Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ACP 1.6V 42MM 2LEVEL

Facility

$6,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270695490
Hospital Revenue Code	278
Min. Negotiated Rate	$907.50
Max. Negotiated Rate	$3,025.00
Rate for Payer: Aetna Commercial	$1,815.00
Rate for Payer: Aetna Medicare Advantage	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,542.75
Rate for Payer: Cigna Commercial	$3,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.10
Rate for Payer: Qualcare PPO/HMO/WC	$907.50

PLATE ACP 1.6V 42MM 2LEVEL

Facility

$6,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270695490
Hospital Revenue Code	278
Min. Negotiated Rate	$907.50
Max. Negotiated Rate	$1,464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.10
Rate for Payer: Qualcare PPO/HMO/WC	$907.50

PLATE ACP 1.9 1 LEVEL

Facility

$11,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694206
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.00
Max. Negotiated Rate	$5,600.00
Rate for Payer: Aetna Commercial	$3,360.00
Rate for Payer: Aetna Medicare Advantage	$3,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,856.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,856.00
Rate for Payer: Cigna Commercial	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,710.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.00

PLATE ACP 1.9 1 LEVEL

Facility

$11,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694206
Hospital Revenue Code	278
Min. Negotiated Rate	$1,680.00
Max. Negotiated Rate	$2,710.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,710.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,680.00

PLATE ACP 1.9 1 LEVEL 16MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698447
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 ACP 1.9 1 LEVEL 16MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698447
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 ACP 1.9H 3LEVEL 52MM

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694727
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$6,534.00
Rate for Payer: Aetna Commercial	$3,920.40
Rate for Payer: Aetna Medicare Advantage	$3,920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,332.34
Rate for Payer: Cigna Commercial	$6,534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 3LEVEL 52MM

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694727
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$3,162.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 54MM 3-LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270695128
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$6,534.00
Rate for Payer: Aetna Commercial	$3,920.40
Rate for Payer: Aetna Medicare Advantage	$3,920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,332.34
Rate for Payer: Cigna Commercial	$6,534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 54MM 3-LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270695128
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$3,162.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 56MM 3LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694183
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$3,162.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP 1.9H 56MM 3LEVEL

Facility

$13,068.00

Service Code	HCPCS C1713
Hospital Charge Code	270694183
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.20
Max. Negotiated Rate	$6,534.00
Rate for Payer: Aetna Commercial	$3,920.40
Rate for Payer: Aetna Medicare Advantage	$3,920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,332.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,613.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,332.34
Rate for Payer: Cigna Commercial	$6,534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.20

PLATE ACP GRUVE 20MM 1681-020

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698920
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE ACP GRUVE 20MM 1681-020

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698920
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE ADAPTION 20HOL 100 44710

Facility

$1,383.90

Hospital Charge Code	270633380
Hospital Revenue Code	278
Min. Negotiated Rate	$207.59
Max. Negotiated Rate	$334.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.90
Rate for Payer: Qualcare PPO/HMO/WC	$207.59

PLATE ADAPTION 20HOL 100 44710

Facility

$1,383.90

Hospital Charge Code	270633380
Hospital Revenue Code	278
Min. Negotiated Rate	$207.59
Max. Negotiated Rate	$691.95
Rate for Payer: Aetna Commercial	$415.17
Rate for Payer: Aetna Medicare Advantage	$415.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.89
Rate for Payer: Cigna Commercial	$691.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.90
Rate for Payer: Qualcare PPO/HMO/WC	$207.59

PLATE ALIP 25MM

Facility

$28,297.50

Service Code	HCPCS C1713
Hospital Charge Code	270679296
Hospital Revenue Code	278
Min. Negotiated Rate	$4,244.62
Max. Negotiated Rate	$6,847.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,659.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,847.99
Rate for Payer: Qualcare PPO/HMO/WC	$4,244.62

PLATE ALIP 25MM

Facility

$28,297.50

Service Code	HCPCS C1713
Hospital Charge Code	270679296
Hospital Revenue Code	278
Min. Negotiated Rate	$4,244.62
Max. Negotiated Rate	$14,148.75
Rate for Payer: Aetna Commercial	$8,489.25
Rate for Payer: Aetna Medicare Advantage	$8,489.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,215.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,215.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,659.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,215.86
Rate for Payer: Cigna Commercial	$14,148.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,847.99
Rate for Payer: Qualcare PPO/HMO/WC	$4,244.62

PLATE AMBASSADOR 1 LEVEL 14MM

Facility

$19,250.55

Service Code	HCPCS C1713
Hospital Charge Code	270695211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.58
Max. Negotiated Rate	$4,658.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.58

PLATE AMBASSADOR 1 LEVEL 14MM

Facility

$19,250.55

Service Code	HCPCS C1713
Hospital Charge Code	270695211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.58
Max. Negotiated Rate	$9,625.27
Rate for Payer: Aetna Commercial	$5,775.16
Rate for Payer: Aetna Medicare Advantage	$5,775.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.89
Rate for Payer: Cigna Commercial	$9,625.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.58

PLATE, AMP-LTX, 2-HOLE

Facility

$15,505.00

Hospital Charge Code	270702580
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.75
Max. Negotiated Rate	$7,752.50
Rate for Payer: Aetna Commercial	$4,651.50
Rate for Payer: Aetna Medicare Advantage	$4,651.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,953.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,953.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,953.78
Rate for Payer: Cigna Commercial	$7,752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,752.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.75

PLATE, AMP-LTX, 2-HOLE

Facility

$15,505.00

Hospital Charge Code	270702580
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.75
Max. Negotiated Rate	$3,752.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,752.21
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.75

PLATE ANATOMIC 6H RT 816207006

Facility

$5,415.00

Hospital Charge Code	270661575
Hospital Revenue Code	278
Min. Negotiated Rate	$812.25
Max. Negotiated Rate	$2,707.50
Rate for Payer: Aetna Commercial	$1,624.50
Rate for Payer: Aetna Medicare Advantage	$1,624.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,380.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,380.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,083.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,380.83
Rate for Payer: Cigna Commercial	$2,707.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,310.43
Rate for Payer: Qualcare PPO/HMO/WC	$812.25

PLATE ANATOMIC 6H RT 816207006

Facility

$5,415.00

Hospital Charge Code	270661575
Hospital Revenue Code	278
Min. Negotiated Rate	$812.25
Max. Negotiated Rate	$1,310.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,083.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,310.43
Rate for Payer: Qualcare PPO/HMO/WC	$812.25

PLATE ANATOMIC (R) 54-25386

Facility

$5,145.00

Hospital Charge Code	270643445
Hospital Revenue Code	278
Min. Negotiated Rate	$771.75
Max. Negotiated Rate	$2,572.50
Rate for Payer: Aetna Commercial	$1,543.50
Rate for Payer: Aetna Medicare Advantage	$1,543.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,029.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,311.97
Rate for Payer: Cigna Commercial	$2,572.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,245.09
Rate for Payer: Qualcare PPO/HMO/WC	$771.75

Know your out-of-pocket cost for care.

All Charges