Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

PLATE 51MM 3-LEVEL

Facility

$13,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,070.00
Max. Negotiated Rate	$3,339.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,760.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,339.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.00

PLATE 51MM 3-LEVEL

Facility

$13,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,070.00
Max. Negotiated Rate	$6,900.00
Rate for Payer: Aetna Commercial	$4,140.00
Rate for Payer: Aetna Medicare Advantage	$4,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,519.00
Rate for Payer: Cigna Commercial	$6,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,339.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.00

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270704950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$3,775.00
Rate for Payer: Aetna Commercial	$2,265.00
Rate for Payer: Aetna Medicare Advantage	$2,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.25
Rate for Payer: Cigna Commercial	$3,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270703950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$1,827.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270703950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$3,775.00
Rate for Payer: Aetna Commercial	$2,265.00
Rate for Payer: Aetna Medicare Advantage	$2,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,925.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,925.25
Rate for Payer: Cigna Commercial	$3,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 51MM 3LVL REF#011.305

Facility

$7,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270704950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.50
Max. Negotiated Rate	$1,827.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,827.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,132.50

PLATE 5H LEFT

Facility

$4,378.55

Hospital Charge Code	270662179
Hospital Revenue Code	278
Min. Negotiated Rate	$656.78
Max. Negotiated Rate	$2,189.28
Rate for Payer: Aetna Commercial	$1,313.57
Rate for Payer: Aetna Medicare Advantage	$1,313.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,116.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,116.53
Rate for Payer: Cigna Commercial	$2,189.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.61
Rate for Payer: Qualcare PPO/HMO/WC	$656.78

PLATE 5H LEFT

Facility

$4,378.55

Hospital Charge Code	270662179
Hospital Revenue Code	278
Min. Negotiated Rate	$656.78
Max. Negotiated Rate	$1,059.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,059.61
Rate for Payer: Qualcare PPO/HMO/WC	$656.78

PLATE 5 HOLE 1/3 TUBULAR

Facility

$460.00

Hospital Charge Code	270669257
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$138.00
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PLATE 5 HOLE 1/3 TUBULAR

Facility

$460.00

Hospital Charge Code	270669257
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$111.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PLATE 5 HOLE 140DEG 107MM

Facility

$1,241.25

Hospital Charge Code	270654992
Hospital Revenue Code	278
Min. Negotiated Rate	$186.19
Max. Negotiated Rate	$300.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.38
Rate for Payer: Qualcare PPO/HMO/WC	$186.19

PLATE 5 HOLE 140DEG 107MM

Facility

$1,241.25

Hospital Charge Code	270654992
Hospital Revenue Code	278
Min. Negotiated Rate	$186.19
Max. Negotiated Rate	$620.62
Rate for Payer: Aetna Commercial	$372.38
Rate for Payer: Aetna Medicare Advantage	$372.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.52
Rate for Payer: Cigna Commercial	$620.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.38
Rate for Payer: Qualcare PPO/HMO/WC	$186.19

PLATE 5 HOLE CONNECTING

Facility

$551.85

Hospital Charge Code	270691900
Hospital Revenue Code	272
Min. Negotiated Rate	$82.78
Max. Negotiated Rate	$82.78
Rate for Payer: Qualcare PPO/HMO/WC	$82.78

PLATE 5 HOLE CONNECTING

Facility

$551.85

Hospital Charge Code	270691900
Hospital Revenue Code	272
Min. Negotiated Rate	$71.74
Max. Negotiated Rate	$275.93
Rate for Payer: Aetna Commercial	$165.56
Rate for Payer: Aetna Medicare Advantage	$165.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.72
Rate for Payer: Cigna Commercial	$275.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.74
Rate for Payer: Oxford Commercial	$275.93
Rate for Payer: Qualcare PPO/HMO/WC	$82.78
Rate for Payer: UnitedHealthcare Commercial	$275.93

PLATE 5 HOLE LOCKING MEDIAL

Facility

$4,970.00

Hospital Charge Code	270702837
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$2,485.00
Rate for Payer: Aetna Commercial	$1,491.00
Rate for Payer: Aetna Medicare Advantage	$1,491.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,267.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,267.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$994.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,267.35
Rate for Payer: Cigna Commercial	$2,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.74
Rate for Payer: Qualcare PPO/HMO/WC	$745.50

PLATE 5 HOLE LOCKING MEDIAL

Facility

$4,970.00

Hospital Charge Code	270702837
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$1,202.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$994.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,202.74
Rate for Payer: Qualcare PPO/HMO/WC	$745.50

PLATE 5-HOLE META SM 814117005

Facility

$1,140.85

Hospital Charge Code	270632798
Hospital Revenue Code	278
Min. Negotiated Rate	$171.13
Max. Negotiated Rate	$276.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.09
Rate for Payer: Qualcare PPO/HMO/WC	$171.13

PLATE 5-HOLE META SM 814117005

Facility

$1,140.85

Hospital Charge Code	270632798
Hospital Revenue Code	278
Min. Negotiated Rate	$171.13
Max. Negotiated Rate	$570.42
Rate for Payer: Aetna Commercial	$342.25
Rate for Payer: Aetna Medicare Advantage	$342.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.92
Rate for Payer: Cigna Commercial	$570.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.09
Rate for Payer: Qualcare PPO/HMO/WC	$171.13

PLATE 5 HOLE RIGHT

Facility

$5,500.00

Hospital Charge Code	270654891
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 5 HOLE RIGHT

Facility

$5,500.00

Hospital Charge Code	270654891
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 5 HOLES TUBULAR 39MM

Facility

$366.00

Hospital Charge Code	270656909
Hospital Revenue Code	278
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$88.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.57
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

PLATE 5 HOLES TUBULAR 39MM

Facility

$366.00

Hospital Charge Code	270656909
Hospital Revenue Code	278
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$109.80
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.57
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

PLATE 5 HOLE TIBIAL LG RT

Facility

$8,100.00

Hospital Charge Code	270648292
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.00
Max. Negotiated Rate	$1,960.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

PLATE 5 HOLE TIBIAL LG RT

Facility

$8,100.00

Hospital Charge Code	270648292
Hospital Revenue Code	278
Min. Negotiated Rate	$1,215.00
Max. Negotiated Rate	$4,050.00
Rate for Payer: Aetna Commercial	$2,430.00
Rate for Payer: Aetna Medicare Advantage	$2,430.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,065.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,065.50
Rate for Payer: Cigna Commercial	$4,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,960.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,215.00

Know your out-of-pocket cost for care.

All Charges