Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CLC FRAC STD X-SM/SM

Facility

$6,620.00

Hospital Charge Code	270656830
Hospital Revenue Code	278
Min. Negotiated Rate	$993.00
Max. Negotiated Rate	$3,310.00
Rate for Payer: Aetna Commercial	$1,986.00
Rate for Payer: Aetna Medicare Advantage	$1,986.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,688.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,688.10
Rate for Payer: Cigna Commercial	$3,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,602.04
Rate for Payer: Qualcare PPO/HMO/WC	$993.00

PLATE CLOVERLEAF

Facility

$1,792.20

Service Code	HCPCS C1713
Hospital Charge Code	270655699
Hospital Revenue Code	278
Min. Negotiated Rate	$268.83
Max. Negotiated Rate	$896.10
Rate for Payer: Aetna Commercial	$537.66
Rate for Payer: Aetna Medicare Advantage	$537.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.01
Rate for Payer: Cigna Commercial	$896.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.71
Rate for Payer: Qualcare PPO/HMO/WC	$268.83

PLATE CLOVERLEAF

Facility

$1,792.20

Service Code	HCPCS C1713
Hospital Charge Code	270655699
Hospital Revenue Code	278
Min. Negotiated Rate	$268.83
Max. Negotiated Rate	$433.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$358.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$433.71
Rate for Payer: Qualcare PPO/HMO/WC	$268.83

PLATE CLOVERLEAF 3H 88MM

Facility

$1,291.60

Service Code	HCPCS C1713
Hospital Charge Code	270604061
Hospital Revenue Code	278
Min. Negotiated Rate	$193.74
Max. Negotiated Rate	$645.80
Rate for Payer: Aetna Commercial	$387.48
Rate for Payer: Aetna Medicare Advantage	$387.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.36
Rate for Payer: Cigna Commercial	$645.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.74

PLATE CLOVERLEAF 3H 88MM

Facility

$1,291.60

Service Code	HCPCS C1713
Hospital Charge Code	270604061
Hospital Revenue Code	278
Min. Negotiated Rate	$193.74
Max. Negotiated Rate	$312.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$258.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.57
Rate for Payer: Qualcare PPO/HMO/WC	$193.74

PLATE CLOVERLEAF 8 HOLES

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270655707
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$1,112.40
Rate for Payer: Aetna Commercial	$667.44
Rate for Payer: Aetna Medicare Advantage	$667.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.32
Rate for Payer: Cigna Commercial	$1,112.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

PLATE CLOVERLEAF 8 HOLES

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270655707
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$538.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

PLATE CLOVERLEAF THIN

Facility

$2,034.00

Service Code	HCPCS C1713
Hospital Charge Code	270655705
Hospital Revenue Code	278
Min. Negotiated Rate	$305.10
Max. Negotiated Rate	$1,017.00
Rate for Payer: Aetna Commercial	$610.20
Rate for Payer: Aetna Medicare Advantage	$610.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.67
Rate for Payer: Cigna Commercial	$1,017.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: Qualcare PPO/HMO/WC	$305.10

PLATE CLOVERLEAF THIN

Facility

$1,424.50

Service Code	HCPCS C1713
Hospital Charge Code	270655698
Hospital Revenue Code	278
Min. Negotiated Rate	$213.68
Max. Negotiated Rate	$712.25
Rate for Payer: Aetna Commercial	$427.35
Rate for Payer: Aetna Medicare Advantage	$427.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.25
Rate for Payer: Cigna Commercial	$712.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.73
Rate for Payer: Qualcare PPO/HMO/WC	$213.68

PLATE CLOVERLEAF THIN

Facility

$1,424.50

Service Code	HCPCS C1713
Hospital Charge Code	270655698
Hospital Revenue Code	278
Min. Negotiated Rate	$213.68
Max. Negotiated Rate	$344.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.73
Rate for Payer: Qualcare PPO/HMO/WC	$213.68

PLATE CLOVERLEAF THIN

Facility

$1,331.80

Service Code	HCPCS C1713
Hospital Charge Code	270655695
Hospital Revenue Code	278
Min. Negotiated Rate	$199.77
Max. Negotiated Rate	$322.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.30
Rate for Payer: Qualcare PPO/HMO/WC	$199.77

PLATE CLOVERLEAF THIN

Facility

$2,034.00

Service Code	HCPCS C1713
Hospital Charge Code	270655705
Hospital Revenue Code	278
Min. Negotiated Rate	$305.10
Max. Negotiated Rate	$492.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$406.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: Qualcare PPO/HMO/WC	$305.10

PLATE CLOVERLEAF THIN

Facility

$1,331.80

Service Code	HCPCS C1713
Hospital Charge Code	270655695
Hospital Revenue Code	278
Min. Negotiated Rate	$199.77
Max. Negotiated Rate	$665.90
Rate for Payer: Aetna Commercial	$399.54
Rate for Payer: Aetna Medicare Advantage	$399.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339.61
Rate for Payer: Cigna Commercial	$665.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.30
Rate for Payer: Qualcare PPO/HMO/WC	$199.77

PLATE CLOVERLEAF THIN 10HOLES

Facility

$2,334.00

Service Code	HCPCS C1713
Hospital Charge Code	270655708
Hospital Revenue Code	278
Min. Negotiated Rate	$350.10
Max. Negotiated Rate	$564.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.83
Rate for Payer: Qualcare PPO/HMO/WC	$350.10

PLATE CLOVERLEAF THIN 10HOLES

Facility

$2,334.00

Service Code	HCPCS C1713
Hospital Charge Code	270655708
Hospital Revenue Code	278
Min. Negotiated Rate	$350.10
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$700.20
Rate for Payer: Aetna Medicare Advantage	$700.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$595.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$595.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$595.17
Rate for Payer: Cigna Commercial	$1,167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.83
Rate for Payer: Qualcare PPO/HMO/WC	$350.10

PLATE CLOVERLEAF THIN 6 HOLES

Facility

$1,946.70

Service Code	HCPCS C1713
Hospital Charge Code	270655702
Hospital Revenue Code	278
Min. Negotiated Rate	$292.00
Max. Negotiated Rate	$973.35
Rate for Payer: Aetna Commercial	$584.01
Rate for Payer: Aetna Medicare Advantage	$584.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$496.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$496.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$496.41
Rate for Payer: Cigna Commercial	$973.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.10
Rate for Payer: Qualcare PPO/HMO/WC	$292.00

PLATE CLOVERLEAF THIN 6 HOLES

Facility

$1,946.70

Service Code	HCPCS C1713
Hospital Charge Code	270655702
Hospital Revenue Code	278
Min. Negotiated Rate	$292.00
Max. Negotiated Rate	$471.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.10
Rate for Payer: Qualcare PPO/HMO/WC	$292.00

PLATE CLOVERLF 2.4/2.7X45MM

Facility

$13,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270700030
Hospital Revenue Code	278
Min. Negotiated Rate	$2,061.00
Max. Negotiated Rate	$3,325.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00

PLATE CLOVERLF 2.4/2.7X45MM

Facility

$13,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270700030
Hospital Revenue Code	278
Min. Negotiated Rate	$2,061.00
Max. Negotiated Rate	$6,870.00
Rate for Payer: Aetna Commercial	$4,122.00
Rate for Payer: Aetna Medicare Advantage	$4,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,503.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,748.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,503.70
Rate for Payer: Cigna Commercial	$6,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,325.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,061.00

PLATE & COLLAR 1/3 TUB 10 HL

Facility

$184.00

Hospital Charge Code	1603851
Hospital Revenue Code	274
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$44.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.53
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

PLATE & COLLAR 1/3 TUB 10 HL

Facility

$184.00

Hospital Charge Code	1603851
Hospital Revenue Code	274
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$92.00
Rate for Payer: Aetna Commercial	$55.20
Rate for Payer: Aetna Medicare Advantage	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.92
Rate for Payer: Cigna Commercial	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.53
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

PLATE & COLLAR 1/3 TUB 2 H

Facility

$135.00

Hospital Charge Code	1603802
Hospital Revenue Code	274
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

PLATE & COLLAR 1/3 TUB 2 H

Facility

$135.00

Hospital Charge Code	1603802
Hospital Revenue Code	274
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$40.50
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

PLATE & COLLAR 1/3 TUB 441.33

Facility

$140.00

Hospital Charge Code	1603810
Hospital Revenue Code	274
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

PLATE & COLLAR 1/3 TUB 441.33

Facility

$140.00

Hospital Charge Code	1603810
Hospital Revenue Code	274
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

Know your out-of-pocket cost for care.

All Charges