Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE 7 HOLES VDF 125MM

Facility

$5,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270671145
Hospital Revenue Code	278
Min. Negotiated Rate	$834.75
Max. Negotiated Rate	$1,346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.73
Rate for Payer: Qualcare PPO/HMO/WC	$834.75

PLATE 7 HOLES VDF 125MM

Facility

$5,565.00

Service Code	HCPCS C1713
Hospital Charge Code	270671145
Hospital Revenue Code	278
Min. Negotiated Rate	$834.75
Max. Negotiated Rate	$2,782.50
Rate for Payer: Aetna Commercial	$1,669.50
Rate for Payer: Aetna Medicare Advantage	$1,669.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,419.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,419.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,113.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,419.08
Rate for Payer: Cigna Commercial	$2,782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.73
Rate for Payer: Qualcare PPO/HMO/WC	$834.75

PLATE 7 MM 4 HOLE

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270693118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 7 MM 4 HOLE

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270693118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$2,835.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 80 HOLE THIRD TUBE

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270682857
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80 HOLE THIRD TUBE

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270682857
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80MM LORDOTIC PRE-BENT.

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703622
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 80MM LORDOTIC PRE-BENT.

Facility

$1,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270703622
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 8H DYNAC COMPRESS PLDCP8

Facility

$830.00

Hospital Charge Code	270638176
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$200.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

PLATE 8H DYNAC COMPRESS PLDCP8

Facility

$830.00

Hospital Charge Code	270638176
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$249.00
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.86
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

PLATE 8-HOLE CLAVICLE LEFT

Facility

$5,610.00

Hospital Charge Code	270648046
Hospital Revenue Code	278
Min. Negotiated Rate	$841.50
Max. Negotiated Rate	$2,805.00
Rate for Payer: Aetna Commercial	$1,683.00
Rate for Payer: Aetna Medicare Advantage	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.55
Rate for Payer: Cigna Commercial	$2,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.62
Rate for Payer: Qualcare PPO/HMO/WC	$841.50

PLATE 8-HOLE CLAVICLE LEFT

Facility

$5,610.00

Hospital Charge Code	270648046
Hospital Revenue Code	278
Min. Negotiated Rate	$841.50
Max. Negotiated Rate	$1,357.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.62
Rate for Payer: Qualcare PPO/HMO/WC	$841.50

PLATE 8-HOLE DISTAL MED 437208

Facility

$9,835.00

Hospital Charge Code	270648064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,475.25
Max. Negotiated Rate	$4,917.50
Rate for Payer: Aetna Commercial	$2,950.50
Rate for Payer: Aetna Medicare Advantage	$2,950.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,507.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,507.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,967.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,507.93
Rate for Payer: Cigna Commercial	$4,917.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,380.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,475.25

PLATE 8-HOLE DISTAL MED 437208

Facility

$9,835.00

Hospital Charge Code	270648064
Hospital Revenue Code	278
Min. Negotiated Rate	$1,475.25
Max. Negotiated Rate	$2,380.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,967.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,380.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,475.25

PLATE 8HOLE LATERAL 27134

Facility

$5,640.00

Hospital Charge Code	270639622
Hospital Revenue Code	278
Min. Negotiated Rate	$846.00
Max. Negotiated Rate	$2,820.00
Rate for Payer: Aetna Commercial	$1,692.00
Rate for Payer: Aetna Medicare Advantage	$1,692.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,438.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,438.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,438.20
Rate for Payer: Cigna Commercial	$2,820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,364.88
Rate for Payer: Qualcare PPO/HMO/WC	$846.00

PLATE 8HOLE LATERAL 27134

Facility

$5,640.00

Hospital Charge Code	270639622
Hospital Revenue Code	278
Min. Negotiated Rate	$846.00
Max. Negotiated Rate	$1,364.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,364.88
Rate for Payer: Qualcare PPO/HMO/WC	$846.00

PLATE 8 HOLES 2.0 MM X 48MM

Facility

$1,308.00

Service Code	HCPCS C1713
Hospital Charge Code	270667562
Hospital Revenue Code	278
Min. Negotiated Rate	$196.20
Max. Negotiated Rate	$316.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.54
Rate for Payer: Qualcare PPO/HMO/WC	$196.20

PLATE 8 HOLES 2.0 MM X 48MM

Facility

$1,308.00

Service Code	HCPCS C1713
Hospital Charge Code	270667562
Hospital Revenue Code	278
Min. Negotiated Rate	$196.20
Max. Negotiated Rate	$654.00
Rate for Payer: Aetna Commercial	$392.40
Rate for Payer: Aetna Medicare Advantage	$392.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$333.54
Rate for Payer: Cigna Commercial	$654.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.54
Rate for Payer: Qualcare PPO/HMO/WC	$196.20

PLATE 8 HOLES 88MM RIGHT

Facility

$8,350.00

Hospital Charge Code	270670805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$4,175.00
Rate for Payer: Aetna Commercial	$2,505.00
Rate for Payer: Aetna Medicare Advantage	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,129.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,129.25
Rate for Payer: Cigna Commercial	$4,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

PLATE 8 HOLES 88MM RIGHT

Facility

$8,350.00

Hospital Charge Code	270670805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,252.50
Max. Negotiated Rate	$2,020.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,020.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,252.50

PLATE 8 HOLE TUBULAR

Facility

$1,325.00

Hospital Charge Code	270664487
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 8 HOLE TUBULAR

Facility

$1,325.00

Hospital Charge Code	270664487
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

PLATE 8MM 4 HOLE PLATE MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693272
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 8MM 4 HOLE PLATE MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693272
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$2,835.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PLATE 8MM CERES-C

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692581
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

Know your out-of-pocket cost for care.

All Charges