Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 2.0mm TITAN T H3-S9HOLE

Facility

$911.55

Service Code	HCPCS C1713
Hospital Charge Code	270603542
Hospital Revenue Code	278
Min. Negotiated Rate	$136.73
Max. Negotiated Rate	$455.77
Rate for Payer: Aetna Commercial	$273.46
Rate for Payer: Aetna Medicare Advantage	$273.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.45
Rate for Payer: Cigna Commercial	$455.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.60
Rate for Payer: Qualcare PPO/HMO/WC	$136.73

PLATE 2.0mm TITAN T H3-S9HOLE

Facility

$911.55

Service Code	HCPCS C1713
Hospital Charge Code	270603542
Hospital Revenue Code	278
Min. Negotiated Rate	$136.73
Max. Negotiated Rate	$220.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.60
Rate for Payer: Qualcare PPO/HMO/WC	$136.73

PLATE 2.0mm TITAN T H4-S9HOLE

Facility

$985.70

Service Code	HCPCS C1713
Hospital Charge Code	270603543
Hospital Revenue Code	278
Min. Negotiated Rate	$147.85
Max. Negotiated Rate	$492.85
Rate for Payer: Aetna Commercial	$295.71
Rate for Payer: Aetna Medicare Advantage	$295.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.35
Rate for Payer: Cigna Commercial	$492.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.54
Rate for Payer: Qualcare PPO/HMO/WC	$147.85

PLATE 2.0mm TITAN T H4-S9HOLE

Facility

$985.70

Service Code	HCPCS C1713
Hospital Charge Code	270603543
Hospital Revenue Code	278
Min. Negotiated Rate	$147.85
Max. Negotiated Rate	$238.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$197.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.54
Rate for Payer: Qualcare PPO/HMO/WC	$147.85

PLATE 2.4/2.7 MM LCP FUS

Facility

$6,216.10

Service Code	HCPCS C1776
Hospital Charge Code	270689384
Hospital Revenue Code	278
Min. Negotiated Rate	$932.41
Max. Negotiated Rate	$1,504.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,243.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.30
Rate for Payer: Qualcare PPO/HMO/WC	$932.41

PLATE 2.4/2.7 MM LCP FUS

Facility

$6,216.10

Service Code	HCPCS C1776
Hospital Charge Code	270689384
Hospital Revenue Code	278
Min. Negotiated Rate	$932.41
Max. Negotiated Rate	$3,108.05
Rate for Payer: Aetna Commercial	$1,864.83
Rate for Payer: Aetna Medicare Advantage	$1,864.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,585.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,585.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,243.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,585.11
Rate for Payer: Cigna Commercial	$3,108.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.30
Rate for Payer: Qualcare PPO/HMO/WC	$932.41

PLATE 2.4/2.7 X-SMALL

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270689658
Hospital Revenue Code	278
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$2,372.50
Rate for Payer: Aetna Commercial	$1,423.50
Rate for Payer: Aetna Medicare Advantage	$1,423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,209.97
Rate for Payer: Cigna Commercial	$2,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: Qualcare PPO/HMO/WC	$711.75

PLATE 2.4/2.7 X-SMALL

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270689658
Hospital Revenue Code	278
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$1,148.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: Qualcare PPO/HMO/WC	$711.75

PLATE 2.4 LCP

Facility

$8,982.00

Service Code	HCPCS C1713
Hospital Charge Code	270685708
Hospital Revenue Code	278
Min. Negotiated Rate	$1,347.30
Max. Negotiated Rate	$2,173.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,796.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,173.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,347.30

PLATE 2.4 LCP

Facility

$8,982.00

Service Code	HCPCS C1713
Hospital Charge Code	270685708
Hospital Revenue Code	278
Min. Negotiated Rate	$1,347.30
Max. Negotiated Rate	$4,491.00
Rate for Payer: Aetna Commercial	$2,694.60
Rate for Payer: Aetna Medicare Advantage	$2,694.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,290.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,290.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,796.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,290.41
Rate for Payer: Cigna Commercial	$4,491.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,173.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,347.30

PLATE 24MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706188
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

PLATE 24MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706188
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

PLATE 24MM

Facility

$4,900.00

Hospital Charge Code	270702973
Hospital Revenue Code	278
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,470.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,185.80
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

PLATE 24MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704672
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 24MM

Facility

$4,900.00

Hospital Charge Code	270702973
Hospital Revenue Code	278
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$1,185.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,185.80
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

PLATE 24MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704672
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 24 MM 1 LEVEL ARCHON

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270693083
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE 24 MM 1 LEVEL ARCHON

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270693083
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE 2.4 MM 4 HOLE 6 HOLE ST

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270688276
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$2,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

PLATE 2.4 MM 4 HOLE 6 HOLE ST

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270688276
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$4,290.00
Rate for Payer: Aetna Commercial	$2,574.00
Rate for Payer: Aetna Medicare Advantage	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,187.90
Rate for Payer: Cigna Commercial	$4,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

PLATE 2.4MM LCP 7 HOLES 60MM

Facility

$930.00

Hospital Charge Code	270670055
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

PLATE 2.4MM LCP 7 HOLES 60MM

Facility

$930.00

Hospital Charge Code	270670055
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

PLATE 24MM SLIM 1LVL

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705536
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PLATE 24MM SLIM 1LVL

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705536
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PLATE 2.4MM ST 12 HOLES

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270656291
Hospital Revenue Code	278
Min. Negotiated Rate	$172.80
Max. Negotiated Rate	$278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80

Know your out-of-pocket cost for care.

All Charges