Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 48MM

Facility

$11,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270663487
Hospital Revenue Code	278
Min. Negotiated Rate	$1,683.75
Max. Negotiated Rate	$2,716.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,716.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75

PLATE 48MM

Facility

$11,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270663487
Hospital Revenue Code	278
Min. Negotiated Rate	$1,683.75
Max. Negotiated Rate	$5,612.50
Rate for Payer: Aetna Commercial	$3,367.50
Rate for Payer: Aetna Medicare Advantage	$3,367.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,862.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,245.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,862.38
Rate for Payer: Cigna Commercial	$5,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,716.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,683.75

PLATE 4HLE LF LT PRX TIB 26130

Facility

$6,425.00

Hospital Charge Code	270639191
Hospital Revenue Code	278
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$1,554.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

PLATE 4HLE LF LT PRX TIB 26130

Facility

$6,425.00

Hospital Charge Code	270639191
Hospital Revenue Code	278
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$1,927.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

PLATE 4 HOLE 14MM

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693155
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

PLATE 4 HOLE 14MM

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693155
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$6,375.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

PLATE 4 HOLE 25MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270671023
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$2,614.50
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

PLATE 4 HOLE 25MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270671023
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

PLATE 4 HOLE 30MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270672103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$4,357.50
Rate for Payer: Aetna Commercial	$2,614.50
Rate for Payer: Aetna Medicare Advantage	$2,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,222.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,222.32
Rate for Payer: Cigna Commercial	$4,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

PLATE 4 HOLE 30MM CLAW II

Facility

$8,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270672103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.25
Max. Negotiated Rate	$2,109.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,109.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.25

PLATE 4 HOLE 3.5 LCP

Facility

$5,838.00

Service Code	HCPCS C1713
Hospital Charge Code	270664330
Hospital Revenue Code	278
Min. Negotiated Rate	$875.70
Max. Negotiated Rate	$2,919.00
Rate for Payer: Aetna Commercial	$1,751.40
Rate for Payer: Aetna Medicare Advantage	$1,751.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,167.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,488.69
Rate for Payer: Cigna Commercial	$2,919.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.80
Rate for Payer: Qualcare PPO/HMO/WC	$875.70

PLATE 4 HOLE 3.5 LCP

Facility

$5,838.00

Service Code	HCPCS C1713
Hospital Charge Code	270664330
Hospital Revenue Code	278
Min. Negotiated Rate	$875.70
Max. Negotiated Rate	$1,412.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,167.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.80
Rate for Payer: Qualcare PPO/HMO/WC	$875.70

PLATE 4 HOLE 3.5x20MM

Facility

$7,990.00

Hospital Charge Code	270656791
Hospital Revenue Code	278
Min. Negotiated Rate	$1,198.50
Max. Negotiated Rate	$3,995.00
Rate for Payer: Aetna Commercial	$2,397.00
Rate for Payer: Aetna Medicare Advantage	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,037.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,037.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,037.45
Rate for Payer: Cigna Commercial	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,933.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.50

PLATE 4 HOLE 3.5x20MM

Facility

$7,990.00

Hospital Charge Code	270656791
Hospital Revenue Code	278
Min. Negotiated Rate	$1,198.50
Max. Negotiated Rate	$1,933.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,598.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,933.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.50

PLATE 4 HOLE 3.5x25MM

Facility

$7,990.00

Hospital Charge Code	270656794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,198.50
Max. Negotiated Rate	$1,933.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,598.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,933.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.50

PLATE 4 HOLE 3.5x25MM

Facility

$7,990.00

Hospital Charge Code	270656794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,198.50
Max. Negotiated Rate	$3,995.00
Rate for Payer: Aetna Commercial	$2,397.00
Rate for Payer: Aetna Medicare Advantage	$2,397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,037.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,037.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,037.45
Rate for Payer: Cigna Commercial	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,933.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.50

PLATE 4HOLE 64mm MEDIAL LEFT

Facility

$4,116.00

Hospital Charge Code	270643697
Hospital Revenue Code	278
Min. Negotiated Rate	$617.40
Max. Negotiated Rate	$2,058.00
Rate for Payer: Aetna Commercial	$1,234.80
Rate for Payer: Aetna Medicare Advantage	$1,234.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,049.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,049.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,049.58
Rate for Payer: Cigna Commercial	$2,058.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.07
Rate for Payer: Qualcare PPO/HMO/WC	$617.40

PLATE 4HOLE 64mm MEDIAL LEFT

Facility

$4,116.00

Hospital Charge Code	270643697
Hospital Revenue Code	278
Min. Negotiated Rate	$617.40
Max. Negotiated Rate	$996.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.07
Rate for Payer: Qualcare PPO/HMO/WC	$617.40

PLATE 4-HOLE REG STR 017040

Facility

$362.15

Hospital Charge Code	270630555
Hospital Revenue Code	278
Min. Negotiated Rate	$54.32
Max. Negotiated Rate	$181.07
Rate for Payer: Aetna Commercial	$108.64
Rate for Payer: Aetna Medicare Advantage	$108.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.35
Rate for Payer: Cigna Commercial	$181.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: Qualcare PPO/HMO/WC	$54.32

PLATE 4-HOLE REG STR 017040

Facility

$362.15

Hospital Charge Code	270630555
Hospital Revenue Code	278
Min. Negotiated Rate	$54.32
Max. Negotiated Rate	$87.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: Qualcare PPO/HMO/WC	$54.32

PLATE 4 HOLES TUBULAR 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270656908
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PLATE 4 HOLES TUBULAR 31MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	270656908
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$103.50
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PLATE 4-HOLE X-LONG STR 017048

Facility

$362.15

Hospital Charge Code	270630554
Hospital Revenue Code	278
Min. Negotiated Rate	$54.32
Max. Negotiated Rate	$181.07
Rate for Payer: Aetna Commercial	$108.64
Rate for Payer: Aetna Medicare Advantage	$108.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.35
Rate for Payer: Cigna Commercial	$181.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: Qualcare PPO/HMO/WC	$54.32

PLATE 4-HOLE X-LONG STR 017048

Facility

$362.15

Hospital Charge Code	270630554
Hospital Revenue Code	278
Min. Negotiated Rate	$54.32
Max. Negotiated Rate	$87.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.64
Rate for Payer: Qualcare PPO/HMO/WC	$54.32

PLATE 4H ULNA PROXDR 234800904

Facility

$3,156.00

Hospital Charge Code	270632812
Hospital Revenue Code	278
Min. Negotiated Rate	$473.40
Max. Negotiated Rate	$763.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$763.75
Rate for Payer: Qualcare PPO/HMO/WC	$473.40

Know your out-of-pocket cost for care.

All Charges