Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP POST 2.7/3.5MM 7H LT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676817
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 POST 2.7/3.5MM 7H LT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676817
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 POST 2.7/3.5MM 7H RT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676816
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 POST 2.7/3.5MM 7H RT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676816
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 PROX 8HOLE 4.5MM

Facility

$6,665.15

Service Code	HCPCS C1713
Hospital Charge Code	270676321
Hospital Revenue Code	278
Min. Negotiated Rate	$189.29
Max. Negotiated Rate	$3,332.57
Rate for Payer: Aetna Commercial	$2,532.76
Rate for Payer: Aetna Medicare Advantage	$1,999.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,699.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,699.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,333.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,699.61
Rate for Payer: Cigna Commercial	$3,332.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.97
Rate for Payer: Qualcare PPO/HMO/WC	$999.77
Rate for Payer: UnitedHealthcare Community & State	$210.62
Rate for Payer: Wellpoint Medicaid Managed Care	$189.29

PLATE LCP PROX 8HOLE 4.5MM

Facility

$6,665.15

Service Code	HCPCS C1713
Hospital Charge Code	270676321
Hospital Revenue Code	278
Min. Negotiated Rate	$999.77
Max. Negotiated Rate	$1,612.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,333.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.97
Rate for Payer: Qualcare PPO/HMO/WC	$999.77

PLATE LCP RECON 3.5x140MM 10 H

Facility

$2,407.10

Service Code	HCPCS C1713
Hospital Charge Code	270645929
Hospital Revenue Code	278
Min. Negotiated Rate	$361.06
Max. Negotiated Rate	$582.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$481.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.52
Rate for Payer: Qualcare PPO/HMO/WC	$361.06

PLATE LCP RECON 3.5x140MM 10 H

Facility

$2,407.10

Service Code	HCPCS C1713
Hospital Charge Code	270645929
Hospital Revenue Code	278
Min. Negotiated Rate	$68.36
Max. Negotiated Rate	$1,203.55
Rate for Payer: Aetna Commercial	$914.70
Rate for Payer: Aetna Medicare Advantage	$722.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$481.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.81
Rate for Payer: Cigna Commercial	$1,203.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.52
Rate for Payer: Qualcare PPO/HMO/WC	$361.06
Rate for Payer: UnitedHealthcare Community & State	$76.06
Rate for Payer: Wellpoint Medicaid Managed Care	$68.36

PLATE LCP RECON 3.5x84MM 6H

Facility

$2,119.75

Service Code	HCPCS C1713
Hospital Charge Code	270641802
Hospital Revenue Code	278
Min. Negotiated Rate	$317.96
Max. Negotiated Rate	$512.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.98
Rate for Payer: Qualcare PPO/HMO/WC	$317.96

PLATE LCP RECON 3.5x84MM 6H

Facility

$2,119.75

Service Code	HCPCS C1713
Hospital Charge Code	270641802
Hospital Revenue Code	278
Min. Negotiated Rate	$60.20
Max. Negotiated Rate	$1,059.88
Rate for Payer: Aetna Commercial	$805.50
Rate for Payer: Aetna Medicare Advantage	$635.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$540.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$540.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$540.54
Rate for Payer: Cigna Commercial	$1,059.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.98
Rate for Payer: Qualcare PPO/HMO/WC	$317.96
Rate for Payer: UnitedHealthcare Community & State	$66.98
Rate for Payer: Wellpoint Medicaid Managed Care	$60.20

PLATE LCP RECON 3.5x98MM 7HOLE

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270641801
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$538.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

PLATE LCP RECON 3.5x98MM 7HOLE

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270641801
Hospital Revenue Code	278
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$1,112.40
Rate for Payer: Aetna Commercial	$845.42
Rate for Payer: Aetna Medicare Advantage	$667.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.32
Rate for Payer: Cigna Commercial	$1,112.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72
Rate for Payer: UnitedHealthcare Community & State	$70.30
Rate for Payer: Wellpoint Medicaid Managed Care	$63.18

PLATE LCP TIBIA 3.5MM 13HOLE L

Facility

$6,529.15

Service Code	HCPCS C1713
Hospital Charge Code	270644882
Hospital Revenue Code	278
Min. Negotiated Rate	$185.43
Max. Negotiated Rate	$3,264.57
Rate for Payer: Aetna Commercial	$2,481.08
Rate for Payer: Aetna Medicare Advantage	$1,958.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,664.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,664.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,664.93
Rate for Payer: Cigna Commercial	$3,264.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.05
Rate for Payer: Qualcare PPO/HMO/WC	$979.37
Rate for Payer: UnitedHealthcare Community & State	$206.32
Rate for Payer: Wellpoint Medicaid Managed Care	$185.43

PLATE LCP TIBIA 3.5MM 13HOLE L

Facility

$6,529.15

Service Code	HCPCS C1713
Hospital Charge Code	270644882
Hospital Revenue Code	278
Min. Negotiated Rate	$979.37
Max. Negotiated Rate	$1,580.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.05
Rate for Payer: Qualcare PPO/HMO/WC	$979.37

PLATE LCP TIBIA 3.5MM 4H LT ST

Facility

$6,090.40

Service Code	HCPCS C1713
Hospital Charge Code	270643261
Hospital Revenue Code	278
Min. Negotiated Rate	$172.97
Max. Negotiated Rate	$3,045.20
Rate for Payer: Aetna Commercial	$2,314.35
Rate for Payer: Aetna Medicare Advantage	$1,827.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,553.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,553.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,553.05
Rate for Payer: Cigna Commercial	$3,045.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.88
Rate for Payer: Qualcare PPO/HMO/WC	$913.56
Rate for Payer: UnitedHealthcare Community & State	$192.46
Rate for Payer: Wellpoint Medicaid Managed Care	$172.97

PLATE LCP TIBIA 3.5MM 4H LT ST

Facility

$6,090.40

Service Code	HCPCS C1713
Hospital Charge Code	270643261
Hospital Revenue Code	278
Min. Negotiated Rate	$913.56
Max. Negotiated Rate	$1,473.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.88
Rate for Payer: Qualcare PPO/HMO/WC	$913.56

PLATE LCP TIBIA 3.5MM 4H RT ST

Facility

$6,238.70

Service Code	HCPCS C1713
Hospital Charge Code	270646927
Hospital Revenue Code	278
Min. Negotiated Rate	$177.18
Max. Negotiated Rate	$3,119.35
Rate for Payer: Aetna Commercial	$2,370.71
Rate for Payer: Aetna Medicare Advantage	$1,871.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,590.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,590.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,247.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,590.87
Rate for Payer: Cigna Commercial	$3,119.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,509.77
Rate for Payer: Qualcare PPO/HMO/WC	$935.80
Rate for Payer: UnitedHealthcare Community & State	$197.14
Rate for Payer: Wellpoint Medicaid Managed Care	$177.18

PLATE LCP TIBIA 3.5MM 4H RT ST

Facility

$6,238.70

Service Code	HCPCS C1713
Hospital Charge Code	270646927
Hospital Revenue Code	278
Min. Negotiated Rate	$935.80
Max. Negotiated Rate	$1,509.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,247.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,509.77
Rate for Payer: Qualcare PPO/HMO/WC	$935.80

PLATE LCP TIBIA 3.5MM 6H LFT

Facility

$5,951.35

Service Code	HCPCS C1713
Hospital Charge Code	270643933
Hospital Revenue Code	278
Min. Negotiated Rate	$169.02
Max. Negotiated Rate	$2,975.68
Rate for Payer: Aetna Commercial	$2,261.51
Rate for Payer: Aetna Medicare Advantage	$1,785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,190.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,517.59
Rate for Payer: Cigna Commercial	$2,975.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.23
Rate for Payer: Qualcare PPO/HMO/WC	$892.70
Rate for Payer: UnitedHealthcare Community & State	$188.06
Rate for Payer: Wellpoint Medicaid Managed Care	$169.02

PLATE LCP TIBIA 3.5MM 6H LFT

Facility

$5,951.35

Service Code	HCPCS C1713
Hospital Charge Code	270643933
Hospital Revenue Code	278
Min. Negotiated Rate	$892.70
Max. Negotiated Rate	$1,440.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,190.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.23
Rate for Payer: Qualcare PPO/HMO/WC	$892.70

PLATE LCP TIBIA 3.5MM 8H RT ST

Facility

$6,214.00

Service Code	HCPCS C1713
Hospital Charge Code	270646922
Hospital Revenue Code	278
Min. Negotiated Rate	$176.48
Max. Negotiated Rate	$3,107.00
Rate for Payer: Aetna Commercial	$2,361.32
Rate for Payer: Aetna Medicare Advantage	$1,864.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,584.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,584.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,584.57
Rate for Payer: Cigna Commercial	$3,107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,503.79
Rate for Payer: Qualcare PPO/HMO/WC	$932.10
Rate for Payer: UnitedHealthcare Community & State	$196.36
Rate for Payer: Wellpoint Medicaid Managed Care	$176.48

PLATE LCP TIBIA 3.5MM 8H RT ST

Facility

$6,214.00

Service Code	HCPCS C1713
Hospital Charge Code	270646922
Hospital Revenue Code	278
Min. Negotiated Rate	$932.10
Max. Negotiated Rate	$1,503.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,503.79
Rate for Payer: Qualcare PPO/HMO/WC	$932.10

PLATE LCP TIBIA 3.5x116 5HOLE

Facility

$6,081.10

Service Code	HCPCS C1713
Hospital Charge Code	270642939
Hospital Revenue Code	278
Min. Negotiated Rate	$912.16
Max. Negotiated Rate	$1,471.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.63
Rate for Payer: Qualcare PPO/HMO/WC	$912.16

PLATE LCP TIBIA 3.5x116 5HOLE

Facility

$6,081.10

Service Code	HCPCS C1713
Hospital Charge Code	270642939
Hospital Revenue Code	278
Min. Negotiated Rate	$172.70
Max. Negotiated Rate	$3,040.55
Rate for Payer: Aetna Commercial	$2,310.82
Rate for Payer: Aetna Medicare Advantage	$1,824.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,550.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,550.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,550.68
Rate for Payer: Cigna Commercial	$3,040.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.63
Rate for Payer: Qualcare PPO/HMO/WC	$912.16
Rate for Payer: UnitedHealthcare Community & State	$192.16
Rate for Payer: Wellpoint Medicaid Managed Care	$172.70

PLATE LCP TIBIA 4H/L 93MM STER

Facility

$6,039.00

Hospital Charge Code	270675550
Hospital Revenue Code	278
Min. Negotiated Rate	$905.85
Max. Negotiated Rate	$1,461.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.44
Rate for Payer: Qualcare PPO/HMO/WC	$905.85

Know your out-of-pocket cost for care.

All Charges