Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP HUMERUS 5H 3.5x114MM

Facility

$6,874.65

Service Code	HCPCS C1713
Hospital Charge Code	270633522
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.20
Max. Negotiated Rate	$1,663.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,374.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.20

PLATE LCP HUMERUS 5H 3.5x114MM

Facility

$6,874.65

Service Code	HCPCS C1713
Hospital Charge Code	270633522
Hospital Revenue Code	278
Min. Negotiated Rate	$195.24
Max. Negotiated Rate	$3,437.32
Rate for Payer: Aetna Commercial	$2,612.37
Rate for Payer: Aetna Medicare Advantage	$2,062.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,374.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.04
Rate for Payer: Cigna Commercial	$3,437.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.20
Rate for Payer: UnitedHealthcare Community & State	$217.24
Rate for Payer: Wellpoint Medicaid Managed Care	$195.24

PLATE LCP LAT 2.7/3.5 3H LFT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270660821
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$1,299.35
Rate for Payer: Aetna Commercial	$987.51
Rate for Payer: Aetna Medicare Advantage	$779.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$662.67
Rate for Payer: Cigna Commercial	$1,299.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81
Rate for Payer: UnitedHealthcare Community & State	$82.12
Rate for Payer: Wellpoint Medicaid Managed Care	$73.80

PLATE LCP LAT 2.7/3.5 3H LFT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270660821
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$628.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 3H RT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270672038
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$628.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 3H RT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270672038
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$1,299.35
Rate for Payer: Aetna Commercial	$987.51
Rate for Payer: Aetna Medicare Advantage	$779.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$662.67
Rate for Payer: Cigna Commercial	$1,299.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81
Rate for Payer: UnitedHealthcare Community & State	$82.12
Rate for Payer: Wellpoint Medicaid Managed Care	$73.80

PLATE LCP LAT 2.7/3.5 4H LT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270653045
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$689.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 4H LT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270653045
Hospital Revenue Code	278
Min. Negotiated Rate	$80.91
Max. Negotiated Rate	$1,424.50
Rate for Payer: Aetna Commercial	$1,082.62
Rate for Payer: Aetna Medicare Advantage	$854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.50
Rate for Payer: Cigna Commercial	$1,424.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35
Rate for Payer: UnitedHealthcare Community & State	$90.03
Rate for Payer: Wellpoint Medicaid Managed Care	$80.91

PLATE LCP LAT 2.7/3.5 4H RT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270646021
Hospital Revenue Code	278
Min. Negotiated Rate	$80.91
Max. Negotiated Rate	$1,424.50
Rate for Payer: Aetna Commercial	$1,082.62
Rate for Payer: Aetna Medicare Advantage	$854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.50
Rate for Payer: Cigna Commercial	$1,424.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35
Rate for Payer: UnitedHealthcare Community & State	$90.03
Rate for Payer: Wellpoint Medicaid Managed Care	$80.91

PLATE LCP LAT 2.7/3.5 4H RT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270646021
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$689.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 5H LT ST

Facility

$2,886.05

Service Code	HCPCS C1713
Hospital Charge Code	270642838
Hospital Revenue Code	278
Min. Negotiated Rate	$81.96
Max. Negotiated Rate	$1,443.03
Rate for Payer: Aetna Commercial	$1,096.70
Rate for Payer: Aetna Medicare Advantage	$865.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.94
Rate for Payer: Cigna Commercial	$1,443.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.42
Rate for Payer: Qualcare PPO/HMO/WC	$432.91
Rate for Payer: UnitedHealthcare Community & State	$91.20
Rate for Payer: Wellpoint Medicaid Managed Care	$81.96

PLATE LCP LAT 2.7/3.5 5H LT ST

Facility

$2,886.05

Service Code	HCPCS C1713
Hospital Charge Code	270642838
Hospital Revenue Code	278
Min. Negotiated Rate	$432.91
Max. Negotiated Rate	$698.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.42
Rate for Payer: Qualcare PPO/HMO/WC	$432.91

PLATE LCP LAT 2.7/3.5 5H RT

Facility

$2,759.40

Service Code	HCPCS C1713
Hospital Charge Code	270642551
Hospital Revenue Code	278
Min. Negotiated Rate	$78.37
Max. Negotiated Rate	$1,379.70
Rate for Payer: Aetna Commercial	$1,048.57
Rate for Payer: Aetna Medicare Advantage	$827.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.65
Rate for Payer: Cigna Commercial	$1,379.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.77
Rate for Payer: Qualcare PPO/HMO/WC	$413.91
Rate for Payer: UnitedHealthcare Community & State	$87.20
Rate for Payer: Wellpoint Medicaid Managed Care	$78.37

PLATE LCP LAT 2.7/3.5 5H RT

Facility

$2,759.40

Service Code	HCPCS C1713
Hospital Charge Code	270642551
Hospital Revenue Code	278
Min. Negotiated Rate	$413.91
Max. Negotiated Rate	$667.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.77
Rate for Payer: Qualcare PPO/HMO/WC	$413.91

PLATE LCP LAT 2.7/3.5 6H LFT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270642839
Hospital Revenue Code	278
Min. Negotiated Rate	$79.54
Max. Negotiated Rate	$1,400.40
Rate for Payer: Aetna Commercial	$1,064.30
Rate for Payer: Aetna Medicare Advantage	$840.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.20
Rate for Payer: Cigna Commercial	$1,400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12
Rate for Payer: UnitedHealthcare Community & State	$88.51
Rate for Payer: Wellpoint Medicaid Managed Care	$79.54

PLATE LCP LAT 2.7/3.5 6H LFT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270642839
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$677.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H LT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270646023
Hospital Revenue Code	278
Min. Negotiated Rate	$83.11
Max. Negotiated Rate	$1,463.12
Rate for Payer: Aetna Commercial	$1,111.97
Rate for Payer: Aetna Medicare Advantage	$877.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.19
Rate for Payer: Cigna Commercial	$1,463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94
Rate for Payer: UnitedHealthcare Community & State	$92.47
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

PLATE LCP LAT 2.7/3.5 6H LT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270646023
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$708.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H RT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270645183
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$677.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H RT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270645183
Hospital Revenue Code	278
Min. Negotiated Rate	$79.54
Max. Negotiated Rate	$1,400.40
Rate for Payer: Aetna Commercial	$1,064.30
Rate for Payer: Aetna Medicare Advantage	$840.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.20
Rate for Payer: Cigna Commercial	$1,400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12
Rate for Payer: UnitedHealthcare Community & State	$88.51
Rate for Payer: Wellpoint Medicaid Managed Care	$79.54

PLATE LCP LAT 2.7/3.5 6H RT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270675622
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$708.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H RT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270675622
Hospital Revenue Code	278
Min. Negotiated Rate	$83.11
Max. Negotiated Rate	$1,463.12
Rate for Payer: Aetna Commercial	$1,111.97
Rate for Payer: Aetna Medicare Advantage	$877.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.19
Rate for Payer: Cigna Commercial	$1,463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94
Rate for Payer: UnitedHealthcare Community & State	$92.47
Rate for Payer: Wellpoint Medicaid Managed Care	$83.11

PLATE LCP LAT 2.7/3.5 7H LT ST

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644879
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$667.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 7H LT ST

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644879
Hospital Revenue Code	278
Min. Negotiated Rate	$78.28
Max. Negotiated Rate	$1,378.15
Rate for Payer: Aetna Commercial	$1,047.39
Rate for Payer: Aetna Medicare Advantage	$826.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.86
Rate for Payer: Cigna Commercial	$1,378.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44
Rate for Payer: UnitedHealthcare Community & State	$87.10
Rate for Payer: Wellpoint Medicaid Managed Care	$78.28

PLATE LCP LAT 2.7/3.5 7H RT

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644814
Hospital Revenue Code	278
Min. Negotiated Rate	$78.28
Max. Negotiated Rate	$1,378.15
Rate for Payer: Aetna Commercial	$1,047.39
Rate for Payer: Aetna Medicare Advantage	$826.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.86
Rate for Payer: Cigna Commercial	$1,378.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44
Rate for Payer: UnitedHealthcare Community & State	$87.10
Rate for Payer: Wellpoint Medicaid Managed Care	$78.28

Know your out-of-pocket cost for care.

All Charges