Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

PLATE 18MM

Facility

$2,825.00

Hospital Charge Code	270702369
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 18MM

Facility

$2,825.00

Hospital Charge Code	270702369
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 1MPJ FUSION SM RT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270693507
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$2,193.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE 1MPJ FUSION SM RT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270693507
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$4,532.50
Rate for Payer: Aetna Commercial	$2,719.50
Rate for Payer: Aetna Medicare Advantage	$2,719.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,311.57
Rate for Payer: Cigna Commercial	$4,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE 20MM

Facility

$2,825.00

Hospital Charge Code	270702698
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 20MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATE 20MM

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270704431
Hospital Revenue Code	279
Min. Negotiated Rate	$679.25
Max. Negotiated Rate	$2,612.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,332.38
Rate for Payer: Cigna Commercial	$2,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$679.25
Rate for Payer: Oxford Commercial	$2,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$783.75
Rate for Payer: UnitedHealthcare Commercial	$2,612.50

PLATE 20MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATE 20MM

Facility

$5,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270704431
Hospital Revenue Code	279
Min. Negotiated Rate	$783.75
Max. Negotiated Rate	$783.75
Rate for Payer: Qualcare PPO/HMO/WC	$783.75

PLATE 20MM

Facility

$2,825.00

Hospital Charge Code	270702698
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 2.0 MM

Facility

$2,702.10

Service Code	HCPCS C1713
Hospital Charge Code	270686172
Hospital Revenue Code	278
Min. Negotiated Rate	$405.31
Max. Negotiated Rate	$1,351.05
Rate for Payer: Aetna Commercial	$810.63
Rate for Payer: Aetna Medicare Advantage	$810.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.04
Rate for Payer: Cigna Commercial	$1,351.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.91
Rate for Payer: Qualcare PPO/HMO/WC	$405.31

PLATE 2.0 MM

Facility

$2,702.10

Service Code	HCPCS C1713
Hospital Charge Code	270686172
Hospital Revenue Code	278
Min. Negotiated Rate	$405.31
Max. Negotiated Rate	$653.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.91
Rate for Payer: Qualcare PPO/HMO/WC	$405.31

PLATE 2.0mm TIT 4-HOLE449.004

Facility

$917.65

Hospital Charge Code	270635600
Hospital Revenue Code	278
Min. Negotiated Rate	$137.65
Max. Negotiated Rate	$458.82
Rate for Payer: Aetna Commercial	$275.30
Rate for Payer: Aetna Medicare Advantage	$275.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.00
Rate for Payer: Cigna Commercial	$458.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.07
Rate for Payer: Qualcare PPO/HMO/WC	$137.65

PLATE 2.0mm TIT 4-HOLE449.004

Facility

$917.65

Hospital Charge Code	270635600
Hospital Revenue Code	278
Min. Negotiated Rate	$137.65
Max. Negotiated Rate	$222.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.07
Rate for Payer: Qualcare PPO/HMO/WC	$137.65

PLATE 2.0mm TITAN CHON 6HOLE L

Facility

$1,288.55

Service Code	HCPCS C1713
Hospital Charge Code	270604099
Hospital Revenue Code	278
Min. Negotiated Rate	$193.28
Max. Negotiated Rate	$311.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.83
Rate for Payer: Qualcare PPO/HMO/WC	$193.28

PLATE 2.0mm TITAN CHON 6HOLE L

Facility

$1,288.55

Service Code	HCPCS C1713
Hospital Charge Code	270604099
Hospital Revenue Code	278
Min. Negotiated Rate	$193.28
Max. Negotiated Rate	$644.27
Rate for Payer: Aetna Commercial	$386.56
Rate for Payer: Aetna Medicare Advantage	$386.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.58
Rate for Payer: Cigna Commercial	$644.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.83
Rate for Payer: Qualcare PPO/HMO/WC	$193.28

PLATE 2.0mm TITAN CHON 6HOLE R

Facility

$1,288.55

Service Code	HCPCS C1713
Hospital Charge Code	270604100
Hospital Revenue Code	278
Min. Negotiated Rate	$193.28
Max. Negotiated Rate	$311.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.83
Rate for Payer: Qualcare PPO/HMO/WC	$193.28

PLATE 2.0mm TITAN CHON 6HOLE R

Facility

$1,288.55

Service Code	HCPCS C1713
Hospital Charge Code	270604100
Hospital Revenue Code	278
Min. Negotiated Rate	$193.28
Max. Negotiated Rate	$644.27
Rate for Payer: Aetna Commercial	$386.56
Rate for Payer: Aetna Medicare Advantage	$386.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.58
Rate for Payer: Cigna Commercial	$644.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.83
Rate for Payer: Qualcare PPO/HMO/WC	$193.28

PLATE 2.0mm TITAN DCP 4HOLE

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270604092
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

PLATE 2.0mm TITAN DCP 4HOLE

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270604092
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

PLATE 2.0mm TITAN DCP 6HOLE

Facility

$1,146.40

Service Code	HCPCS C1713
Hospital Charge Code	270604094
Hospital Revenue Code	278
Min. Negotiated Rate	$171.96
Max. Negotiated Rate	$573.20
Rate for Payer: Aetna Commercial	$343.92
Rate for Payer: Aetna Medicare Advantage	$343.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.33
Rate for Payer: Cigna Commercial	$573.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.43
Rate for Payer: Qualcare PPO/HMO/WC	$171.96

PLATE 2.0mm TITAN DCP 6HOLE

Facility

$1,146.40

Service Code	HCPCS C1713
Hospital Charge Code	270604094
Hospital Revenue Code	278
Min. Negotiated Rate	$171.96
Max. Negotiated Rate	$277.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.43
Rate for Payer: Qualcare PPO/HMO/WC	$171.96

PLATE 2.0mm TITAN DCP 7HOLE

Facility

$1,242.20

Service Code	HCPCS C1713
Hospital Charge Code	270604095
Hospital Revenue Code	278
Min. Negotiated Rate	$186.33
Max. Negotiated Rate	$300.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.61
Rate for Payer: Qualcare PPO/HMO/WC	$186.33

PLATE 2.0mm TITAN DCP 7HOLE

Facility

$1,242.20

Service Code	HCPCS C1713
Hospital Charge Code	270604095
Hospital Revenue Code	278
Min. Negotiated Rate	$186.33
Max. Negotiated Rate	$621.10
Rate for Payer: Aetna Commercial	$372.66
Rate for Payer: Aetna Medicare Advantage	$372.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.76
Rate for Payer: Cigna Commercial	$621.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.61
Rate for Payer: Qualcare PPO/HMO/WC	$186.33

Know your out-of-pocket cost for care.

All Charges