Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE DPY 7H 143557

Facility

$310.45

Hospital Charge Code	270622979
Hospital Revenue Code	278
Min. Negotiated Rate	$46.57
Max. Negotiated Rate	$155.22
Rate for Payer: Aetna Commercial	$93.14
Rate for Payer: Aetna Medicare Advantage	$93.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.16
Rate for Payer: Cigna Commercial	$155.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.13
Rate for Payer: Qualcare PPO/HMO/WC	$46.57

PLATE DPY 7H 143557

Facility

$310.45

Hospital Charge Code	270622979
Hospital Revenue Code	278
Min. Negotiated Rate	$46.57
Max. Negotiated Rate	$75.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.13
Rate for Payer: Qualcare PPO/HMO/WC	$46.57

PLATE DPY ACP 4.5 8H 14669800

Facility

$892.00

Hospital Charge Code	270622953
Hospital Revenue Code	278
Min. Negotiated Rate	$133.80
Max. Negotiated Rate	$215.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.86
Rate for Payer: Qualcare PPO/HMO/WC	$133.80

PLATE DPY ACP 4.5 8H 14669800

Facility

$892.00

Hospital Charge Code	270622953
Hospital Revenue Code	278
Min. Negotiated Rate	$133.80
Max. Negotiated Rate	$446.00
Rate for Payer: Aetna Commercial	$267.60
Rate for Payer: Aetna Medicare Advantage	$267.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.46
Rate for Payer: Cigna Commercial	$446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.86
Rate for Payer: Qualcare PPO/HMO/WC	$133.80

PLATE DSTI PI 8-HI ANTMCL POST

Facility

$5,472.50

Service Code	HCPCS C1713
Hospital Charge Code	270702044
Hospital Revenue Code	278
Min. Negotiated Rate	$820.88
Max. Negotiated Rate	$2,736.25
Rate for Payer: Aetna Commercial	$1,641.75
Rate for Payer: Aetna Medicare Advantage	$1,641.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,395.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,395.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,395.49
Rate for Payer: Cigna Commercial	$2,736.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.35
Rate for Payer: Qualcare PPO/HMO/WC	$820.88

PLATE DSTI PI 8-HI ANTMCL POST

Facility

$5,472.50

Service Code	HCPCS C1713
Hospital Charge Code	270702044
Hospital Revenue Code	278
Min. Negotiated Rate	$820.88
Max. Negotiated Rate	$1,324.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,094.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.35
Rate for Payer: Qualcare PPO/HMO/WC	$820.88

PLATE DVR LFT WD DVRAWL

Facility

$5,005.00

Hospital Charge Code	270651364
Hospital Revenue Code	278
Min. Negotiated Rate	$750.75
Max. Negotiated Rate	$1,211.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,001.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,211.21
Rate for Payer: Qualcare PPO/HMO/WC	$750.75

PLATE DVR LFT WD DVRAWL

Facility

$5,005.00

Hospital Charge Code	270651364
Hospital Revenue Code	278
Min. Negotiated Rate	$750.75
Max. Negotiated Rate	$2,502.50
Rate for Payer: Aetna Commercial	$1,501.50
Rate for Payer: Aetna Medicare Advantage	$1,501.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,276.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,276.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,276.28
Rate for Payer: Cigna Commercial	$2,502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,211.21
Rate for Payer: Qualcare PPO/HMO/WC	$750.75

PLATE DVR LOCK MINI RT

Facility

$6,352.50

Service Code	HCPCS C1716
Hospital Charge Code	270702388
Hospital Revenue Code	278
Min. Negotiated Rate	$952.88
Max. Negotiated Rate	$1,905.75
Rate for Payer: Aetna Commercial	$1,905.75
Rate for Payer: Aetna Medicare Advantage	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,619.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,619.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,619.89
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,537.31
Rate for Payer: Qualcare PPO/HMO/WC	$952.88

PLATE DVR LOCK MINI RT

Facility

$6,352.50

Service Code	HCPCS C1716
Hospital Charge Code	270702388
Hospital Revenue Code	278
Min. Negotiated Rate	$952.88
Max. Negotiated Rate	$1,537.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,537.31
Rate for Payer: Qualcare PPO/HMO/WC	$952.88

PLATE DVR LOCK STANDARD

Facility

$5,500.00

Hospital Charge Code	270663844
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE DVR LOCK STANDARD

Facility

$5,500.00

Hospital Charge Code	270663844
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

PLATE DVR NARROW SHORT LEFT

Facility

$5,005.00

Hospital Charge Code	270648140
Hospital Revenue Code	278
Min. Negotiated Rate	$750.75
Max. Negotiated Rate	$2,502.50
Rate for Payer: Aetna Commercial	$1,501.50
Rate for Payer: Aetna Medicare Advantage	$1,501.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,276.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,276.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,276.28
Rate for Payer: Cigna Commercial	$2,502.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,211.21
Rate for Payer: Qualcare PPO/HMO/WC	$750.75

PLATE DVR NARROW SHORT LEFT

Facility

$5,005.00

Hospital Charge Code	270648140
Hospital Revenue Code	278
Min. Negotiated Rate	$750.75
Max. Negotiated Rate	$1,211.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,001.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,211.21
Rate for Payer: Qualcare PPO/HMO/WC	$750.75

PLATE DVR WIDE HEAD RIGHT

Facility

$5,395.00

Hospital Charge Code	270671835
Hospital Revenue Code	278
Min. Negotiated Rate	$809.25
Max. Negotiated Rate	$1,305.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,305.59
Rate for Payer: Qualcare PPO/HMO/WC	$809.25

PLATE DVR WIDE HEAD RIGHT

Facility

$5,395.00

Hospital Charge Code	270671835
Hospital Revenue Code	278
Min. Negotiated Rate	$809.25
Max. Negotiated Rate	$2,697.50
Rate for Payer: Aetna Commercial	$1,618.50
Rate for Payer: Aetna Medicare Advantage	$1,618.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,375.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,375.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,375.72
Rate for Payer: Cigna Commercial	$2,697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,305.59
Rate for Payer: Qualcare PPO/HMO/WC	$809.25

PLATE DVR WRIST SPANNING 180MM

Facility

$16,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270699272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.75
Max. Negotiated Rate	$8,172.50
Rate for Payer: Aetna Commercial	$4,903.50
Rate for Payer: Aetna Medicare Advantage	$4,903.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,167.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,167.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,269.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,167.98
Rate for Payer: Cigna Commercial	$8,172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,955.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.75

PLATE DVR WRIST SPANNING 180MM

Facility

$16,345.00

Service Code	HCPCS C1713
Hospital Charge Code	270699272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.75
Max. Negotiated Rate	$3,955.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,269.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,955.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.75

PLATE ECT 1/2 TUB 12/119MM 7H

Facility

$205.65

Hospital Charge Code	270605559
Hospital Revenue Code	278
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$49.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.77
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PLATE ECT 1/2 TUB 12/119MM 7H

Facility

$205.65

Hospital Charge Code	270605559
Hospital Revenue Code	278
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$102.83
Rate for Payer: Aetna Commercial	$61.70
Rate for Payer: Aetna Medicare Advantage	$61.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.44
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.77
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PLATE ECT L BUTTRESS 4 HL

Facility

$905.65

Hospital Charge Code	270605558
Hospital Revenue Code	278
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$219.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.17
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

PLATE ECT L BUTTRESS 4 HL

Facility

$905.65

Hospital Charge Code	270605558
Hospital Revenue Code	278
Min. Negotiated Rate	$135.85
Max. Negotiated Rate	$452.82
Rate for Payer: Aetna Commercial	$271.69
Rate for Payer: Aetna Medicare Advantage	$271.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.94
Rate for Payer: Cigna Commercial	$452.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.17
Rate for Payer: Qualcare PPO/HMO/WC	$135.85

PLATE ECT MINI-ST 3 HL

Facility

$81.00

Hospital Charge Code	1602630
Hospital Revenue Code	274
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$24.30
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

PLATE ECT MINI-ST 3 HL

Facility

$81.00

Hospital Charge Code	1602630
Hospital Revenue Code	274
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

PLATE ECT MINI-ST 4 HL

Facility

$87.00

Hospital Charge Code	1602648
Hospital Revenue Code	274
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$21.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

Know your out-of-pocket cost for care.

All Charges