Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP 4 HOLES 2x31MM

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270674229
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 5 HOLES 2.7x49MM

Facility

$1,707.00

Service Code	HCPCS C1713
Hospital Charge Code	270673107
Hospital Revenue Code	278
Min. Negotiated Rate	$48.48
Max. Negotiated Rate	$853.50
Rate for Payer: Aetna Commercial	$648.66
Rate for Payer: Aetna Medicare Advantage	$512.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.29
Rate for Payer: Cigna Commercial	$853.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.09
Rate for Payer: Qualcare PPO/HMO/WC	$256.05
Rate for Payer: UnitedHealthcare Community & State	$53.94
Rate for Payer: Wellpoint Medicaid Managed Care	$48.48

PLATE LCP 5 HOLES 2.7x49MM

Facility

$1,707.00

Service Code	HCPCS C1713
Hospital Charge Code	270673107
Hospital Revenue Code	278
Min. Negotiated Rate	$256.05
Max. Negotiated Rate	$413.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.09
Rate for Payer: Qualcare PPO/HMO/WC	$256.05

PLATE LCP 6 HOLE 2.4x36MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270677804
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 6 HOLE 2.4x36MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270677804
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 6 HOLE 2.7x58MM

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270669793
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 6 HOLE 2.7x58MM

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270669793
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 7 HOLE 2.7X67MM

Facility

$5,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270700154
Hospital Revenue Code	278
Min. Negotiated Rate	$153.50
Max. Negotiated Rate	$2,702.50
Rate for Payer: Aetna Commercial	$2,053.90
Rate for Payer: Aetna Medicare Advantage	$1,621.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,378.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,378.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,081.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,378.28
Rate for Payer: Cigna Commercial	$2,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.01
Rate for Payer: Qualcare PPO/HMO/WC	$810.75
Rate for Payer: UnitedHealthcare Community & State	$170.80
Rate for Payer: Wellpoint Medicaid Managed Care	$153.50

PLATE LCP 7 HOLE 2.7X67MM

Facility

$5,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270700154
Hospital Revenue Code	278
Min. Negotiated Rate	$810.75
Max. Negotiated Rate	$1,308.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,081.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.01
Rate for Payer: Qualcare PPO/HMO/WC	$810.75

PLATE LCP 7 HOLE 7.5 MM

Facility

$1,872.00

Hospital Charge Code	270665748
Hospital Revenue Code	278
Min. Negotiated Rate	$53.16
Max. Negotiated Rate	$936.00
Rate for Payer: Aetna Commercial	$711.36
Rate for Payer: Aetna Medicare Advantage	$561.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$477.36
Rate for Payer: Cigna Commercial	$936.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.02
Rate for Payer: Qualcare PPO/HMO/WC	$280.80
Rate for Payer: UnitedHealthcare Community & State	$59.16
Rate for Payer: Wellpoint Medicaid Managed Care	$53.16

PLATE LCP 7 HOLE 7.5 MM

Facility

$1,872.00

Hospital Charge Code	270665748
Hospital Revenue Code	278
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$453.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.02
Rate for Payer: Qualcare PPO/HMO/WC	$280.80

PLATE LCP 7 HOLES 2.4x60MM

Facility

$1,617.00

Service Code	HCPCS C1713
Hospital Charge Code	270670415
Hospital Revenue Code	278
Min. Negotiated Rate	$242.55
Max. Negotiated Rate	$391.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.31
Rate for Payer: Qualcare PPO/HMO/WC	$242.55

PLATE LCP 7 HOLES 2.4x60MM

Facility

$1,617.00

Service Code	HCPCS C1713
Hospital Charge Code	270670415
Hospital Revenue Code	278
Min. Negotiated Rate	$45.92
Max. Negotiated Rate	$808.50
Rate for Payer: Aetna Commercial	$614.46
Rate for Payer: Aetna Medicare Advantage	$485.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$412.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$412.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$412.33
Rate for Payer: Cigna Commercial	$808.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.31
Rate for Payer: Qualcare PPO/HMO/WC	$242.55
Rate for Payer: UnitedHealthcare Community & State	$51.10
Rate for Payer: Wellpoint Medicaid Managed Care	$45.92

PLATE LCP 9HOLE 4.5x170mm BRD

Facility

$2,424.00

Service Code	HCPCS C1713
Hospital Charge Code	270666771
Hospital Revenue Code	278
Min. Negotiated Rate	$363.60
Max. Negotiated Rate	$586.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.61
Rate for Payer: Qualcare PPO/HMO/WC	$363.60

PLATE LCP 9HOLE 4.5x170mm BRD

Facility

$2,424.00

Service Code	HCPCS C1713
Hospital Charge Code	270666771
Hospital Revenue Code	278
Min. Negotiated Rate	$68.84
Max. Negotiated Rate	$1,212.00
Rate for Payer: Aetna Commercial	$921.12
Rate for Payer: Aetna Medicare Advantage	$727.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.12
Rate for Payer: Cigna Commercial	$1,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.61
Rate for Payer: Qualcare PPO/HMO/WC	$363.60
Rate for Payer: UnitedHealthcare Community & State	$76.60
Rate for Payer: Wellpoint Medicaid Managed Care	$68.84

PLATE LCP ANT 6 HOLE 100MM

Facility

$4,532.15

Service Code	HCPCS C1713
Hospital Charge Code	270684726
Hospital Revenue Code	278
Min. Negotiated Rate	$679.82
Max. Negotiated Rate	$1,096.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.78
Rate for Payer: Qualcare PPO/HMO/WC	$679.82

PLATE LCP ANT 6 HOLE 100MM

Facility

$4,532.15

Service Code	HCPCS C1713
Hospital Charge Code	270684726
Hospital Revenue Code	278
Min. Negotiated Rate	$128.71
Max. Negotiated Rate	$2,266.07
Rate for Payer: Aetna Commercial	$1,722.22
Rate for Payer: Aetna Medicare Advantage	$1,359.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,155.70
Rate for Payer: Cigna Commercial	$2,266.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.78
Rate for Payer: Qualcare PPO/HMO/WC	$679.82
Rate for Payer: UnitedHealthcare Community & State	$143.22
Rate for Payer: Wellpoint Medicaid Managed Care	$128.71

PLATE LCP BRDCRVD 12H4.5x229MM

Facility

$3,241.40

Service Code	HCPCS C1713
Hospital Charge Code	270679265
Hospital Revenue Code	278
Min. Negotiated Rate	$92.06
Max. Negotiated Rate	$1,620.70
Rate for Payer: Aetna Commercial	$1,231.73
Rate for Payer: Aetna Medicare Advantage	$972.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$648.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.56
Rate for Payer: Cigna Commercial	$1,620.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$784.42
Rate for Payer: Qualcare PPO/HMO/WC	$486.21
Rate for Payer: UnitedHealthcare Community & State	$102.43
Rate for Payer: Wellpoint Medicaid Managed Care	$92.06

PLATE LCP BRDCRVD 12H4.5x229MM

Facility

$3,241.40

Service Code	HCPCS C1713
Hospital Charge Code	270679265
Hospital Revenue Code	278
Min. Negotiated Rate	$486.21
Max. Negotiated Rate	$784.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$648.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$784.42
Rate for Payer: Qualcare PPO/HMO/WC	$486.21

PLATE LCP BROAD 14H 4.5x247MM

Facility

$3,423.70

Service Code	HCPCS C1713
Hospital Charge Code	270678078
Hospital Revenue Code	278
Min. Negotiated Rate	$97.23
Max. Negotiated Rate	$1,711.85
Rate for Payer: Aetna Commercial	$1,301.01
Rate for Payer: Aetna Medicare Advantage	$1,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.04
Rate for Payer: Cigna Commercial	$1,711.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.54
Rate for Payer: Qualcare PPO/HMO/WC	$513.55
Rate for Payer: UnitedHealthcare Community & State	$108.19
Rate for Payer: Wellpoint Medicaid Managed Care	$97.23

PLATE LCP BROAD 14H 4.5x247MM

Facility

$3,423.70

Service Code	HCPCS C1713
Hospital Charge Code	270678078
Hospital Revenue Code	278
Min. Negotiated Rate	$513.55
Max. Negotiated Rate	$828.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.54
Rate for Payer: Qualcare PPO/HMO/WC	$513.55

PLATE LCP BROAD 9H 4.5x152MM

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270685043
Hospital Revenue Code	278
Min. Negotiated Rate	$67.52
Max. Negotiated Rate	$1,188.75
Rate for Payer: Aetna Commercial	$903.45
Rate for Payer: Aetna Medicare Advantage	$713.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.26
Rate for Payer: Cigna Commercial	$1,188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62
Rate for Payer: UnitedHealthcare Community & State	$75.13
Rate for Payer: Wellpoint Medicaid Managed Care	$67.52

PLATE LCP BROAD 9H 4.5x152MM

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270685043
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$575.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE LCP CLAV 3.5x100MM 6H RT

Facility

$4,299.85

Service Code	HCPCS C1713
Hospital Charge Code	270688178
Hospital Revenue Code	278
Min. Negotiated Rate	$644.98
Max. Negotiated Rate	$1,040.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$859.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.56
Rate for Payer: Qualcare PPO/HMO/WC	$644.98

PLATE LCP CLAV 3.5x100MM 6H RT

Facility

$4,299.85

Service Code	HCPCS C1713
Hospital Charge Code	270688178
Hospital Revenue Code	278
Min. Negotiated Rate	$122.12
Max. Negotiated Rate	$2,149.93
Rate for Payer: Aetna Commercial	$1,633.94
Rate for Payer: Aetna Medicare Advantage	$1,289.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$859.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.46
Rate for Payer: Cigna Commercial	$2,149.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.56
Rate for Payer: Qualcare PPO/HMO/WC	$644.98
Rate for Payer: UnitedHealthcare Community & State	$135.88
Rate for Payer: Wellpoint Medicaid Managed Care	$122.12

Know your out-of-pocket cost for care.

All Charges