Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 14MM

Facility

$4,775.00

Hospital Charge Code	270703046
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$2,387.50
Rate for Payer: Aetna Commercial	$1,432.50
Rate for Payer: Aetna Medicare Advantage	$1,432.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,217.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,217.62
Rate for Payer: Cigna Commercial	$2,387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

PLATE 14MM

Facility

$4,775.00

Hospital Charge Code	270703046
Hospital Revenue Code	278
Min. Negotiated Rate	$716.25
Max. Negotiated Rate	$1,155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,155.55
Rate for Payer: Qualcare PPO/HMO/WC	$716.25

PLATE 1/4 TUB TITN 5H****

Facility

$151.00

Hospital Charge Code	270603410
Hospital Revenue Code	279
Min. Negotiated Rate	$22.65
Max. Negotiated Rate	$22.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.65

PLATE 1/4 TUB TITN 5H****

Facility

$151.00

Hospital Charge Code	270603410
Hospital Revenue Code	279
Min. Negotiated Rate	$19.63
Max. Negotiated Rate	$75.50
Rate for Payer: Aetna Commercial	$45.30
Rate for Payer: Aetna Medicare Advantage	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.51
Rate for Payer: Cigna Commercial	$75.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.63
Rate for Payer: Oxford Commercial	$75.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.65
Rate for Payer: UnitedHealthcare Commercial	$75.50

PLATE 15MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

PLATE 15MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

PLATE 1.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270685254
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

PLATE 1.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270685254
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

PLATE 1.5mm TITAN CHON 6HOLE L

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604105
Hospital Revenue Code	278
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$611.83
Rate for Payer: Aetna Commercial	$367.10
Rate for Payer: Aetna Medicare Advantage	$367.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.03
Rate for Payer: Cigna Commercial	$611.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55

PLATE 1.5mm TITAN CHON 6HOLE L

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604105
Hospital Revenue Code	278
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$296.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55

PLATE 1.5mm TITAN CHON 6HOLE R

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604106
Hospital Revenue Code	278
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$296.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55

PLATE 1.5mm TITAN CHON 6HOLE R

Facility

$1,223.65

Service Code	HCPCS C1713
Hospital Charge Code	270604106
Hospital Revenue Code	278
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$611.83
Rate for Payer: Aetna Commercial	$367.10
Rate for Payer: Aetna Medicare Advantage	$367.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.03
Rate for Payer: Cigna Commercial	$611.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.12
Rate for Payer: Qualcare PPO/HMO/WC	$183.55

PLATE 1.5mm TITAN T H3-S9HOLE

Facility

$861.00

Hospital Charge Code	270604103
Hospital Revenue Code	278
Min. Negotiated Rate	$129.15
Max. Negotiated Rate	$430.50
Rate for Payer: Aetna Commercial	$258.30
Rate for Payer: Aetna Medicare Advantage	$258.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.56
Rate for Payer: Cigna Commercial	$430.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.36
Rate for Payer: Qualcare PPO/HMO/WC	$129.15

PLATE 1.5mm TITAN T H3-S9HOLE

Facility

$861.00

Hospital Charge Code	270604103
Hospital Revenue Code	278
Min. Negotiated Rate	$129.15
Max. Negotiated Rate	$208.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.36
Rate for Payer: Qualcare PPO/HMO/WC	$129.15

PLATE 1.5mm TITAN T H4-S9HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270604104
Hospital Revenue Code	278
Min. Negotiated Rate	$145.07
Max. Negotiated Rate	$483.57
Rate for Payer: Aetna Commercial	$290.14
Rate for Payer: Aetna Medicare Advantage	$290.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.62
Rate for Payer: Cigna Commercial	$483.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.05
Rate for Payer: Qualcare PPO/HMO/WC	$145.07

PLATE 1.5mm TITAN T H4-S9HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270604104
Hospital Revenue Code	278
Min. Negotiated Rate	$145.07
Max. Negotiated Rate	$234.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.05
Rate for Payer: Qualcare PPO/HMO/WC	$145.07

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270335737
Hospital Revenue Code	278
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$238.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270332587
Hospital Revenue Code	278
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$238.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270335737
Hospital Revenue Code	278
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$492.00
Rate for Payer: Aetna Commercial	$295.20
Rate for Payer: Aetna Medicare Advantage	$295.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.92
Rate for Payer: Cigna Commercial	$492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PLATE 1.5 RESORB ORBIT

Facility

$984.00

Hospital Charge Code	270332587
Hospital Revenue Code	278
Min. Negotiated Rate	$147.60
Max. Negotiated Rate	$492.00
Rate for Payer: Aetna Commercial	$295.20
Rate for Payer: Aetna Medicare Advantage	$295.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.92
Rate for Payer: Cigna Commercial	$492.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.13
Rate for Payer: Qualcare PPO/HMO/WC	$147.60

PLATE 16MM

Facility

$2,825.00

Hospital Charge Code	270702552
Hospital Revenue Code	278
Min. Negotiated Rate	$423.75
Max. Negotiated Rate	$683.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75

PLATE 16MM

Facility

$2,825.00

Hospital Charge Code	270702552
Hospital Revenue Code	278
Min. Negotiated Rate	$423.75
Max. Negotiated Rate	$1,412.50
Rate for Payer: Aetna Commercial	$847.50
Rate for Payer: Aetna Medicare Advantage	$847.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$720.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$565.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$720.38
Rate for Payer: Cigna Commercial	$1,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$683.65
Rate for Payer: Qualcare PPO/HMO/WC	$423.75

PLATE 16X14MM 7DEG 7H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704845
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PLATE 16X14MM 7DEG 7H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704845
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PLATE 16X14MM 7DEG 8H

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704842
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

Know your out-of-pocket cost for care.

All Charges