Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

PLATE ANATOMIC STRD LT DVRA

Facility

$3,725.00

Hospital Charge Code	270638277
Hospital Revenue Code	278
Min. Negotiated Rate	$558.75
Max. Negotiated Rate	$901.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.45
Rate for Payer: Qualcare PPO/HMO/WC	$558.75

PLATE ANATOMIC STRD LT DVRA

Facility

$3,725.00

Hospital Charge Code	270638277
Hospital Revenue Code	278
Min. Negotiated Rate	$558.75
Max. Negotiated Rate	$1,862.50
Rate for Payer: Aetna Commercial	$1,117.50
Rate for Payer: Aetna Medicare Advantage	$1,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$949.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$949.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$949.88
Rate for Payer: Cigna Commercial	$1,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.45
Rate for Payer: Qualcare PPO/HMO/WC	$558.75

PLATE ANCHON 22 MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692208
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 ANCHON 22 MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692208
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 ANCHORING MED 10H 16MM

Facility

$28,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680019
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

PLATE ANCHORING MED 10H 16MM

Facility

$28,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680019
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$8,400.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

PLATE ANCHORING ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270692180
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE ANCHORING ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270692180
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$3,499.99
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE ANCHORING S

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683450
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

PLATE ANCHORING S

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683450
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

PLATE ANKLE FUSION POSTERIOR R

Facility

$11,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,706.25
Max. Negotiated Rate	$2,752.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,752.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,706.25

PLATE ANKLE FUSION POSTERIOR R

Facility

$11,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,706.25
Max. Negotiated Rate	$5,687.50
Rate for Payer: Aetna Commercial	$3,412.50
Rate for Payer: Aetna Medicare Advantage	$3,412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,900.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,900.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,900.62
Rate for Payer: Cigna Commercial	$5,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,752.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,706.25

PLATE ANT CERV 1 LEV 16MM

Facility

$12,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270695715
Hospital Revenue Code	278
Min. Negotiated Rate	$1,841.25
Max. Negotiated Rate	$2,970.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,970.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,841.25

PLATE ANT CERV 1 LEV 16MM

Facility

$12,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270695715
Hospital Revenue Code	278
Min. Negotiated Rate	$1,841.25
Max. Negotiated Rate	$6,137.50
Rate for Payer: Aetna Commercial	$3,682.50
Rate for Payer: Aetna Medicare Advantage	$3,682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,130.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,130.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,130.12
Rate for Payer: Cigna Commercial	$6,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,970.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,841.25

PLATE ANT CERV 1LEV 16MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698203
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 ANT CERV 1LEV 16MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698203
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 ANT CERV 2LEV 30MM

Facility

$15,553.00

Service Code	HCPCS C1713
Hospital Charge Code	270694345
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.95
Max. Negotiated Rate	$3,763.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.95

PLATE ANT CERV 2LEV 30MM

Facility

$15,553.00

Service Code	HCPCS C1713
Hospital Charge Code	270694345
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.95
Max. Negotiated Rate	$7,776.50
Rate for Payer: Aetna Commercial	$4,665.90
Rate for Payer: Aetna Medicare Advantage	$4,665.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,966.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,966.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,966.01
Rate for Payer: Cigna Commercial	$7,776.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.83
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.95

PLATE ANT CERV 2LEV 36MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695983
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 ANT CERV 2LEV 36MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695983
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 ANT CERV 3LEV 46MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696725
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 ANT CERV 3LEV 46MM

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696725
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 ANT CERV 3 LEVEL 46MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696981
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$7,275.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

PLATE ANT CERV 3 LEVEL 46MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696981
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

Know your out-of-pocket cost for care.

All Charges