Community & State	$22.60
Rate for Payer: Wellpoint Medicaid Managed Care	$20.31

PLATE LCP 10HOLE 3.5x137MM

Facility

$1,509.00

Hospital Charge Code	270677336
Hospital Revenue Code	278
Min. Negotiated Rate	$226.35
Max. Negotiated Rate	$365.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.18
Rate for Payer: Qualcare PPO/HMO/WC	$226.35

PLATE LCP 10HOLE 3.5x137MM

Facility

$1,509.00

Hospital Charge Code	270677336
Hospital Revenue Code	278
Min. Negotiated Rate	$42.86
Max. Negotiated Rate	$754.50
Rate for Payer: Aetna Commercial	$573.42
Rate for Payer: Aetna Medicare Advantage	$452.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.80
Rate for Payer: Cigna Commercial	$754.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.18
Rate for Payer: Qualcare PPO/HMO/WC	$226.35
Rate for Payer: UnitedHealthcare Community & State	$47.68
Rate for Payer: Wellpoint Medicaid Managed Care	$42.86

PLATE LCP 1/3 TUBULAR 4H 57MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270671206
Hospital Revenue Code	278
Min. Negotiated Rate	$20.97
Max. Negotiated Rate	$369.20
Rate for Payer: Aetna Commercial	$280.59
Rate for Payer: Aetna Medicare Advantage	$221.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.29
Rate for Payer: Cigna Commercial	$369.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: Qualcare PPO/HMO/WC	$110.76
Rate for Payer: UnitedHealthcare Community & State	$23.33
Rate for Payer: Wellpoint Medicaid Managed Care	$20.97

PLATE LCP 1/3 TUBULAR 4H 57MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270671206
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$178.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: Qualcare PPO/HMO/WC	$110.76

PLATE LCP 1/3 TUBULAR 6H 69MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270648519
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$178.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: Qualcare PPO/HMO/WC	$110.76

PLATE LCP 1/3 TUBULAR 6H 69MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270648519
Hospital Revenue Code	278
Min. Negotiated Rate	$20.97
Max. Negotiated Rate	$369.20
Rate for Payer: Aetna Commercial	$280.59
Rate for Payer: Aetna Medicare Advantage	$221.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.29
Rate for Payer: Cigna Commercial	$369.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: Qualcare PPO/HMO/WC	$110.76
Rate for Payer: UnitedHealthcare Community & State	$23.33
Rate for Payer: Wellpoint Medicaid Managed Care	$20.97

PLATE LCP 1/3 TUBULAR 7H 81MM

Facility

$754.30

Service Code	HCPCS C1713
Hospital Charge Code	270645152
Hospital Revenue Code	278
Min. Negotiated Rate	$113.14
Max. Negotiated Rate	$182.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.54
Rate for Payer: Qualcare PPO/HMO/WC	$113.14

PLATE LCP 1/3 TUBULAR 7H 81MM

Facility

$754.30

Service Code	HCPCS C1713
Hospital Charge Code	270645152
Hospital Revenue Code	278
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$377.15
Rate for Payer: Aetna Commercial	$286.63
Rate for Payer: Aetna Medicare Advantage	$226.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.35
Rate for Payer: Cigna Commercial	$377.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.54
Rate for Payer: Qualcare PPO/HMO/WC	$113.14
Rate for Payer: UnitedHealthcare Community & State	$23.84
Rate for Payer: Wellpoint Medicaid Managed Care	$21.42

PLATE LCP 1/3 TUBULAR 8H 93MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270637257
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$302.37
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36
Rate for Payer: UnitedHealthcare Community & State	$25.14
Rate for Payer: Wellpoint Medicaid Managed Care	$22.60

PLATE LCP 1/3 TUBULAR 8H 93MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270637257
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULR 10H 117MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270653166
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$302.37
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36
Rate for Payer: UnitedHealthcare Community & State	$25.14
Rate for Payer: Wellpoint Medicaid Managed Care	$22.60

PLATE LCP 1/3 TUBULR 10H 117MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270653166
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULR 12H 141MM

Facility

$797.20

Hospital Charge Code	270656708
Hospital Revenue Code	278
Min. Negotiated Rate	$22.64
Max. Negotiated Rate	$398.60
Rate for Payer: Aetna Commercial	$302.94
Rate for Payer: Aetna Medicare Advantage	$239.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.29
Rate for Payer: Cigna Commercial	$398.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: Qualcare PPO/HMO/WC	$119.58
Rate for Payer: UnitedHealthcare Community & State	$25.19
Rate for Payer: Wellpoint Medicaid Managed Care	$22.64

PLATE LCP 1/3 TUBULR 12H 141MM

Facility

$797.20

Hospital Charge Code	270656708
Hospital Revenue Code	278
Min. Negotiated Rate	$119.58
Max. Negotiated Rate	$192.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: Qualcare PPO/HMO/WC	$119.58

PLATE LCP 1.5MM 6HOLE W/GUIDES

Facility

$1,112.40

Service Code	HCPCS C1713
Hospital Charge Code	270666006
Hospital Revenue Code	278
Min. Negotiated Rate	$166.86
Max. Negotiated Rate	$269.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.86

Know your out-of-pocket cost for care.

All Charges