Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP CLAV 3.5x100MM 7H LF

Facility

$3,942.85

Service Code	HCPCS C1713
Hospital Charge Code	270670741
Hospital Revenue Code	278
Min. Negotiated Rate	$591.43
Max. Negotiated Rate	$954.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.17
Rate for Payer: Qualcare PPO/HMO/WC	$591.43

PLATE LCP CLAV 3.5x100MM 7H LF

Facility

$3,942.85

Service Code	HCPCS C1713
Hospital Charge Code	270670741
Hospital Revenue Code	278
Min. Negotiated Rate	$111.98
Max. Negotiated Rate	$1,971.42
Rate for Payer: Aetna Commercial	$1,498.28
Rate for Payer: Aetna Medicare Advantage	$1,182.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,005.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,005.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,005.43
Rate for Payer: Cigna Commercial	$1,971.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.17
Rate for Payer: Qualcare PPO/HMO/WC	$591.43
Rate for Payer: UnitedHealthcare Community & State	$124.59
Rate for Payer: Wellpoint Medicaid Managed Care	$111.98

PLATE LCP CLAV 3.5x100MM 7H LT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270675952
Hospital Revenue Code	278
Min. Negotiated Rate	$117.86
Max. Negotiated Rate	$2,074.93
Rate for Payer: Aetna Commercial	$1,576.94
Rate for Payer: Aetna Medicare Advantage	$1,244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.21
Rate for Payer: Cigna Commercial	$2,074.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48
Rate for Payer: UnitedHealthcare Community & State	$131.14
Rate for Payer: Wellpoint Medicaid Managed Care	$117.86

PLATE LCP CLAV 3.5x100MM 7H LT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270675952
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$1,004.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H RT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270676235
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$1,004.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H RT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270676235
Hospital Revenue Code	278
Min. Negotiated Rate	$117.86
Max. Negotiated Rate	$2,074.93
Rate for Payer: Aetna Commercial	$1,576.94
Rate for Payer: Aetna Medicare Advantage	$1,244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.21
Rate for Payer: Cigna Commercial	$2,074.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48
Rate for Payer: UnitedHealthcare Community & State	$131.14
Rate for Payer: Wellpoint Medicaid Managed Care	$117.86

PLATE LCP CLAV 3.5x105MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270677248
Hospital Revenue Code	278
Min. Negotiated Rate	$607.18
Max. Negotiated Rate	$979.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$809.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.59
Rate for Payer: Qualcare PPO/HMO/WC	$607.18

PLATE LCP CLAV 3.5x105MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270677248
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,023.95
Rate for Payer: Aetna Commercial	$1,538.20
Rate for Payer: Aetna Medicare Advantage	$1,214.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$809.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.21
Rate for Payer: Cigna Commercial	$2,023.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.59
Rate for Payer: Qualcare PPO/HMO/WC	$607.18
Rate for Payer: UnitedHealthcare Community & State	$127.91
Rate for Payer: Wellpoint Medicaid Managed Care	$114.96

PLATE LCP CLAV 3.5x115MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270677247
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$2,125.93
Rate for Payer: Aetna Commercial	$1,615.70
Rate for Payer: Aetna Medicare Advantage	$1,275.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.22
Rate for Payer: Cigna Commercial	$2,125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78
Rate for Payer: UnitedHealthcare Community & State	$134.36
Rate for Payer: Wellpoint Medicaid Managed Care	$120.75

PLATE LCP CLAV 3.5x115MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270677247
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$1,028.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

PLATE LCP CLAV 3.5x120MM 6H LT

Facility

$4,404.80

Service Code	HCPCS C1713
Hospital Charge Code	270676301
Hospital Revenue Code	278
Min. Negotiated Rate	$660.72
Max. Negotiated Rate	$1,065.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.96
Rate for Payer: Qualcare PPO/HMO/WC	$660.72

PLATE LCP CLAV 3.5x120MM 6H LT

Facility

$4,404.80

Service Code	HCPCS C1713
Hospital Charge Code	270676301
Hospital Revenue Code	278
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$2,202.40
Rate for Payer: Aetna Commercial	$1,673.82
Rate for Payer: Aetna Medicare Advantage	$1,321.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,123.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,123.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,123.22
Rate for Payer: Cigna Commercial	$2,202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,065.96
Rate for Payer: Qualcare PPO/HMO/WC	$660.72
Rate for Payer: UnitedHealthcare Community & State	$139.19
Rate for Payer: Wellpoint Medicaid Managed Care	$125.10

PLATE LCP CLAV 3.5x120MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270665696
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$1,028.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

PLATE LCP CLAV 3.5x120MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270665696
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$2,125.93
Rate for Payer: Aetna Commercial	$1,615.70
Rate for Payer: Aetna Medicare Advantage	$1,275.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.22
Rate for Payer: Cigna Commercial	$2,125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78
Rate for Payer: UnitedHealthcare Community & State	$134.36
Rate for Payer: Wellpoint Medicaid Managed Care	$120.75

PLATE LCP CLAV 3.5x69MM 3H LT/

Facility

$4,000.65

Service Code	HCPCS C1713
Hospital Charge Code	270681461
Hospital Revenue Code	278
Min. Negotiated Rate	$113.62
Max. Negotiated Rate	$2,000.33
Rate for Payer: Aetna Commercial	$1,520.25
Rate for Payer: Aetna Medicare Advantage	$1,200.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.17
Rate for Payer: Cigna Commercial	$2,000.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.16
Rate for Payer: Qualcare PPO/HMO/WC	$600.10
Rate for Payer: UnitedHealthcare Community & State	$126.42
Rate for Payer: Wellpoint Medicaid Managed Care	$113.62

PLATE LCP CLAV 3.5x69MM 3H LT/

Facility

$4,000.65

Service Code	HCPCS C1713
Hospital Charge Code	270681461
Hospital Revenue Code	278
Min. Negotiated Rate	$600.10
Max. Negotiated Rate	$968.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.16
Rate for Payer: Qualcare PPO/HMO/WC	$600.10

PLATE LCP CLAV 3.5x79MM 6H

Facility

$4,044.80

Service Code	HCPCS C1713
Hospital Charge Code	270676302
Hospital Revenue Code	278
Min. Negotiated Rate	$114.87
Max. Negotiated Rate	$2,022.40
Rate for Payer: Aetna Commercial	$1,537.02
Rate for Payer: Aetna Medicare Advantage	$1,213.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,031.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,031.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,031.42
Rate for Payer: Cigna Commercial	$2,022.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.84
Rate for Payer: Qualcare PPO/HMO/WC	$606.72
Rate for Payer: UnitedHealthcare Community & State	$127.82
Rate for Payer: Wellpoint Medicaid Managed Care	$114.87

PLATE LCP CLAV 3.5x79MM 6H

Facility

$4,044.80

Service Code	HCPCS C1713
Hospital Charge Code	270676302
Hospital Revenue Code	278
Min. Negotiated Rate	$606.72
Max. Negotiated Rate	$978.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.84
Rate for Payer: Qualcare PPO/HMO/WC	$606.72

PLATE LCP CLAV 3.5x85MM 6H RT

Facility

$3,840.85

Hospital Charge Code	270677754
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$1,920.42
Rate for Payer: Aetna Commercial	$1,459.52
Rate for Payer: Aetna Medicare Advantage	$1,152.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$979.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$979.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$979.42
Rate for Payer: Cigna Commercial	$1,920.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$929.49
Rate for Payer: Qualcare PPO/HMO/WC	$576.13
Rate for Payer: UnitedHealthcare Community & State	$121.37
Rate for Payer: Wellpoint Medicaid Managed Care	$109.08

PLATE LCP CLAV 3.5x85MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270671684
Hospital Revenue Code	278
Min. Negotiated Rate	$607.18
Max. Negotiated Rate	$979.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$809.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.59
Rate for Payer: Qualcare PPO/HMO/WC	$607.18

PLATE LCP CLAV 3.5x85MM 6H RT

Facility

$3,840.85

Hospital Charge Code	270677754
Hospital Revenue Code	278
Min. Negotiated Rate	$576.13
Max. Negotiated Rate	$929.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$929.49
Rate for Payer: Qualcare PPO/HMO/WC	$576.13

PLATE LCP CLAV 3.5x85MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270671684
Hospital Revenue Code	278
Min. Negotiated Rate	$114.96
Max. Negotiated Rate	$2,023.95
Rate for Payer: Aetna Commercial	$1,538.20
Rate for Payer: Aetna Medicare Advantage	$1,214.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$809.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.21
Rate for Payer: Cigna Commercial	$2,023.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.59
Rate for Payer: Qualcare PPO/HMO/WC	$607.18
Rate for Payer: UnitedHealthcare Community & State	$127.91
Rate for Payer: Wellpoint Medicaid Managed Care	$114.96

PLATE LCP CLAV 3.5x94MM 5H RT

Facility

$3,797.60

Service Code	HCPCS C1713
Hospital Charge Code	270672277
Hospital Revenue Code	278
Min. Negotiated Rate	$569.64
Max. Negotiated Rate	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$759.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.02
Rate for Payer: Qualcare PPO/HMO/WC	$569.64

PLATE LCP CLAV 3.5x94MM 5H RT

Facility

$3,797.60

Service Code	HCPCS C1713
Hospital Charge Code	270672277
Hospital Revenue Code	278
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$1,898.80
Rate for Payer: Aetna Commercial	$1,443.09
Rate for Payer: Aetna Medicare Advantage	$1,139.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$968.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$968.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$759.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$968.39
Rate for Payer: Cigna Commercial	$1,898.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.02
Rate for Payer: Qualcare PPO/HMO/WC	$569.64
Rate for Payer: UnitedHealthcare Community & State	$120.00
Rate for Payer: Wellpoint Medicaid Managed Care	$107.85

PLATE LCP CONDYLAR 7H 2.4x59MM

Facility

$2,499.80

Service Code	HCPCS C1713
Hospital Charge Code	270667136
Hospital Revenue Code	278
Min. Negotiated Rate	$374.97
Max. Negotiated Rate	$604.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.95
Rate for Payer: Qualcare PPO/HMO/WC	$374.97

Know your out-of-pocket cost for care.

All Charges