Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DCP 3.5MM 8H

Facility

$558.45

Hospital Charge Code	270604400
Hospital Revenue Code	278
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$279.23
Rate for Payer: Aetna Commercial	$167.53
Rate for Payer: Aetna Medicare Advantage	$167.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.40
Rate for Payer: Cigna Commercial	$279.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.14
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

PLATE DCP 3.5MM 9H

Facility

$581.65

Hospital Charge Code	270604401
Hospital Revenue Code	278
Min. Negotiated Rate	$87.25
Max. Negotiated Rate	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.76
Rate for Payer: Qualcare PPO/HMO/WC	$87.25

PLATE DCP 3.5MM 9H

Facility

$581.65

Hospital Charge Code	270604401
Hospital Revenue Code	278
Min. Negotiated Rate	$87.25
Max. Negotiated Rate	$290.82
Rate for Payer: Aetna Commercial	$174.50
Rate for Payer: Aetna Medicare Advantage	$174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.32
Rate for Payer: Cigna Commercial	$290.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.76
Rate for Payer: Qualcare PPO/HMO/WC	$87.25

PLATE DCP 6 HOLE 3.5x73MM

Facility

$645.00

Service Code	HCPCS C1713
Hospital Charge Code	270668575
Hospital Revenue Code	278
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$156.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.09
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

PLATE DCP 6 HOLE 3.5x73MM

Facility

$645.00

Service Code	HCPCS C1713
Hospital Charge Code	270668575
Hospital Revenue Code	278
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$322.50
Rate for Payer: Aetna Commercial	$193.50
Rate for Payer: Aetna Medicare Advantage	$193.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.47
Rate for Payer: Cigna Commercial	$322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.09
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

PLATE DCP NARROW 4H 4.5x71MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651715
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$186.33
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE DCP NARROW 4H 4.5x71MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651715
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE DCP NARROW 5H 4.5x87MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651716
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$310.55
Rate for Payer: Aetna Commercial	$186.33
Rate for Payer: Aetna Medicare Advantage	$186.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.38
Rate for Payer: Cigna Commercial	$310.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE DCP NARROW 5H 4.5x87MM

Facility

$621.10

Service Code	HCPCS C1713
Hospital Charge Code	270651716
Hospital Revenue Code	278
Min. Negotiated Rate	$93.17
Max. Negotiated Rate	$150.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.31
Rate for Payer: Qualcare PPO/HMO/WC	$93.17

PLATE DCP NARROW 6H 103MM

Facility

$687.00

Hospital Charge Code	270671823
Hospital Revenue Code	278
Min. Negotiated Rate	$103.05
Max. Negotiated Rate	$343.50
Rate for Payer: Aetna Commercial	$206.10
Rate for Payer: Aetna Medicare Advantage	$206.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.19
Rate for Payer: Cigna Commercial	$343.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.25
Rate for Payer: Qualcare PPO/HMO/WC	$103.05

PLATE DCP NARROW 6H 103MM

Facility

$687.00

Hospital Charge Code	270671823
Hospital Revenue Code	278
Min. Negotiated Rate	$103.05
Max. Negotiated Rate	$166.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.25
Rate for Payer: Qualcare PPO/HMO/WC	$103.05

PLATE DCP NARROW 8H 4.5x135MM

Facility

$707.60

Service Code	HCPCS C1713
Hospital Charge Code	270651717
Hospital Revenue Code	278
Min. Negotiated Rate	$106.14
Max. Negotiated Rate	$171.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.24
Rate for Payer: Qualcare PPO/HMO/WC	$106.14

PLATE DCP NARROW 8H 4.5x135MM

Facility

$707.60

Service Code	HCPCS C1713
Hospital Charge Code	270651717
Hospital Revenue Code	278
Min. Negotiated Rate	$106.14
Max. Negotiated Rate	$353.80
Rate for Payer: Aetna Commercial	$212.28
Rate for Payer: Aetna Medicare Advantage	$212.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.44
Rate for Payer: Cigna Commercial	$353.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.24
Rate for Payer: Qualcare PPO/HMO/WC	$106.14

PLATE DCP TT 2.0MM 5H

Facility

$920.00

Hospital Charge Code	270604093
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$276.00
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

PLATE DCP TT 2.0MM 5H

Facility

$920.00

Hospital Charge Code	270604093
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$222.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

PLATE DCP TT 2.0MM 8H

Facility

$1,180.85

Hospital Charge Code	270604096
Hospital Revenue Code	278
Min. Negotiated Rate	$177.13
Max. Negotiated Rate	$285.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.77
Rate for Payer: Qualcare PPO/HMO/WC	$177.13

PLATE DCP TT 2.0MM 8H

Facility

$1,180.85

Hospital Charge Code	270604096
Hospital Revenue Code	278
Min. Negotiated Rate	$177.13
Max. Negotiated Rate	$590.42
Rate for Payer: Aetna Commercial	$354.25
Rate for Payer: Aetna Medicare Advantage	$354.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.12
Rate for Payer: Cigna Commercial	$590.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.77
Rate for Payer: Qualcare PPO/HMO/WC	$177.13

PLATE DCP TT 2.7MM 2H

Facility

$1,035.25

Hospital Charge Code	270604089
Hospital Revenue Code	278
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$250.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.53
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

PLATE DCP TT 2.7MM 2H

Facility

$1,035.25

Hospital Charge Code	270604089
Hospital Revenue Code	278
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$517.62
Rate for Payer: Aetna Commercial	$310.57
Rate for Payer: Aetna Medicare Advantage	$310.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.99
Rate for Payer: Cigna Commercial	$517.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.53
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

PLATE DCP TT 2.7MM 4H

Facility

$1,242.45

Hospital Charge Code	270604081
Hospital Revenue Code	278
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$300.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

PLATE DCP TT 2.7MM 4H

Facility

$1,242.45

Hospital Charge Code	270604081
Hospital Revenue Code	278
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$621.23
Rate for Payer: Aetna Commercial	$372.74
Rate for Payer: Aetna Medicare Advantage	$372.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.82
Rate for Payer: Cigna Commercial	$621.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

PLATE DCP TT 2.7MM 7H

Facility

$1,693.65

Hospital Charge Code	270604084
Hospital Revenue Code	278
Min. Negotiated Rate	$254.05
Max. Negotiated Rate	$409.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.86
Rate for Payer: Qualcare PPO/HMO/WC	$254.05

PLATE DCP TT 2.7MM 7H

Facility

$1,693.65

Hospital Charge Code	270604084
Hospital Revenue Code	278
Min. Negotiated Rate	$254.05
Max. Negotiated Rate	$846.83
Rate for Payer: Aetna Commercial	$508.10
Rate for Payer: Aetna Medicare Advantage	$508.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$431.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$431.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$431.88
Rate for Payer: Cigna Commercial	$846.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.86
Rate for Payer: Qualcare PPO/HMO/WC	$254.05

PLATE DCP TT 2.7MM 8H

Facility

$1,771.25

Hospital Charge Code	270604085
Hospital Revenue Code	278
Min. Negotiated Rate	$265.69
Max. Negotiated Rate	$428.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.64
Rate for Payer: Qualcare PPO/HMO/WC	$265.69

PLATE DCP TT 2.7MM 8H

Facility

$1,771.25

Hospital Charge Code	270604085
Hospital Revenue Code	278
Min. Negotiated Rate	$265.69
Max. Negotiated Rate	$885.62
Rate for Payer: Aetna Commercial	$531.38
Rate for Payer: Aetna Medicare Advantage	$531.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.67
Rate for Payer: Cigna Commercial	$885.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.64
Rate for Payer: Qualcare PPO/HMO/WC	$265.69

Know your out-of-pocket cost for care.

All Charges