Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 9H RT ST

Facility

$3,099.25

Service Code	HCPCS C1713
Hospital Charge Code	270645138
Hospital Revenue Code	278
Min. Negotiated Rate	$464.89
Max. Negotiated Rate	$750.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$619.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.02
Rate for Payer: Qualcare PPO/HMO/WC	$464.89

PLATE LCP LAT 2.7/3.5 9H RT ST

Facility

$3,099.25

Service Code	HCPCS C1713
Hospital Charge Code	270645138
Hospital Revenue Code	278
Min. Negotiated Rate	$88.02
Max. Negotiated Rate	$1,549.62
Rate for Payer: Aetna Commercial	$1,177.71
Rate for Payer: Aetna Medicare Advantage	$929.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$619.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.31
Rate for Payer: Cigna Commercial	$1,549.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.02
Rate for Payer: Qualcare PPO/HMO/WC	$464.89
Rate for Payer: UnitedHealthcare Community & State	$97.94
Rate for Payer: Wellpoint Medicaid Managed Care	$88.02

PLATE LCP NARROW 10H 4.5x188MM

Facility

$2,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270637792
Hospital Revenue Code	278
Min. Negotiated Rate	$65.82
Max. Negotiated Rate	$1,158.75
Rate for Payer: Aetna Commercial	$880.65
Rate for Payer: Aetna Medicare Advantage	$695.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.96
Rate for Payer: Cigna Commercial	$1,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.84
Rate for Payer: Qualcare PPO/HMO/WC	$347.62
Rate for Payer: UnitedHealthcare Community & State	$73.23
Rate for Payer: Wellpoint Medicaid Managed Care	$65.82

PLATE LCP NARROW 10H 4.5x188MM

Facility

$2,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270637792
Hospital Revenue Code	278
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$560.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.84
Rate for Payer: Qualcare PPO/HMO/WC	$347.62

PLATE LCP NARROW 11H 4.5x206MM

Facility

$2,424.00

Hospital Charge Code	270677246
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 NARROW 11H 4.5x206MM

Facility

$2,424.00

Hospital Charge Code	270677246
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 NARROW 6H 4.5x116MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270646168
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 NARROW 6H 4.5x116MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270646168
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 NARROW 9H 4.5X170MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695092
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

PLATE LCP NARROW 9H 4.5X170MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695092
Hospital Revenue Code	278
Min. Negotiated Rate	$170.40
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$189.60
Rate for Payer: Wellpoint Medicaid Managed Care	$170.40

PLATE LCP POST 2.7/3.5MM 3H LT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676810
Hospital Revenue Code	278
Min. Negotiated Rate	$76.35
Max. Negotiated Rate	$1,344.15
Rate for Payer: Aetna Commercial	$1,021.55
Rate for Payer: Aetna Medicare Advantage	$806.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.52
Rate for Payer: Cigna Commercial	$1,344.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25
Rate for Payer: UnitedHealthcare Community & State	$84.95
Rate for Payer: Wellpoint Medicaid Managed Care	$76.35

PLATE LCP POST 2.7/3.5MM 3H LT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676810
Hospital Revenue Code	278
Min. Negotiated Rate	$403.25
Max. Negotiated Rate	$650.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25

PLATE LCP POST 2.7/3.5MM 3H RT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676809
Hospital Revenue Code	278
Min. Negotiated Rate	$76.35
Max. Negotiated Rate	$1,344.15
Rate for Payer: Aetna Commercial	$1,021.55
Rate for Payer: Aetna Medicare Advantage	$806.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.52
Rate for Payer: Cigna Commercial	$1,344.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25
Rate for Payer: UnitedHealthcare Community & State	$84.95
Rate for Payer: Wellpoint Medicaid Managed Care	$76.35

PLATE LCP POST 2.7/3.5MM 3H RT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676809
Hospital Revenue Code	278
Min. Negotiated Rate	$403.25
Max. Negotiated Rate	$650.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25

PLATE LCP POST 2.7/3.5MM 4H LT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676812
Hospital Revenue Code	278
Min. Negotiated Rate	$409.73
Max. Negotiated Rate	$661.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73

PLATE LCP POST 2.7/3.5MM 4H LT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676812
Hospital Revenue Code	278
Min. Negotiated Rate	$77.58
Max. Negotiated Rate	$1,365.78
Rate for Payer: Aetna Commercial	$1,037.99
Rate for Payer: Aetna Medicare Advantage	$819.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.55
Rate for Payer: Cigna Commercial	$1,365.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73
Rate for Payer: UnitedHealthcare Community & State	$86.32
Rate for Payer: Wellpoint Medicaid Managed Care	$77.58

PLATE LCP POST 2.7/3.5MM 4H RT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676811
Hospital Revenue Code	278
Min. Negotiated Rate	$409.73
Max. Negotiated Rate	$661.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73

PLATE LCP POST 2.7/3.5MM 4H RT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676811
Hospital Revenue Code	278
Min. Negotiated Rate	$77.58
Max. Negotiated Rate	$1,365.78
Rate for Payer: Aetna Commercial	$1,037.99
Rate for Payer: Aetna Medicare Advantage	$819.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.55
Rate for Payer: Cigna Commercial	$1,365.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73
Rate for Payer: UnitedHealthcare Community & State	$86.32
Rate for Payer: Wellpoint Medicaid Managed Care	$77.58

PLATE LCP POST 2.7/3.5MM 5H RT

Facility

$2,768.65

Service Code	HCPCS C1713
Hospital Charge Code	270676813
Hospital Revenue Code	278
Min. Negotiated Rate	$78.63
Max. Negotiated Rate	$1,384.33
Rate for Payer: Aetna Commercial	$1,052.09
Rate for Payer: Aetna Medicare Advantage	$830.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$706.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$706.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$553.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$706.01
Rate for Payer: Cigna Commercial	$1,384.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$670.01
Rate for Payer: Qualcare PPO/HMO/WC	$415.30
Rate for Payer: UnitedHealthcare Community & State	$87.49
Rate for Payer: Wellpoint Medicaid Managed Care	$78.63

PLATE LCP POST 2.7/3.5MM 5H RT

Facility

$2,768.65

Service Code	HCPCS C1713
Hospital Charge Code	270676813
Hospital Revenue Code	278
Min. Negotiated Rate	$415.30
Max. Negotiated Rate	$670.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$553.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$670.01
Rate for Payer: Qualcare PPO/HMO/WC	$415.30

PLATE LCP POST 2.7/3.5MM 6H LT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270671205
Hospital Revenue Code	278
Min. Negotiated Rate	$421.79
Max. Negotiated Rate	$680.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79

PLATE LCP POST 2.7/3.5MM 6H LT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270671205
Hospital Revenue Code	278
Min. Negotiated Rate	$79.86
Max. Negotiated Rate	$1,405.95
Rate for Payer: Aetna Commercial	$1,068.52
Rate for Payer: Aetna Medicare Advantage	$843.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.03
Rate for Payer: Cigna Commercial	$1,405.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79
Rate for Payer: UnitedHealthcare Community & State	$88.86
Rate for Payer: Wellpoint Medicaid Managed Care	$79.86

PLATE LCP POST 2.7/3.5MM 6H RT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270676815
Hospital Revenue Code	278
Min. Negotiated Rate	$79.86
Max. Negotiated Rate	$1,405.95
Rate for Payer: Aetna Commercial	$1,068.52
Rate for Payer: Aetna Medicare Advantage	$843.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.03
Rate for Payer: Cigna Commercial	$1,405.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79
Rate for Payer: UnitedHealthcare Community & State	$88.86
Rate for Payer: Wellpoint Medicaid Managed Care	$79.86

PLATE LCP POST 2.7/3.5MM 6H RT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270676815
Hospital Revenue Code	278
Min. Negotiated Rate	$421.79
Max. Negotiated Rate	$680.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79

Know your out-of-pocket cost for care.

All Charges