Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$31.59
Max. Negotiated Rate	$556.20
Rate for Payer: Aetna Commercial	$422.71
Rate for Payer: Aetna Medicare Advantage	$333.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.66
Rate for Payer: Cigna Commercial	$556.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.86
Rate for Payer: UnitedHealthcare Community & State	$35.15
Rate for Payer: Wellpoint Medicaid Managed Care	$31.59

PLATE LCP 2.0 6 HOLE

Facility

$1,515.80

Hospital Charge Code	270671710
Hospital Revenue Code	278
Min. Negotiated Rate	$227.37
Max. Negotiated Rate	$366.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.82
Rate for Payer: Qualcare PPO/HMO/WC	$227.37

PLATE LCP 2.0 6 HOLE

Facility

$1,515.80

Hospital Charge Code	270671710
Hospital Revenue Code	278
Min. Negotiated Rate	$43.05
Max. Negotiated Rate	$757.90
Rate for Payer: Aetna Commercial	$576.00
Rate for Payer: Aetna Medicare Advantage	$454.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.53
Rate for Payer: Cigna Commercial	$757.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.82
Rate for Payer: Qualcare PPO/HMO/WC	$227.37
Rate for Payer: UnitedHealthcare Community & State	$47.90
Rate for Payer: Wellpoint Medicaid Managed Care	$43.05

PLATE LCP 2.0x38MM 5HOLE

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270671287
Hospital Revenue Code	278
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$520.67
Rate for Payer: Aetna Commercial	$395.71
Rate for Payer: Aetna Medicare Advantage	$312.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.54
Rate for Payer: Cigna Commercial	$520.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.20
Rate for Payer: UnitedHealthcare Community & State	$32.91
Rate for Payer: Wellpoint Medicaid Managed Care	$29.57

PLATE LCP 2.0x38MM 5HOLE

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270671287
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$252.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.20

PLATE LCP 2.0x45MM 6HOLE

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270667131
Hospital Revenue Code	278
Min. Negotiated Rate	$30.46
Max. Negotiated Rate	$536.30
Rate for Payer: Aetna Commercial	$407.59
Rate for Payer: Aetna Medicare Advantage	$321.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.51
Rate for Payer: Cigna Commercial	$536.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89
Rate for Payer: UnitedHealthcare Community & State	$33.89
Rate for Payer: Wellpoint Medicaid Managed Care	$30.46

PLATE LCP 2.0x45MM 6HOLE

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270667131
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$259.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89

PLATE LCP 2.0x52MM 7H

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270675499
Hospital Revenue Code	278
Min. Negotiated Rate	$30.46
Max. Negotiated Rate	$536.30
Rate for Payer: Aetna Commercial	$407.59
Rate for Payer: Aetna Medicare Advantage	$321.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.51
Rate for Payer: Cigna Commercial	$536.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89
Rate for Payer: UnitedHealthcare Community & State	$33.89
Rate for Payer: Wellpoint Medicaid Managed Care	$30.46

PLATE LCP 2.0x52MM 7H

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270675499
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$259.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89

PLATE LCP 2.4MM RAD HD 2H RT

Facility

$2,595.60

Service Code	HCPCS C1713
Hospital Charge Code	270675285
Hospital Revenue Code	278
Min. Negotiated Rate	$73.72
Max. Negotiated Rate	$1,297.80
Rate for Payer: Aetna Commercial	$986.33
Rate for Payer: Aetna Medicare Advantage	$778.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.88
Rate for Payer: Cigna Commercial	$1,297.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.14
Rate for Payer: Qualcare PPO/HMO/WC	$389.34
Rate for Payer: UnitedHealthcare Community & State	$82.02
Rate for Payer: Wellpoint Medicaid Managed Care	$73.72

PLATE LCP 2.4MM RAD HD 2H RT

Facility

$2,595.60

Service Code	HCPCS C1713
Hospital Charge Code	270675285
Hospital Revenue Code	278
Min. Negotiated Rate	$389.34
Max. Negotiated Rate	$628.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.14
Rate for Payer: Qualcare PPO/HMO/WC	$389.34

PLATE LCP 2.4x44MM 5HOLE

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270659768
Hospital Revenue Code	278
Min. Negotiated Rate	$47.30
Max. Negotiated Rate	$832.75
Rate for Payer: Aetna Commercial	$632.89
Rate for Payer: Aetna Medicare Advantage	$499.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.70
Rate for Payer: Cigna Commercial	$832.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.05
Rate for Payer: Qualcare PPO/HMO/WC	$249.82
Rate for Payer: UnitedHealthcare Community & State	$52.63
Rate for Payer: Wellpoint Medicaid Managed Care	$47.30

PLATE LCP 2.4x44MM 5HOLE

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270659768
Hospital Revenue Code	278
Min. Negotiated Rate	$249.82
Max. Negotiated Rate	$403.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.05
Rate for Payer: Qualcare PPO/HMO/WC	$249.82

PLATE LCP 2.73/3.5MM

Facility

$8,824.40

Service Code	HCPCS C1713
Hospital Charge Code	270688202
Hospital Revenue Code	278
Min. Negotiated Rate	$250.61
Max. Negotiated Rate	$4,412.20
Rate for Payer: Aetna Commercial	$3,353.27
Rate for Payer: Aetna Medicare Advantage	$2,647.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,250.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,250.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,250.22
Rate for Payer: Cigna Commercial	$4,412.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.66
Rate for Payer: UnitedHealthcare Community & State	$278.85
Rate for Payer: Wellpoint Medicaid Managed Care	$250.61

PLATE LCP 2.73/3.5MM

Facility

$8,824.40

Service Code	HCPCS C1713
Hospital Charge Code	270688202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,323.66
Max. Negotiated Rate	$2,135.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.66

PLATE LCP 2.7/3.5MM FIB 5H LFT

Facility

$2,688.00

Hospital Charge Code	270676814
Hospital Revenue Code	278
Min. Negotiated Rate	$76.34
Max. Negotiated Rate	$1,344.00
Rate for Payer: Aetna Commercial	$1,021.44
Rate for Payer: Aetna Medicare Advantage	$806.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.44
Rate for Payer: Cigna Commercial	$1,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.50
Rate for Payer: Qualcare PPO/HMO/WC	$403.20
Rate for Payer: UnitedHealthcare Community & State	$84.94
Rate for Payer: Wellpoint Medicaid Managed Care	$76.34

PLATE LCP 2.7/3.5MM FIB 5H LFT

Facility

$2,688.00

Hospital Charge Code	270676814
Hospital Revenue Code	278
Min. Negotiated Rate	$403.20
Max. Negotiated Rate	$650.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.50
Rate for Payer: Qualcare PPO/HMO/WC	$403.20

PLATE LCP 2.7x94MM 10HOLE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270675842
Hospital Revenue Code	278
Min. Negotiated Rate	$263.73
Max. Negotiated Rate	$425.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: Qualcare PPO/HMO/WC	$263.73

PLATE LCP 2.7x94MM 10HOLE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270675842
Hospital Revenue Code	278
Min. Negotiated Rate	$49.93
Max. Negotiated Rate	$879.10
Rate for Payer: Aetna Commercial	$668.12
Rate for Payer: Aetna Medicare Advantage	$527.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.34
Rate for Payer: Cigna Commercial	$879.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: Qualcare PPO/HMO/WC	$263.73
Rate for Payer: UnitedHealthcare Community & State	$55.56
Rate for Payer: Wellpoint Medicaid Managed Care	$49.93

PLATE LCP 2MM 8 HOLE

Facility

$1,011.00

Hospital Charge Code	270673372
Hospital Revenue Code	278
Min. Negotiated Rate	$28.71
Max. Negotiated Rate	$505.50
Rate for Payer: Aetna Commercial	$384.18
Rate for Payer: Aetna Medicare Advantage	$303.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.81
Rate for Payer: Cigna Commercial	$505.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.66
Rate for Payer: Qualcare PPO/HMO/WC	$151.65
Rate for Payer: UnitedHealthcare Community & State	$31.95
Rate for Payer: Wellpoint Medicaid Managed Care	$28.71

PLATE LCP 2MM 8 HOLE

Facility

$1,011.00

Hospital Charge Code	270673372
Hospital Revenue Code	278
Min. Negotiated Rate	$151.65
Max. Negotiated Rate	$244.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.66
Rate for Payer: Qualcare PPO/HMO/WC	$151.65

PLATE LCP 3.5 5 HOLE

Facility

$7,154.70

Service Code	HCPCS C1713
Hospital Charge Code	270684399
Hospital Revenue Code	278
Min. Negotiated Rate	$1,073.20
Max. Negotiated Rate	$1,731.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.20

PLATE LCP 3.5 5 HOLE

Facility

$7,154.70

Service Code	HCPCS C1713
Hospital Charge Code	270684399
Hospital Revenue Code	278
Min. Negotiated Rate	$203.19
Max. Negotiated Rate	$3,577.35
Rate for Payer: Aetna Commercial	$2,718.79
Rate for Payer: Aetna Medicare Advantage	$2,146.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.45
Rate for Payer: Cigna Commercial	$3,577.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.20
Rate for Payer: UnitedHealthcare Community & State	$226.09
Rate for Payer: Wellpoint Medicaid Managed Care	$203.19

PLATE LCP 3.5MM 12H 163MM

Facility

$1,771.80

Service Code	HCPCS C1713
Hospital Charge Code	270671054
Hospital Revenue Code	278
Min. Negotiated Rate	$265.77
Max. Negotiated Rate	$428.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.78
Rate for Payer: Qualcare PPO/HMO/WC	$265.77

PLATE LCP 3.5MM 12H 163MM

Facility

$1,771.80

Service Code	HCPCS C1713
Hospital Charge Code	270671054
Hospital Revenue Code	278
Min. Negotiated Rate	$50.32
Max. Negotiated Rate	$885.90
Rate for Payer: Aetna Commercial	$673.28
Rate for Payer: Aetna Medicare Advantage	$531.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.81
Rate for Payer: Cigna Commercial	$885.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.78
Rate for Payer: Qualcare PPO/HMO/WC	$265.77
Rate for Payer: UnitedHealthcare Community & State	$55.99
Rate for Payer: Wellpoint Medicaid Managed Care	$50.32

Know your out-of-pocket cost for care.

All Charges