Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 3.5mm TITAN LCDCP 7HOLE

Facility

$645.80

Service Code	HCPCS C1713
Hospital Charge Code	270603342
Hospital Revenue Code	278
Min. Negotiated Rate	$96.87
Max. Negotiated Rate	$156.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$96.87

PLATE 3.5mm TITAN LCDCP 7HOLE

Facility

$645.80

Service Code	HCPCS C1713
Hospital Charge Code	270603342
Hospital Revenue Code	278
Min. Negotiated Rate	$96.87
Max. Negotiated Rate	$322.90
Rate for Payer: Aetna Commercial	$193.74
Rate for Payer: Aetna Medicare Advantage	$193.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.68
Rate for Payer: Cigna Commercial	$322.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.28
Rate for Payer: Qualcare PPO/HMO/WC	$96.87

PLATE 3.5mm TITAN LCDCP 8HOLE

Facility

$679.80

Service Code	HCPCS C1713
Hospital Charge Code	270603343
Hospital Revenue Code	278
Min. Negotiated Rate	$101.97
Max. Negotiated Rate	$164.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.51
Rate for Payer: Qualcare PPO/HMO/WC	$101.97

PLATE 3.5mm TITAN LCDCP 8HOLE

Facility

$679.80

Service Code	HCPCS C1713
Hospital Charge Code	270603343
Hospital Revenue Code	278
Min. Negotiated Rate	$101.97
Max. Negotiated Rate	$339.90
Rate for Payer: Aetna Commercial	$203.94
Rate for Payer: Aetna Medicare Advantage	$203.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.35
Rate for Payer: Cigna Commercial	$339.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.51
Rate for Payer: Qualcare PPO/HMO/WC	$101.97

PLATE 3.5MM TITAN RECON 10HOLE

Facility

$2,197.00

Service Code	HCPCS C1713
Hospital Charge Code	270603394
Hospital Revenue Code	278
Min. Negotiated Rate	$329.55
Max. Negotiated Rate	$1,098.50
Rate for Payer: Aetna Commercial	$659.10
Rate for Payer: Aetna Medicare Advantage	$659.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$560.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$560.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$560.24
Rate for Payer: Cigna Commercial	$1,098.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.67
Rate for Payer: Qualcare PPO/HMO/WC	$329.55

PLATE 3.5MM TITAN RECON 10HOLE

Facility

$2,197.00

Service Code	HCPCS C1713
Hospital Charge Code	270603394
Hospital Revenue Code	278
Min. Negotiated Rate	$329.55
Max. Negotiated Rate	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$439.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.67
Rate for Payer: Qualcare PPO/HMO/WC	$329.55

PLATE 3.5MM VA GT PPFX HOOK LG

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,734.15
Max. Negotiated Rate	$2,797.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15

PLATE 3.5MM VA GT PPFX HOOK LG

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697520
Hospital Revenue Code	278
Min. Negotiated Rate	$1,734.15
Max. Negotiated Rate	$5,780.50
Rate for Payer: Aetna Commercial	$3,468.30
Rate for Payer: Aetna Medicare Advantage	$3,468.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,948.05
Rate for Payer: Cigna Commercial	$5,780.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15

PLATE 3.5MM VA GT PPFX HOOK SM

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697518
Hospital Revenue Code	278
Min. Negotiated Rate	$1,734.15
Max. Negotiated Rate	$2,797.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15

PLATE 3.5MM VA GT PPFX HOOK SM

Facility

$11,561.00

Service Code	HCPCS C1713
Hospital Charge Code	270697518
Hospital Revenue Code	278
Min. Negotiated Rate	$1,734.15
Max. Negotiated Rate	$5,780.50
Rate for Payer: Aetna Commercial	$3,468.30
Rate for Payer: Aetna Medicare Advantage	$3,468.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,948.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,312.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,948.05
Rate for Payer: Cigna Commercial	$5,780.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,797.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,734.15

PLATE 3.5 VA LCP TIBIA

Facility

$6,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270665277
Hospital Revenue Code	278
Min. Negotiated Rate	$947.25
Max. Negotiated Rate	$1,528.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,528.23
Rate for Payer: Qualcare PPO/HMO/WC	$947.25

PLATE 3.5 VA LCP TIBIA

Facility

$6,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270665277
Hospital Revenue Code	278
Min. Negotiated Rate	$947.25
Max. Negotiated Rate	$3,157.50
Rate for Payer: Aetna Commercial	$1,894.50
Rate for Payer: Aetna Medicare Advantage	$1,894.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,610.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,610.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,610.33
Rate for Payer: Cigna Commercial	$3,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,528.23
Rate for Payer: Qualcare PPO/HMO/WC	$947.25

PLATE 3.5VA LOCKING 4H

Facility

$3,638.00

Service Code	HCPCS C1713
Hospital Charge Code	270693774
Hospital Revenue Code	278
Min. Negotiated Rate	$545.70
Max. Negotiated Rate	$1,819.00
Rate for Payer: Aetna Commercial	$1,091.40
Rate for Payer: Aetna Medicare Advantage	$1,091.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$927.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$927.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$727.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$927.69
Rate for Payer: Cigna Commercial	$1,819.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.40
Rate for Payer: Qualcare PPO/HMO/WC	$545.70

PLATE 3.5VA LOCKING 4H

Facility

$3,638.00

Service Code	HCPCS C1713
Hospital Charge Code	270693774
Hospital Revenue Code	278
Min. Negotiated Rate	$545.70
Max. Negotiated Rate	$880.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$727.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$880.40
Rate for Payer: Qualcare PPO/HMO/WC	$545.70

PLATE 3.5VA RIT PROXIMAL

Facility

$9,053.20

Service Code	HCPCS C1713
Hospital Charge Code	270688360
Hospital Revenue Code	278
Min. Negotiated Rate	$1,357.98
Max. Negotiated Rate	$4,526.60
Rate for Payer: Aetna Commercial	$2,715.96
Rate for Payer: Aetna Medicare Advantage	$2,715.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,308.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,308.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,810.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,308.57
Rate for Payer: Cigna Commercial	$4,526.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,190.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,357.98

PLATE 3.5VA RIT PROXIMAL

Facility

$9,053.20

Service Code	HCPCS C1713
Hospital Charge Code	270688360
Hospital Revenue Code	278
Min. Negotiated Rate	$1,357.98
Max. Negotiated Rate	$2,190.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,810.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,190.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,357.98

PLATE 36MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270689965
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

PLATE 36MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270689965
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

PLATE 38MM 2LVL

Facility

$5,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270706122
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

PLATE 38MM 2LVL

Facility

$5,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270706122
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

PLATE 3 HOLE

Facility

$10,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270665933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,602.00
Max. Negotiated Rate	$5,340.00
Rate for Payer: Aetna Commercial	$3,204.00
Rate for Payer: Aetna Medicare Advantage	$3,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,723.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,723.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,723.40
Rate for Payer: Cigna Commercial	$5,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,584.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,602.00

PLATE 3 HOLE

Facility

$10,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270665933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,602.00
Max. Negotiated Rate	$2,584.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,584.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,602.00

PLATE 3HOLE OLECRANON 70-0302

Facility

$5,350.00

Hospital Charge Code	270646195
Hospital Revenue Code	278
Min. Negotiated Rate	$802.50
Max. Negotiated Rate	$1,294.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,294.70
Rate for Payer: Qualcare PPO/HMO/WC	$802.50

PLATE 3HOLE OLECRANON 70-0302

Facility

$5,350.00

Hospital Charge Code	270646195
Hospital Revenue Code	278
Min. Negotiated Rate	$802.50
Max. Negotiated Rate	$2,675.00
Rate for Payer: Aetna Commercial	$1,605.00
Rate for Payer: Aetna Medicare Advantage	$1,605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,364.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,364.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,364.25
Rate for Payer: Cigna Commercial	$2,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,294.70
Rate for Payer: Qualcare PPO/HMO/WC	$802.50

PLATE 3 HOL R PROX HUME 437123

Facility

$6,900.00

Hospital Charge Code	270640119
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,669.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00

Know your out-of-pocket cost for care.

All Charges