Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

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	$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 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605377
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 150 DEG

Facility

$723.00

Hospital Charge Code	1605294
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 150 DEG

Facility

$723.00

Hospital Charge Code	1605294
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 6 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605427
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 6 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605427
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 6 HL 140 DEG

Facility

$1,146.00

Hospital Charge Code	1605369
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 6 HL 140 DEG

Facility

$1,146.00

Hospital Charge Code	1605369
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 6 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605336
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 6 HL 145 DEG

Facility

$1,146.00

Hospital Charge Code	1605336
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 6 HL 160 DEG

Facility

$723.00

Hospital Charge Code	1605252
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 6 HL 160 DEG

Facility

$723.00

Hospital Charge Code	1605252
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 8 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605419
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 8 HL 130 DEG

Facility

$1,146.00

Hospital Charge Code	1605419
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 8 HL 140 DEG

Facility

$1,371.00

Hospital Charge Code	1605351
Hospital Revenue Code	274
Min. Negotiated Rate	$205.65
Max. Negotiated Rate	$685.50
Rate for Payer: Aetna Commercial	$411.30
Rate for Payer: Aetna Medicare Advantage	$411.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.61
Rate for Payer: Cigna Commercial	$685.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.78
Rate for Payer: Qualcare PPO/HMO/WC	$205.65

PLATE FRLOK COMP 8 HL 140 DEG

Facility

$1,371.00

Hospital Charge Code	1605351
Hospital Revenue Code	274
Min. Negotiated Rate	$205.65
Max. Negotiated Rate	$331.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.78
Rate for Payer: Qualcare PPO/HMO/WC	$205.65

PLATE FRLOK COMP 8 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605260
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 8 HL 150 DEG

Facility

$723.00

Hospital Charge Code	1605260
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 FUSION 1MPJ SM 7D LT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270694322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$4,532.50
Rate for Payer: Aetna Commercial	$2,719.50
Rate for Payer: Aetna Medicare Advantage	$2,719.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,311.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,311.57
Rate for Payer: Cigna Commercial	$4,532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE FUSION 1MPJ SM 7D LT

Facility

$9,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270694322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,359.75
Max. Negotiated Rate	$2,193.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,813.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,193.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,359.75

PLATE FUSION MIS HA COATED G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694466
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 FUSION MIS HA COATED G3R

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694466
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
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
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLATE FUSION VA-LCP 2.4/2.7MM

Facility

$3,909.00

Hospital Charge Code	270676909
Hospital Revenue Code	278
Min. Negotiated Rate	$586.35
Max. Negotiated Rate	$1,954.50
Rate for Payer: Aetna Commercial	$1,172.70
Rate for Payer: Aetna Medicare Advantage	$1,172.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$996.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$996.79
Rate for Payer: Cigna Commercial	$1,954.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35

PLATE FUSION VA-LCP 2.4/2.7MM

Facility

$3,909.00

Hospital Charge Code	270676909
Hospital Revenue Code	278
Min. Negotiated Rate	$586.35
Max. Negotiated Rate	$945.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$781.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$945.98
Rate for Payer: Qualcare PPO/HMO/WC	$586.35

Know your out-of-pocket cost for care.

All Charges