Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE, FRAGMENT PROTEAN DOUBLE

Facility

$4,475.00

Hospital Charge Code	270668298
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE, FRAGMENT PROTEAN DOUBLE

Facility

$4,475.00

Hospital Charge Code	270668298
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE FRLOK COMP 10 HL 135 DEG

Facility

$1,685.00

Hospital Charge Code	1605393
Hospital Revenue Code	274
Min. Negotiated Rate	$252.75
Max. Negotiated Rate	$407.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.77
Rate for Payer: Qualcare PPO/HMO/WC	$252.75

PLATE FRLOK COMP 10 HL 135 DEG

Facility

$1,685.00

Hospital Charge Code	1605393
Hospital Revenue Code	274
Min. Negotiated Rate	$252.75
Max. Negotiated Rate	$842.50
Rate for Payer: Aetna Commercial	$505.50
Rate for Payer: Aetna Medicare Advantage	$505.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.68
Rate for Payer: Cigna Commercial	$842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.77
Rate for Payer: Qualcare PPO/HMO/WC	$252.75

PLATE FRLOK COMP 10 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605278
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$216.90
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 10 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605278
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 12 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605286
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$216.90
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 12 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605286
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97

PLATE FRLOK COMP 2 HL 135 DEG

Facility

$1,075.00

Hospital Charge Code	1605443
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 2 HL 135 DEG

Facility

$1,075.00

Hospital Charge Code	1605443
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 2 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605310
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 2 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605310
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$216.90
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 3 HL 135 DEG

Facility

$1,075.00

Hospital Charge Code	1605450
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 135 DEG

Facility

$1,075.00

Hospital Charge Code	1605450
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 140 DEG

Facility

$1,075.00

Hospital Charge Code	1605385
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 140 DEG

Facility

$1,075.00

Hospital Charge Code	1605385
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 145 DEG

Facility

$1,075.00

Hospital Charge Code	1605344
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 145 DEG

Facility

$1,075.00

Hospital Charge Code	1605344
Hospital Revenue Code	274
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PLATE FRLOK COMP 3 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605302
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$174.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 3 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605302
Hospital Revenue Code	274
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$361.50
Rate for Payer: Aetna Commercial	$216.90
Rate for Payer: Aetna Medicare Advantage	$216.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.37
Rate for Payer: Cigna Commercial	$361.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.97
Rate for Payer: Qualcare PPO/HMO/WC	$108.45

PLATE FRLOK COMP 5 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605435
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605435
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$343.80
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 135 DEG

Facility

$1,146.00

Hospital Charge Code	1605401
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$573.00
Rate for Payer: Aetna Commercial	$343.80
Rate for Payer: Aetna Medicare Advantage	$343.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.23
Rate for Payer: Cigna Commercial	$573.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 135 DEG

Facility

$1,146.00

Hospital Charge Code	1605401
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

PLATE FRLOK COMP 5 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605328
Hospital Revenue Code	274
Min. Negotiated Rate	$171.90
Max. Negotiated Rate	$277.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.33
Rate for Payer: Qualcare PPO/HMO/WC	$171.90

Know your out-of-pocket cost for care.

All Charges