Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE & COLLAR 1/3 TUB 4&5 HL

Facility

$169.00

Hospital Charge Code	1603828
Hospital Revenue Code	274
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$84.50
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$50.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.09
Rate for Payer: Cigna Commercial	$84.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.90
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

PLATE & COLLAR 1/3 TUB 4&5 HL

Facility

$169.00

Hospital Charge Code	1603828
Hospital Revenue Code	274
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$40.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.90
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

PLATE & COLLAR 1/3 TUB 6&7 HL

Facility

$179.00

Hospital Charge Code	1603836
Hospital Revenue Code	274
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$89.50
Rate for Payer: Cigna Commercial	$89.50
Rate for Payer: Aetna Commercial	$53.70
Rate for Payer: Aetna Medicare Advantage	$53.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.32
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

PLATE & COLLAR 1/3 TUB 6&7 HL

Facility

$179.00

Hospital Charge Code	1603836
Hospital Revenue Code	274
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$43.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.32
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

PLATE & COLLAR 1/3 TUB 8 HL

Facility

$184.00

Hospital Charge Code	1603844
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 8 HL

Facility

$184.00

Hospital Charge Code	1603844
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 COMP LCK 10 HOLE 5.0MM

Facility

$12,034.15

Service Code	HCPCS C1713
Hospital Charge Code	270700876
Hospital Revenue Code	278
Min. Negotiated Rate	$1,805.12
Max. Negotiated Rate	$6,017.07
Rate for Payer: Aetna Commercial	$3,610.24
Rate for Payer: Aetna Medicare Advantage	$3,610.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,068.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,068.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,068.71
Rate for Payer: Cigna Commercial	$6,017.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,912.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,805.12

PLATE COMP LCK 10 HOLE 5.0MM

Facility

$12,034.15

Service Code	HCPCS C1713
Hospital Charge Code	270700876
Hospital Revenue Code	278
Min. Negotiated Rate	$1,805.12
Max. Negotiated Rate	$2,912.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,912.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,805.12

PLATE COMP LKG 187MM 10H 3.5MM

Facility

$8,186.75

Service Code	HCPCS C1713
Hospital Charge Code	270697112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,228.01
Max. Negotiated Rate	$1,981.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,637.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,981.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,228.01

PLATE COMP LKG 187MM 10H 3.5MM

Facility

$8,186.75

Service Code	HCPCS C1713
Hospital Charge Code	270697112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,228.01
Max. Negotiated Rate	$4,093.38
Rate for Payer: Aetna Commercial	$2,456.03
Rate for Payer: Aetna Medicare Advantage	$2,456.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,087.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,087.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,637.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,087.62
Rate for Payer: Cigna Commercial	$4,093.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,981.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,228.01

PLATE COMPOSITE 8 HOLE

Facility

$1,015.00

Hospital Charge Code	270648905
Hospital Revenue Code	278
Min. Negotiated Rate	$152.25
Max. Negotiated Rate	$507.50
Rate for Payer: Aetna Commercial	$304.50
Rate for Payer: Aetna Medicare Advantage	$304.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$258.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$258.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$258.82
Rate for Payer: Cigna Commercial	$507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.63
Rate for Payer: Qualcare PPO/HMO/WC	$152.25

PLATE COMPOSITE 8 HOLE

Facility

$1,015.00

Hospital Charge Code	270648905
Hospital Revenue Code	278
Min. Negotiated Rate	$152.25
Max. Negotiated Rate	$245.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.63
Rate for Payer: Qualcare PPO/HMO/WC	$152.25

PLATE COMPRESSION 3HOLE 20MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677562
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

PLATE COMPRESSION 3HOLE 20MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677562
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

PLATE COMPRESSION 3HOLE 25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677561
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

PLATE COMPRESSION 3HOLE 25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270677561
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

PLATE COMPRESSION 4 HOLE

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270679503
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$1,792.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

PLATE COMPRESSION 4 HOLE

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270679503
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

PLATE COMPRS 10 HOLE 130-150DG

Facility

$1,849.00

Hospital Charge Code	1605732
Hospital Revenue Code	274
Min. Negotiated Rate	$277.35
Max. Negotiated Rate	$924.50
Rate for Payer: Aetna Commercial	$554.70
Rate for Payer: Aetna Medicare Advantage	$554.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.50
Rate for Payer: Cigna Commercial	$924.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.46
Rate for Payer: Qualcare PPO/HMO/WC	$277.35

PLATE COMPRS 10 HOLE 130-150DG

Facility

$1,849.00

Hospital Charge Code	1605732
Hospital Revenue Code	274
Min. Negotiated Rate	$277.35
Max. Negotiated Rate	$447.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.46
Rate for Payer: Qualcare PPO/HMO/WC	$277.35

PLATE COMPRS 12 HOLE 130-150DG

Facility

$1,964.00

Hospital Charge Code	1605724
Hospital Revenue Code	274
Min. Negotiated Rate	$294.60
Max. Negotiated Rate	$475.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.29
Rate for Payer: Qualcare PPO/HMO/WC	$294.60

PLATE COMPRS 12 HOLE 130-150DG

Facility

$1,964.00

Hospital Charge Code	1605724
Hospital Revenue Code	274
Min. Negotiated Rate	$294.60
Max. Negotiated Rate	$982.00
Rate for Payer: Aetna Commercial	$589.20
Rate for Payer: Aetna Medicare Advantage	$589.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$500.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$500.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$500.82
Rate for Payer: Cigna Commercial	$982.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$475.29
Rate for Payer: Qualcare PPO/HMO/WC	$294.60

PLATE COMPRS 14 HOLE 130-150DG

Facility

$2,392.00

Hospital Charge Code	1605716
Hospital Revenue Code	274
Min. Negotiated Rate	$358.80
Max. Negotiated Rate	$578.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.86
Rate for Payer: Qualcare PPO/HMO/WC	$358.80

PLATE COMPRS 14 HOLE 130-150DG

Facility

$2,392.00

Hospital Charge Code	1605716
Hospital Revenue Code	274
Min. Negotiated Rate	$358.80
Max. Negotiated Rate	$1,196.00
Rate for Payer: Aetna Commercial	$717.60
Rate for Payer: Aetna Medicare Advantage	$717.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$478.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.96
Rate for Payer: Cigna Commercial	$1,196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.86
Rate for Payer: Qualcare PPO/HMO/WC	$358.80

PLATE COMPRS 2 HOLE 130-150DEG

Facility

$1,111.00

Hospital Charge Code	1605799
Hospital Revenue Code	274
Min. Negotiated Rate	$166.65
Max. Negotiated Rate	$555.50
Rate for Payer: Aetna Commercial	$333.30
Rate for Payer: Aetna Medicare Advantage	$333.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.31
Rate for Payer: Cigna Commercial	$555.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.86
Rate for Payer: Qualcare PPO/HMO/WC	$166.65

Know your out-of-pocket cost for care.

All Charges