Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VA-LCP 2.7/3.5 2H RT ST

Facility

$4,613.35

Service Code	HCPCS C1713
Hospital Charge Code	270669498
Hospital Revenue Code	278
Min. Negotiated Rate	$131.02
Max. Negotiated Rate	$2,306.68
Rate for Payer: Aetna Commercial	$1,753.07
Rate for Payer: Aetna Medicare Advantage	$1,384.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$922.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,176.40
Rate for Payer: Cigna Commercial	$2,306.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.43
Rate for Payer: Qualcare PPO/HMO/WC	$692.00
Rate for Payer: UnitedHealthcare Community & State	$145.78
Rate for Payer: Wellpoint Medicaid Managed Care	$131.02

PLATE VA-LCP 2.7/3.5 2H RT ST

Facility

$4,613.35

Service Code	HCPCS C1713
Hospital Charge Code	270669498
Hospital Revenue Code	278
Min. Negotiated Rate	$692.00
Max. Negotiated Rate	$1,116.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$922.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.43
Rate for Payer: Qualcare PPO/HMO/WC	$692.00

PLATE VA-LCP 2.7/3.5 4H/L/116

Facility

$4,406.35

Hospital Charge Code	270677626
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$2,203.18
Rate for Payer: Aetna Commercial	$1,674.41
Rate for Payer: Aetna Medicare Advantage	$1,321.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,123.62
Rate for Payer: Cigna Commercial	$2,203.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95
Rate for Payer: UnitedHealthcare Community & State	$139.24
Rate for Payer: Wellpoint Medicaid Managed Care	$125.14

PLATE VA-LCP 2.7/3.5 4H/L/116

Facility

$4,406.35

Hospital Charge Code	270677626
Hospital Revenue Code	278
Min. Negotiated Rate	$660.95
Max. Negotiated Rate	$1,066.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95

PLATE VA-LCP 2.7/3.5 4H/R/116

Facility

$4,406.35

Hospital Charge Code	270677624
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$2,203.18
Rate for Payer: Aetna Commercial	$1,674.41
Rate for Payer: Aetna Medicare Advantage	$1,321.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,123.62
Rate for Payer: Cigna Commercial	$2,203.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95
Rate for Payer: UnitedHealthcare Community & State	$139.24
Rate for Payer: Wellpoint Medicaid Managed Care	$125.14

PLATE VA-LCP 2.7/3.5 4H/R/116

Facility

$4,406.35

Hospital Charge Code	270677624
Hospital Revenue Code	278
Min. Negotiated Rate	$660.95
Max. Negotiated Rate	$1,066.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95

PLATE VA-LCP 2.7/3.5 4H RT ST

Facility

$4,613.35

Service Code	HCPCS C1713
Hospital Charge Code	270676979
Hospital Revenue Code	278
Min. Negotiated Rate	$692.00
Max. Negotiated Rate	$1,116.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$922.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.43
Rate for Payer: Qualcare PPO/HMO/WC	$692.00

PLATE VA-LCP 2.7/3.5 4H RT ST

Facility

$4,613.35

Service Code	HCPCS C1713
Hospital Charge Code	270676979
Hospital Revenue Code	278
Min. Negotiated Rate	$131.02
Max. Negotiated Rate	$2,306.68
Rate for Payer: Aetna Commercial	$1,753.07
Rate for Payer: Aetna Medicare Advantage	$1,384.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$922.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,176.40
Rate for Payer: Cigna Commercial	$2,306.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.43
Rate for Payer: Qualcare PPO/HMO/WC	$692.00
Rate for Payer: UnitedHealthcare Community & State	$145.78
Rate for Payer: Wellpoint Medicaid Managed Care	$131.02

PLATE VA-LCP 2.7 3.5 6H L 142

Facility

$4,406.35

Service Code	HCPCS C1713
Hospital Charge Code	270677627
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$2,203.18
Rate for Payer: Aetna Commercial	$1,674.41
Rate for Payer: Aetna Medicare Advantage	$1,321.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,123.62
Rate for Payer: Cigna Commercial	$2,203.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95
Rate for Payer: UnitedHealthcare Community & State	$139.24
Rate for Payer: Wellpoint Medicaid Managed Care	$125.14

PLATE VA-LCP 2.7 3.5 6H L 142

Facility

$4,406.35

Service Code	HCPCS C1713
Hospital Charge Code	270677627
Hospital Revenue Code	278
Min. Negotiated Rate	$660.95
Max. Negotiated Rate	$1,066.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95

PLATE VA-LCP 2.7/3.5 6H/R/142

Facility

$4,406.35

Hospital Charge Code	270677625
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$2,203.18
Rate for Payer: Aetna Commercial	$1,674.41
Rate for Payer: Aetna Medicare Advantage	$1,321.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,123.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,123.62
Rate for Payer: Cigna Commercial	$2,203.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95
Rate for Payer: UnitedHealthcare Community & State	$139.24
Rate for Payer: Wellpoint Medicaid Managed Care	$125.14

PLATE VA-LCP 2.7/3.5 6H/R/142

Facility

$4,406.35

Hospital Charge Code	270677625
Hospital Revenue Code	278
Min. Negotiated Rate	$660.95
Max. Negotiated Rate	$1,066.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$881.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,066.34
Rate for Payer: Qualcare PPO/HMO/WC	$660.95

PLATE VA-LCP 2.7/3.5 6H RT ST

Facility

$4,613.35

Service Code	HCPCS C1713
Hospital Charge Code	270669932
Hospital Revenue Code	278
Min. Negotiated Rate	$692.00
Max. Negotiated Rate	$1,116.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$922.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.43
Rate for Payer: Qualcare PPO/HMO/WC	$692.00

PLATE VA-LCP 2.7/3.5 6H RT ST

Facility

$4,613.35

Service Code	HCPCS C1713
Hospital Charge Code	270669932
Hospital Revenue Code	278
Min. Negotiated Rate	$131.02
Max. Negotiated Rate	$2,306.68
Rate for Payer: Aetna Commercial	$1,753.07
Rate for Payer: Aetna Medicare Advantage	$1,384.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$922.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,176.40
Rate for Payer: Cigna Commercial	$2,306.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,116.43
Rate for Payer: Qualcare PPO/HMO/WC	$692.00
Rate for Payer: UnitedHealthcare Community & State	$145.78
Rate for Payer: Wellpoint Medicaid Managed Care	$131.02

PLATE VA-LCP 2.7/3.5MM 10H LT

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689600
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

PLATE VA-LCP 2.7/3.5MM 10H LT

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689600
Hospital Revenue Code	278
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$254.90
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: Qualcare PPO/HMO/WC	$100.62
Rate for Payer: UnitedHealthcare Community & State	$21.20
Rate for Payer: Wellpoint Medicaid Managed Care	$19.05

PLATE VA-LCP 2.7/3.5MM 10H LT

Facility

$6,878.35

Hospital Charge Code	270677598
Hospital Revenue Code	278
Min. Negotiated Rate	$195.35
Max. Negotiated Rate	$3,439.18
Rate for Payer: Aetna Commercial	$2,613.77
Rate for Payer: Aetna Medicare Advantage	$2,063.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.98
Rate for Payer: Cigna Commercial	$3,439.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,664.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.75
Rate for Payer: UnitedHealthcare Community & State	$217.36
Rate for Payer: Wellpoint Medicaid Managed Care	$195.35

PLATE VA-LCP 2.7/3.5MM 10H LT

Facility

$6,878.35

Hospital Charge Code	270677598
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.75
Max. Negotiated Rate	$1,664.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,664.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.75

PLATE VA-LCP 2.7/3.5MM 10H RT

Facility

$6,464.30

Hospital Charge Code	270677599
Hospital Revenue Code	278
Min. Negotiated Rate	$969.64
Max. Negotiated Rate	$1,564.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,292.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,564.36
Rate for Payer: Qualcare PPO/HMO/WC	$969.64

PLATE VA-LCP 2.7/3.5MM 10H RT

Facility

$6,878.35

Hospital Charge Code	270677597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.75
Max. Negotiated Rate	$1,664.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,664.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.75

PLATE VA-LCP 2.7/3.5MM 10H RT

Facility

$6,671.30

Service Code	HCPCS C1713
Hospital Charge Code	270675893
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.70
Max. Negotiated Rate	$1,614.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.70

PLATE VA-LCP 2.7/3.5MM 10H RT

Facility

$6,464.30

Hospital Charge Code	270677599
Hospital Revenue Code	278
Min. Negotiated Rate	$183.59
Max. Negotiated Rate	$3,232.15
Rate for Payer: Aetna Commercial	$2,456.43
Rate for Payer: Aetna Medicare Advantage	$1,939.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,648.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,648.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,292.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,648.40
Rate for Payer: Cigna Commercial	$3,232.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,564.36
Rate for Payer: Qualcare PPO/HMO/WC	$969.64
Rate for Payer: UnitedHealthcare Community & State	$204.27
Rate for Payer: Wellpoint Medicaid Managed Care	$183.59

PLATE VA-LCP 2.7/3.5MM 10H RT

Facility

$6,878.35

Hospital Charge Code	270677597
Hospital Revenue Code	278
Min. Negotiated Rate	$195.35
Max. Negotiated Rate	$3,439.18
Rate for Payer: Aetna Commercial	$2,613.77
Rate for Payer: Aetna Medicare Advantage	$2,063.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,375.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.98
Rate for Payer: Cigna Commercial	$3,439.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,664.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.75
Rate for Payer: UnitedHealthcare Community & State	$217.36
Rate for Payer: Wellpoint Medicaid Managed Care	$195.35

PLATE VA-LCP 2.7/3.5MM 10H RT

Facility

$6,671.30

Service Code	HCPCS C1713
Hospital Charge Code	270675893
Hospital Revenue Code	278
Min. Negotiated Rate	$189.46
Max. Negotiated Rate	$3,335.65
Rate for Payer: Aetna Commercial	$2,535.09
Rate for Payer: Aetna Medicare Advantage	$2,001.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,701.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,701.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,701.18
Rate for Payer: Cigna Commercial	$3,335.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.70
Rate for Payer: UnitedHealthcare Community & State	$210.81
Rate for Payer: Wellpoint Medicaid Managed Care	$189.46

PLATE VA-LCP 2.7/3.5MM 12H LT

Facility

$7,752.80

Service Code	HCPCS C1713
Hospital Charge Code	270676154
Hospital Revenue Code	278
Min. Negotiated Rate	$220.18
Max. Negotiated Rate	$3,876.40
Rate for Payer: Aetna Commercial	$2,946.06
Rate for Payer: Aetna Medicare Advantage	$2,325.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.96
Rate for Payer: Cigna Commercial	$3,876.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,876.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.92
Rate for Payer: UnitedHealthcare Community & State	$244.99
Rate for Payer: Wellpoint Medicaid Managed Care	$220.18

Know your out-of-pocket cost for care.

All Charges