Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE CONDYLAR 2.4MM 8HOLE LT

Facility

$1,171.10

Service Code	HCPCS C1713
Hospital Charge Code	270654866
Hospital Revenue Code	278
Min. Negotiated Rate	$175.66
Max. Negotiated Rate	$585.55
Rate for Payer: Aetna Commercial	$351.33
Rate for Payer: Aetna Medicare Advantage	$351.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.63
Rate for Payer: Cigna Commercial	$585.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.41
Rate for Payer: Qualcare PPO/HMO/WC	$175.66

PLATE CONDYLAR 2.4MM 8HOLE LT

Facility

$1,171.10

Service Code	HCPCS C1713
Hospital Charge Code	270654866
Hospital Revenue Code	278
Min. Negotiated Rate	$175.66
Max. Negotiated Rate	$283.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.41
Rate for Payer: Qualcare PPO/HMO/WC	$175.66

PLATE CONDYLAR 2.4MM 8HOLE RT

Facility

$1,171.10

Service Code	HCPCS C1713
Hospital Charge Code	270654865
Hospital Revenue Code	278
Min. Negotiated Rate	$175.66
Max. Negotiated Rate	$283.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.41
Rate for Payer: Qualcare PPO/HMO/WC	$175.66

PLATE CONDYLAR 2.4MM 8HOLE RT

Facility

$1,171.10

Service Code	HCPCS C1713
Hospital Charge Code	270654865
Hospital Revenue Code	278
Min. Negotiated Rate	$175.66
Max. Negotiated Rate	$585.55
Rate for Payer: Aetna Commercial	$351.33
Rate for Payer: Aetna Medicare Advantage	$351.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.63
Rate for Payer: Cigna Commercial	$585.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.41
Rate for Payer: Qualcare PPO/HMO/WC	$175.66

PLATE CONDYLAR 2.7 MM LCP

Facility

$2,733.05

Service Code	HCPCS C1713
Hospital Charge Code	270691488
Hospital Revenue Code	278
Min. Negotiated Rate	$409.96
Max. Negotiated Rate	$1,366.53
Rate for Payer: Aetna Commercial	$819.91
Rate for Payer: Aetna Medicare Advantage	$819.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.93
Rate for Payer: Cigna Commercial	$1,366.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.40
Rate for Payer: Qualcare PPO/HMO/WC	$409.96

PLATE CONDYLAR 2.7 MM LCP

Facility

$2,733.05

Service Code	HCPCS C1713
Hospital Charge Code	270691488
Hospital Revenue Code	278
Min. Negotiated Rate	$409.96
Max. Negotiated Rate	$661.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.40
Rate for Payer: Qualcare PPO/HMO/WC	$409.96

PLATE CONDYLAR 4.5MM 10H RT

Facility

$7,564.30

Hospital Charge Code	270677611
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.64
Max. Negotiated Rate	$1,830.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.64

PLATE CONDYLAR 4.5MM 10H RT

Facility

$7,564.30

Hospital Charge Code	270677611
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.64
Max. Negotiated Rate	$3,782.15
Rate for Payer: Aetna Commercial	$2,269.29
Rate for Payer: Aetna Medicare Advantage	$2,269.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,928.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,928.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,928.90
Rate for Payer: Cigna Commercial	$3,782.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.64

PLATE CONDYLAR 4.5MM 12H LT

Facility

$7,721.90

Hospital Charge Code	270677613
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.29
Max. Negotiated Rate	$1,868.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,544.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,868.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.29

PLATE CONDYLAR 4.5MM 12H LT

Facility

$7,721.90

Hospital Charge Code	270677613
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.29
Max. Negotiated Rate	$3,860.95
Rate for Payer: Aetna Commercial	$2,316.57
Rate for Payer: Aetna Medicare Advantage	$2,316.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,544.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.08
Rate for Payer: Cigna Commercial	$3,860.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,868.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.29

PLATE CONDYLAR 4.5MM 12H LT ST

Facility

$7,929.30

Service Code	HCPCS C1713
Hospital Charge Code	270649684
Hospital Revenue Code	278
Min. Negotiated Rate	$1,189.39
Max. Negotiated Rate	$1,918.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,585.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,918.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,189.39

PLATE CONDYLAR 4.5MM 12H LT ST

Facility

$7,929.30

Service Code	HCPCS C1713
Hospital Charge Code	270649684
Hospital Revenue Code	278
Min. Negotiated Rate	$1,189.39
Max. Negotiated Rate	$3,964.65
Rate for Payer: Aetna Commercial	$2,378.79
Rate for Payer: Aetna Medicare Advantage	$2,378.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,021.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,021.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,585.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,021.97
Rate for Payer: Cigna Commercial	$3,964.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,918.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,189.39

PLATE CONDYLAR 4.5MM 12H RT

Facility

$7,221.90

Hospital Charge Code	270677612
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.29
Max. Negotiated Rate	$3,610.95
Rate for Payer: Aetna Commercial	$2,166.57
Rate for Payer: Aetna Medicare Advantage	$2,166.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,841.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,841.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,444.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,841.58
Rate for Payer: Cigna Commercial	$3,610.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,747.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.29

PLATE CONDYLAR 4.5MM 12H RT

Facility

$7,221.90

Hospital Charge Code	270677612
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.29
Max. Negotiated Rate	$1,747.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,444.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,747.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.29

PLATE CONDYLAR 4.5MM 14H LT

Facility

$8,241.05

Hospital Charge Code	270677615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,236.16
Max. Negotiated Rate	$4,120.52
Rate for Payer: Aetna Commercial	$2,472.32
Rate for Payer: Aetna Medicare Advantage	$2,472.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,101.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,101.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,648.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,101.47
Rate for Payer: Cigna Commercial	$4,120.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,994.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,236.16

PLATE CONDYLAR 4.5MM 14H LT

Facility

$8,241.05

Hospital Charge Code	270677615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,236.16
Max. Negotiated Rate	$1,994.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,648.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,994.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,236.16

PLATE CONDYLAR 4.5MM 14H RT

Facility

$8,241.05

Hospital Charge Code	270677614
Hospital Revenue Code	278
Min. Negotiated Rate	$1,236.16
Max. Negotiated Rate	$1,994.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,648.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,994.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,236.16

PLATE CONDYLAR 4.5MM 14H RT

Facility

$8,241.05

Hospital Charge Code	270677614
Hospital Revenue Code	278
Min. Negotiated Rate	$1,236.16
Max. Negotiated Rate	$4,120.52
Rate for Payer: Aetna Commercial	$2,472.32
Rate for Payer: Aetna Medicare Advantage	$2,472.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,101.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,101.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,648.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,101.47
Rate for Payer: Cigna Commercial	$4,120.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,994.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,236.16

PLATE CONDYLAR 4.5MM 16H LT

Facility

$8,401.70

Service Code	HCPCS C1713
Hospital Charge Code	270677617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.26
Max. Negotiated Rate	$2,033.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,033.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.26

PLATE CONDYLAR 4.5MM 16H LT

Facility

$8,401.70

Service Code	HCPCS C1713
Hospital Charge Code	270677617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.26
Max. Negotiated Rate	$4,200.85
Rate for Payer: Aetna Commercial	$2,520.51
Rate for Payer: Aetna Medicare Advantage	$2,520.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,142.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,142.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,142.43
Rate for Payer: Cigna Commercial	$4,200.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,033.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.26

PLATE CONDYLAR 4.5MM 16H RT

Facility

$8,401.70

Hospital Charge Code	270677616
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.26
Max. Negotiated Rate	$2,033.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,033.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.26

PLATE CONDYLAR 4.5MM 16H RT

Facility

$8,401.70

Hospital Charge Code	270677616
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.26
Max. Negotiated Rate	$4,200.85
Rate for Payer: Aetna Commercial	$2,520.51
Rate for Payer: Aetna Medicare Advantage	$2,520.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,142.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,142.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,680.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,142.43
Rate for Payer: Cigna Commercial	$4,200.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,033.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.26

PLATE CONDYLAR 4.5MM 6H LT

Facility

$7,088.45

Hospital Charge Code	270677608
Hospital Revenue Code	278
Min. Negotiated Rate	$1,063.27
Max. Negotiated Rate	$3,544.22
Rate for Payer: Aetna Commercial	$2,126.53
Rate for Payer: Aetna Medicare Advantage	$2,126.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,417.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,807.55
Rate for Payer: Cigna Commercial	$3,544.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,715.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.27

PLATE CONDYLAR 4.5MM 6H LT

Facility

$7,088.45

Hospital Charge Code	270677608
Hospital Revenue Code	278
Min. Negotiated Rate	$1,063.27
Max. Negotiated Rate	$1,715.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,417.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,715.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.27

PLATE CONDYLAR 4.5MM 6H RT

Facility

$7,088.45

Hospital Charge Code	270677607
Hospital Revenue Code	278
Min. Negotiated Rate	$1,063.27
Max. Negotiated Rate	$1,715.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,417.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,715.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,063.27

Know your out-of-pocket cost for care.

All Charges