Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DISTAL 2.7 MM 8 HOLE

Facility

$6,804.60

Service Code	HCPCS C1713
Hospital Charge Code	270680966
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.69
Max. Negotiated Rate	$3,402.30
Rate for Payer: Aetna Commercial	$2,041.38
Rate for Payer: Aetna Medicare Advantage	$2,041.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.17
Rate for Payer: Cigna Commercial	$3,402.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.69

PLATE DISTAL 2.7 MM 8 HOLE

Facility

$6,804.60

Service Code	HCPCS C1713
Hospital Charge Code	270680966
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.69
Max. Negotiated Rate	$1,646.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.69

PLATE DISTAL 6HOLE 27234

Facility

$5,940.00

Hospital Charge Code	270639676
Hospital Revenue Code	278
Min. Negotiated Rate	$891.00
Max. Negotiated Rate	$1,437.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.48
Rate for Payer: Qualcare PPO/HMO/WC	$891.00

PLATE DISTAL 6HOLE 27234

Facility

$5,940.00

Hospital Charge Code	270639676
Hospital Revenue Code	278
Min. Negotiated Rate	$891.00
Max. Negotiated Rate	$2,970.00
Rate for Payer: Aetna Commercial	$1,782.00
Rate for Payer: Aetna Medicare Advantage	$1,782.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,514.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,514.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,514.70
Rate for Payer: Cigna Commercial	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.48
Rate for Payer: Qualcare PPO/HMO/WC	$891.00

PLATE DISTAL CLAVICLE 70MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687755
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

PLATE DISTAL CLAVICLE 70MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687755
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

PLATE DISTAL FEMORA R 3H 122mm

Facility

$7,500.00

Hospital Charge Code	270671122
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PLATE DISTAL FEMORA R 3H 122mm

Facility

$7,500.00

Hospital Charge Code	270671122
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PLATE DISTAL FEMUR 5H 156MM LF

Facility

$6,804.00

Hospital Charge Code	270674359
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$3,402.00
Rate for Payer: Aetna Commercial	$2,041.20
Rate for Payer: Aetna Medicare Advantage	$2,041.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.02
Rate for Payer: Cigna Commercial	$3,402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE DISTAL FEMUR 5H 156MM LF

Facility

$6,804.00

Hospital Charge Code	270674359
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$1,646.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE DISTAL FEMUR 6H LF 166MM

Facility

$9,824.10

Service Code	HCPCS C1713
Hospital Charge Code	270673222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.62
Max. Negotiated Rate	$2,377.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.62

PLATE DISTAL FEMUR 6H LF 166MM

Facility

$9,824.10

Service Code	HCPCS C1713
Hospital Charge Code	270673222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.62
Max. Negotiated Rate	$4,912.05
Rate for Payer: Aetna Commercial	$2,947.23
Rate for Payer: Aetna Medicare Advantage	$2,947.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,964.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.15
Rate for Payer: Cigna Commercial	$4,912.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.62

PLATE DISTAL FEMUR LEFT

Facility

$5,379.00

Hospital Charge Code	270668421
Hospital Revenue Code	278
Min. Negotiated Rate	$806.85
Max. Negotiated Rate	$2,689.50
Rate for Payer: Aetna Commercial	$1,613.70
Rate for Payer: Aetna Medicare Advantage	$1,613.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,371.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,371.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,371.64
Rate for Payer: Cigna Commercial	$2,689.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,301.72
Rate for Payer: Qualcare PPO/HMO/WC	$806.85

PLATE DISTAL FEMUR LEFT

Facility

$5,379.00

Hospital Charge Code	270668421
Hospital Revenue Code	278
Min. Negotiated Rate	$806.85
Max. Negotiated Rate	$1,301.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,301.72
Rate for Payer: Qualcare PPO/HMO/WC	$806.85

PLATE DISTAL FEMUR RT 6 HOLE

Facility

$12,730.00

Hospital Charge Code	270668436
Hospital Revenue Code	278
Min. Negotiated Rate	$1,909.50
Max. Negotiated Rate	$6,365.00
Rate for Payer: Aetna Commercial	$3,819.00
Rate for Payer: Aetna Medicare Advantage	$3,819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,246.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,246.15
Rate for Payer: Cigna Commercial	$6,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,080.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,909.50

PLATE DISTAL FEMUR RT 6 HOLE

Facility

$12,730.00

Hospital Charge Code	270668436
Hospital Revenue Code	278
Min. Negotiated Rate	$1,909.50
Max. Negotiated Rate	$3,080.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,080.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,909.50

PLATE DISTAL FIBULA

Facility

$5,885.00

Hospital Charge Code	270702537
Hospital Revenue Code	278
Min. Negotiated Rate	$882.75
Max. Negotiated Rate	$2,942.50
Rate for Payer: Aetna Commercial	$1,765.50
Rate for Payer: Aetna Medicare Advantage	$1,765.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,500.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,500.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,500.67
Rate for Payer: Cigna Commercial	$2,942.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,424.17
Rate for Payer: Qualcare PPO/HMO/WC	$882.75

PLATE DISTAL FIBULA

Facility

$5,885.00

Hospital Charge Code	270702537
Hospital Revenue Code	278
Min. Negotiated Rate	$882.75
Max. Negotiated Rate	$1,424.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,424.17
Rate for Payer: Qualcare PPO/HMO/WC	$882.75

PLATE DISTALFIBULA 13HOLE 2.7R

Facility

$4,734.00

Hospital Charge Code	270664152
Hospital Revenue Code	278
Min. Negotiated Rate	$710.10
Max. Negotiated Rate	$2,367.00
Rate for Payer: Aetna Commercial	$1,420.20
Rate for Payer: Aetna Medicare Advantage	$1,420.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,207.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,207.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$946.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,207.17
Rate for Payer: Cigna Commercial	$2,367.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,145.63
Rate for Payer: Qualcare PPO/HMO/WC	$710.10

PLATE DISTALFIBULA 13HOLE 2.7R

Facility

$4,734.00

Hospital Charge Code	270664152
Hospital Revenue Code	278
Min. Negotiated Rate	$710.10
Max. Negotiated Rate	$1,145.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$946.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,145.63
Rate for Payer: Qualcare PPO/HMO/WC	$710.10

PLATE DISTALFIBULA 15HOLE 2.7L

Facility

$4,938.00

Hospital Charge Code	270664154
Hospital Revenue Code	278
Min. Negotiated Rate	$740.70
Max. Negotiated Rate	$2,469.00
Rate for Payer: Aetna Commercial	$1,481.40
Rate for Payer: Aetna Medicare Advantage	$1,481.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.19
Rate for Payer: Cigna Commercial	$2,469.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$740.70

PLATE DISTALFIBULA 15HOLE 2.7L

Facility

$4,938.00

Hospital Charge Code	270664154
Hospital Revenue Code	278
Min. Negotiated Rate	$740.70
Max. Negotiated Rate	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$740.70

PLATE DISTALFIBULA 15HOLE 2.7R

Facility

$4,938.00

Hospital Charge Code	270664151
Hospital Revenue Code	278
Min. Negotiated Rate	$740.70
Max. Negotiated Rate	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$740.70

PLATE DISTALFIBULA 15HOLE 2.7R

Facility

$4,938.00

Hospital Charge Code	270664151
Hospital Revenue Code	278
Min. Negotiated Rate	$740.70
Max. Negotiated Rate	$2,469.00
Rate for Payer: Aetna Commercial	$1,481.40
Rate for Payer: Aetna Medicare Advantage	$1,481.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.19
Rate for Payer: Cigna Commercial	$2,469.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.00
Rate for Payer: Qualcare PPO/HMO/WC	$740.70

PLATE DISTAL FIBULA 2.7 MM 5 H

Facility

$5,810.00

Hospital Charge Code	207661556
Hospital Revenue Code	278
Min. Negotiated Rate	$871.50
Max. Negotiated Rate	$1,406.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,406.02
Rate for Payer: Qualcare PPO/HMO/WC	$871.50

Know your out-of-pocket cost for care.

All Charges