Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 9H 3.5CM LCP METAPHYSEAL

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270656671
Hospital Revenue Code	278
Min. Negotiated Rate	$580.05
Max. Negotiated Rate	$935.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: Qualcare PPO/HMO/WC	$580.05

PLATE 9H 3.5CM LCP METAPHYSEAL

Facility

$3,867.00

Service Code	HCPCS C1713
Hospital Charge Code	270656671
Hospital Revenue Code	278
Min. Negotiated Rate	$580.05
Max. Negotiated Rate	$1,933.50
Rate for Payer: Aetna Commercial	$1,160.10
Rate for Payer: Aetna Medicare Advantage	$1,160.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$986.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$773.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$986.09
Rate for Payer: Cigna Commercial	$1,933.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.81
Rate for Payer: Qualcare PPO/HMO/WC	$580.05

PLATE 9MM 4 HOLE

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705745
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

PLATE 9MM 4 HOLE

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705745
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

PLATE ACDF VAULT C 16X14X6MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695547
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$5,175.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE ACDF VAULT C 16X14X6MM

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695547
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

PLATE ACP 14MM 1LEVEL

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695532
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$5,775.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

PLATE ACP 14MM 1LEVEL

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695532
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

PLATE ACP 1.6V 18MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694182
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$3,361.05
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 18MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694182
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 1LEV 20MM

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270696632
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$3,361.05
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 1LEV 20MM

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270696632
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 22MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270695533
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$3,361.05
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 22MM 1LEVEL

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270695533
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 24MM 1LEV

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694491
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$2,711.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 24MM 1LEV

Facility

$11,203.50

Service Code	HCPCS C1713
Hospital Charge Code	270694491
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.53
Max. Negotiated Rate	$5,601.75
Rate for Payer: Aetna Commercial	$3,361.05
Rate for Payer: Aetna Medicare Advantage	$3,361.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.89
Rate for Payer: Cigna Commercial	$5,601.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,711.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.53

PLATE ACP 1.6V 2LEVEL 34MM

Facility

$12,144.00

Service Code	HCPCS C1713
Hospital Charge Code	270694722
Hospital Revenue Code	278
Min. Negotiated Rate	$1,821.60
Max. Negotiated Rate	$2,938.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,428.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,938.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,821.60

PLATE ACP 1.6V 2LEVEL 34MM

Facility

$12,144.00

Service Code	HCPCS C1713
Hospital Charge Code	270694722
Hospital Revenue Code	278
Min. Negotiated Rate	$1,821.60
Max. Negotiated Rate	$6,072.00
Rate for Payer: Aetna Commercial	$3,643.20
Rate for Payer: Aetna Medicare Advantage	$3,643.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,096.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,096.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,428.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,096.72
Rate for Payer: Cigna Commercial	$6,072.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,938.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,821.60

PLATE ACP 1.6V 36MM 2-LEVEL

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695254
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

PLATE ACP 1.6V 36MM 2-LEVEL

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695254
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

PLATE ACP 1.6V 38MM 2 LEVEL

Facility

$12,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270693080
Hospital Revenue Code	278
Min. Negotiated Rate	$1,821.00
Max. Negotiated Rate	$2,937.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,428.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,937.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,821.00

PLATE ACP 1.6V 38MM 2 LEVEL

Facility

$12,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270693080
Hospital Revenue Code	278
Min. Negotiated Rate	$1,821.00
Max. Negotiated Rate	$6,070.00
Rate for Payer: Aetna Commercial	$3,642.00
Rate for Payer: Aetna Medicare Advantage	$3,642.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,095.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,095.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,095.70
Rate for Payer: Cigna Commercial	$6,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,937.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,821.00

PLATE ACP 1.6V 40MM 2LEVEL

Facility

$12,144.00

Service Code	HCPCS C1713
Hospital Charge Code	270694179
Hospital Revenue Code	278
Min. Negotiated Rate	$1,821.60
Max. Negotiated Rate	$2,938.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,428.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,938.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,821.60

PLATE ACP 1.6V 40MM 2LEVEL

Facility

$12,144.00

Service Code	HCPCS C1713
Hospital Charge Code	270694179
Hospital Revenue Code	278
Min. Negotiated Rate	$1,821.60
Max. Negotiated Rate	$6,072.00
Rate for Payer: Aetna Commercial	$3,643.20
Rate for Payer: Aetna Medicare Advantage	$3,643.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,096.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,096.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,428.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,096.72
Rate for Payer: Cigna Commercial	$6,072.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,938.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,821.60

Know your out-of-pocket cost for care.

All Charges