Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

PLATE ECT MINI T 4H 2419-22-04

Facility

$159.25

Hospital Charge Code	270608057
Hospital Revenue Code	278
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$79.62
Rate for Payer: Aetna Commercial	$47.77
Rate for Payer: Aetna Medicare Advantage	$47.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.61
Rate for Payer: Cigna Commercial	$79.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.54
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

PLATE ECT MINI T 4H 2419-22-04

Facility

$159.25

Hospital Charge Code	270608057
Hospital Revenue Code	278
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$38.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.54
Rate for Payer: Qualcare PPO/HMO/WC	$23.89

PLATE ECT T LG 6H

Facility

$859.25

Hospital Charge Code	270606819
Hospital Revenue Code	278
Min. Negotiated Rate	$128.89
Max. Negotiated Rate	$207.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.89

PLATE ECT T LG 6H

Facility

$859.25

Hospital Charge Code	270606819
Hospital Revenue Code	278
Min. Negotiated Rate	$128.89
Max. Negotiated Rate	$429.62
Rate for Payer: Aetna Commercial	$257.77
Rate for Payer: Aetna Medicare Advantage	$257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.11
Rate for Payer: Cigna Commercial	$429.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.89

PLATE END MIS HA MINUTEMAN G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693753
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$12,000.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLATE END MIS HA MINUTEMAN G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693753
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00

PLATE EXPRESSEW II AC DIVBRD

Facility

$1,020.00

Hospital Charge Code	270672122
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

PLATE EXPRESSEW II AC DIVBRD

Facility

$1,020.00

Hospital Charge Code	270672122
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$306.00
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

PLATE EXTVOLAR DR 53MM 3 HOLE

Facility

$10,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270703684
Hospital Revenue Code	278
Min. Negotiated Rate	$1,540.50
Max. Negotiated Rate	$2,485.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,054.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,485.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,540.50

PLATE EXTVOLAR DR 53MM 3 HOLE

Facility

$10,270.00

Service Code	HCPCS C1713
Hospital Charge Code	270703684
Hospital Revenue Code	278
Min. Negotiated Rate	$1,540.50
Max. Negotiated Rate	$5,135.00
Rate for Payer: Aetna Commercial	$3,081.00
Rate for Payer: Aetna Medicare Advantage	$3,081.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,618.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,618.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,054.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,618.85
Rate for Payer: Cigna Commercial	$5,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,485.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,540.50

PLATE FEM DIST LAT 12H 274MM

Facility

$16,190.30

Service Code	HCPCS C1713
Hospital Charge Code	270697352
Hospital Revenue Code	278
Min. Negotiated Rate	$2,428.55
Max. Negotiated Rate	$8,095.15
Rate for Payer: Aetna Commercial	$4,857.09
Rate for Payer: Aetna Medicare Advantage	$4,857.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,128.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,128.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,238.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,128.53
Rate for Payer: Cigna Commercial	$8,095.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,918.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.55

PLATE FEM DIST LAT 12H 274MM

Facility

$16,190.30

Service Code	HCPCS C1713
Hospital Charge Code	270697352
Hospital Revenue Code	278
Min. Negotiated Rate	$2,428.55
Max. Negotiated Rate	$3,918.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,238.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,918.05
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.55

PLATE FEM DIST LAT RT 6H 166MM

Facility

$15,160.10

Service Code	HCPCS C1713
Hospital Charge Code	270697989
Hospital Revenue Code	278
Min. Negotiated Rate	$2,274.01
Max. Negotiated Rate	$7,580.05
Rate for Payer: Aetna Commercial	$4,548.03
Rate for Payer: Aetna Medicare Advantage	$4,548.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,865.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,865.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,032.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,865.83
Rate for Payer: Cigna Commercial	$7,580.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,668.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,274.01

PLATE FEM DIST LAT RT 6H 166MM

Facility

$15,160.10

Service Code	HCPCS C1713
Hospital Charge Code	270697989
Hospital Revenue Code	278
Min. Negotiated Rate	$2,274.01
Max. Negotiated Rate	$3,668.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,032.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,668.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,274.01

PLATE FEMORAL 10 HOLE DISTAL

Facility

$12,730.00

Hospital Charge Code	270663305
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 FEMORAL 10 HOLE DISTAL

Facility

$12,730.00

Hospital Charge Code	270663305
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 FEMUR DISTAL 10H 238mm R

Facility

$11,871.00

Hospital Charge Code	270673781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,780.65
Max. Negotiated Rate	$5,935.50
Rate for Payer: Aetna Commercial	$3,561.30
Rate for Payer: Aetna Medicare Advantage	$3,561.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,374.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,027.11
Rate for Payer: Cigna Commercial	$5,935.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,872.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,780.65

PLATE FEMUR DISTAL 10H 238mm R

Facility

$11,871.00

Hospital Charge Code	270673781
Hospital Revenue Code	278
Min. Negotiated Rate	$1,780.65
Max. Negotiated Rate	$2,872.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,374.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,872.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,780.65

PLATE FIB 3DI 89MM RT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$3,906.28
Rate for Payer: Aetna Commercial	$2,343.76
Rate for Payer: Aetna Medicare Advantage	$2,343.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,992.20
Rate for Payer: Cigna Commercial	$3,906.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB 3DI 89MM RT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$1,890.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB LAT 3DI 77MM LT

Facility

$7,642.60

Service Code	HCPCS C1713
Hospital Charge Code	270700343
Hospital Revenue Code	278
Min. Negotiated Rate	$1,146.39
Max. Negotiated Rate	$3,821.30
Rate for Payer: Aetna Commercial	$2,292.78
Rate for Payer: Aetna Medicare Advantage	$2,292.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,948.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,948.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,528.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,948.86
Rate for Payer: Cigna Commercial	$3,821.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,849.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.39

PLATE FIB LAT 3DI 77MM LT

Facility

$7,642.60

Service Code	HCPCS C1713
Hospital Charge Code	270700343
Hospital Revenue Code	278
Min. Negotiated Rate	$1,146.39
Max. Negotiated Rate	$1,849.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,528.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,849.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.39

PLATE FIB LAT 3DI 89MM LT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700379
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$3,906.28
Rate for Payer: Aetna Commercial	$2,343.76
Rate for Payer: Aetna Medicare Advantage	$2,343.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,992.20
Rate for Payer: Cigna Commercial	$3,906.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

PLATE FIB LAT 3DI 89MM LT

Facility

$7,812.55

Service Code	HCPCS C1713
Hospital Charge Code	270700379
Hospital Revenue Code	278
Min. Negotiated Rate	$1,171.88
Max. Negotiated Rate	$1,890.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,562.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,171.88

Know your out-of-pocket cost for care.

All Charges