Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$70.99
Max. Negotiated Rate	$1,249.90
Rate for Payer: Aetna Commercial	$949.92
Rate for Payer: Aetna Medicare Advantage	$749.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.45
Rate for Payer: Cigna Commercial	$1,249.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.95
Rate for Payer: Qualcare PPO/HMO/WC	$374.97
Rate for Payer: UnitedHealthcare Community & State	$78.99
Rate for Payer: Wellpoint Medicaid Managed Care	$70.99

PLATE LCP DIA-2.4/3.5 5HOLE LF

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270679665
Hospital Revenue Code	278
Min. Negotiated Rate	$193.76
Max. Negotiated Rate	$3,411.35
Rate for Payer: Aetna Commercial	$2,592.63
Rate for Payer: Aetna Medicare Advantage	$2,046.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.79
Rate for Payer: Cigna Commercial	$3,411.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40
Rate for Payer: UnitedHealthcare Community & State	$215.60
Rate for Payer: Wellpoint Medicaid Managed Care	$193.76

PLATE LCP DIA-2.4/3.5 5HOLE LF

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270679665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.40
Max. Negotiated Rate	$1,651.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40

PLATE LCP DIA-META 5HOLE RT

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270671709
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.40
Max. Negotiated Rate	$1,651.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40

PLATE LCP DIA-META 5HOLE RT

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270671709
Hospital Revenue Code	278
Min. Negotiated Rate	$193.76
Max. Negotiated Rate	$3,411.35
Rate for Payer: Aetna Commercial	$2,592.63
Rate for Payer: Aetna Medicare Advantage	$2,046.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.79
Rate for Payer: Cigna Commercial	$3,411.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40
Rate for Payer: UnitedHealthcare Community & State	$215.60
Rate for Payer: Wellpoint Medicaid Managed Care	$193.76

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270671711
Hospital Revenue Code	278
Min. Negotiated Rate	$198.33
Max. Negotiated Rate	$3,491.70
Rate for Payer: Aetna Commercial	$2,653.69
Rate for Payer: Aetna Medicare Advantage	$2,095.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.77
Rate for Payer: Cigna Commercial	$3,491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51
Rate for Payer: UnitedHealthcare Community & State	$220.68
Rate for Payer: Wellpoint Medicaid Managed Care	$198.33

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270671711
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$1,689.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Hospital Charge Code	270677875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$1,689.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Hospital Charge Code	270677875
Hospital Revenue Code	278
Min. Negotiated Rate	$198.33
Max. Negotiated Rate	$3,491.70
Rate for Payer: Aetna Commercial	$2,653.69
Rate for Payer: Aetna Medicare Advantage	$2,095.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.77
Rate for Payer: Cigna Commercial	$3,491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51
Rate for Payer: UnitedHealthcare Community & State	$220.68
Rate for Payer: Wellpoint Medicaid Managed Care	$198.33

PLATE LCP DISTAL 2.0MM 7HOLE

Facility

$3,497.90

Service Code	HCPCS C1713
Hospital Charge Code	270666014
Hospital Revenue Code	278
Min. Negotiated Rate	$99.34
Max. Negotiated Rate	$1,748.95
Rate for Payer: Aetna Commercial	$1,329.20
Rate for Payer: Aetna Medicare Advantage	$1,049.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$891.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$891.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$699.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$891.96
Rate for Payer: Cigna Commercial	$1,748.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$846.49
Rate for Payer: Qualcare PPO/HMO/WC	$524.68
Rate for Payer: UnitedHealthcare Community & State	$110.53
Rate for Payer: Wellpoint Medicaid Managed Care	$99.34

PLATE LCP DISTAL 2.0MM 7HOLE

Facility

$3,497.90

Service Code	HCPCS C1713
Hospital Charge Code	270666014
Hospital Revenue Code	278
Min. Negotiated Rate	$524.68
Max. Negotiated Rate	$846.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$699.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$846.49
Rate for Payer: Qualcare PPO/HMO/WC	$524.68

PLATE LCP-HK 3.5mm 3/H STER

Facility

$155.15

Service Code	HCPCS C1713
Hospital Charge Code	270682564
Hospital Revenue Code	278
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$77.58
Rate for Payer: Aetna Commercial	$58.96
Rate for Payer: Aetna Medicare Advantage	$46.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.56
Rate for Payer: Cigna Commercial	$77.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.27
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.41

PLATE LCP-HK 3.5mm 3/H STER

Facility

$155.15

Service Code	HCPCS C1713
Hospital Charge Code	270682564
Hospital Revenue Code	278
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

PLATE LCP HOOK 3.5MM 3HOLE ST

Facility

$8,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270667999
Hospital Revenue Code	278
Min. Negotiated Rate	$251.34
Max. Negotiated Rate	$4,425.00
Rate for Payer: Aetna Commercial	$3,363.00
Rate for Payer: Aetna Medicare Advantage	$2,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,256.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,256.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,256.75
Rate for Payer: Cigna Commercial	$4,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,141.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,327.50
Rate for Payer: UnitedHealthcare Community & State	$279.66
Rate for Payer: Wellpoint Medicaid Managed Care	$251.34

PLATE LCP HOOK 3.5MM 3HOLE ST

Facility

$8,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270667999
Hospital Revenue Code	278
Min. Negotiated Rate	$1,327.50
Max. Negotiated Rate	$2,141.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,141.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,327.50

PLATE LCP HUM 3.5x196MM 8H ST

Facility

$7,484.00

Hospital Charge Code	270669506
Hospital Revenue Code	278
Min. Negotiated Rate	$212.55
Max. Negotiated Rate	$3,742.00
Rate for Payer: Aetna Commercial	$2,843.92
Rate for Payer: Aetna Medicare Advantage	$2,245.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,908.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,908.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,496.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,908.42
Rate for Payer: Cigna Commercial	$3,742.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,811.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,122.60
Rate for Payer: UnitedHealthcare Community & State	$236.49
Rate for Payer: Wellpoint Medicaid Managed Care	$212.55

PLATE LCP HUM 3.5x196MM 8H ST

Facility

$7,484.00

Hospital Charge Code	270669506
Hospital Revenue Code	278
Min. Negotiated Rate	$1,122.60
Max. Negotiated Rate	$1,811.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,496.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,811.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,122.60

PLATE LCP HUM 3.5x232MM 10H ST

Facility

$7,750.90

Service Code	HCPCS C1713
Hospital Charge Code	270660600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.63
Max. Negotiated Rate	$1,875.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.63

PLATE LCP HUM 3.5x232MM 10H ST

Facility

$7,750.90

Service Code	HCPCS C1713
Hospital Charge Code	270660600
Hospital Revenue Code	278
Min. Negotiated Rate	$220.13
Max. Negotiated Rate	$3,875.45
Rate for Payer: Aetna Commercial	$2,945.34
Rate for Payer: Aetna Medicare Advantage	$2,325.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.48
Rate for Payer: Cigna Commercial	$3,875.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.63
Rate for Payer: UnitedHealthcare Community & State	$244.93
Rate for Payer: Wellpoint Medicaid Managed Care	$220.13

PLATE LCP HUMERUS 12H 3.5x268

Facility

$8,255.90

Service Code	HCPCS C1713
Hospital Charge Code	270683625
Hospital Revenue Code	278
Min. Negotiated Rate	$234.47
Max. Negotiated Rate	$4,127.95
Rate for Payer: Aetna Commercial	$3,137.24
Rate for Payer: Aetna Medicare Advantage	$2,476.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,651.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,105.25
Rate for Payer: Cigna Commercial	$4,127.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,997.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.38
Rate for Payer: UnitedHealthcare Community & State	$260.89
Rate for Payer: Wellpoint Medicaid Managed Care	$234.47

PLATE LCP HUMERUS 12H 3.5x268

Facility

$8,255.90

Service Code	HCPCS C1713
Hospital Charge Code	270683625
Hospital Revenue Code	278
Min. Negotiated Rate	$1,238.38
Max. Negotiated Rate	$1,997.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,651.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,997.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.38

PLATE LCP HUMERUS 3.5x160MM 6H

Facility

$7,008.10

Service Code	HCPCS C1713
Hospital Charge Code	270645878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,051.21
Max. Negotiated Rate	$1,695.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,401.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,695.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,051.21

PLATE LCP HUMERUS 3.5x160MM 6H

Facility

$7,008.10

Service Code	HCPCS C1713
Hospital Charge Code	270645878
Hospital Revenue Code	278
Min. Negotiated Rate	$199.03
Max. Negotiated Rate	$3,504.05
Rate for Payer: Aetna Commercial	$2,663.08
Rate for Payer: Aetna Medicare Advantage	$2,102.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,787.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,787.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,787.07
Rate for Payer: Cigna Commercial	$3,504.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,695.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,051.21
Rate for Payer: UnitedHealthcare Community & State	$221.46
Rate for Payer: Wellpoint Medicaid Managed Care	$199.03

PLATE LCP HUMERUS 3H 3.5x90MM

Facility

$6,470.45

Service Code	HCPCS C1713
Hospital Charge Code	270634386
Hospital Revenue Code	278
Min. Negotiated Rate	$970.57
Max. Negotiated Rate	$1,565.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.85
Rate for Payer: Qualcare PPO/HMO/WC	$970.57

PLATE LCP HUMERUS 3H 3.5x90MM

Facility

$6,470.45

Service Code	HCPCS C1713
Hospital Charge Code	270634386
Hospital Revenue Code	278
Min. Negotiated Rate	$183.76
Max. Negotiated Rate	$3,235.22
Rate for Payer: Aetna Commercial	$2,458.77
Rate for Payer: Aetna Medicare Advantage	$1,941.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,649.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,649.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,649.96
Rate for Payer: Cigna Commercial	$3,235.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.85
Rate for Payer: Qualcare PPO/HMO/WC	$970.57
Rate for Payer: UnitedHealthcare Community & State	$204.47
Rate for Payer: Wellpoint Medicaid Managed Care	$183.76

Know your out-of-pocket cost for care.

All Charges