Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FUSION WRIST NEUTRAL

Facility

$11,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270691338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$5,792.50
Rate for Payer: Aetna Commercial	$3,475.50
Rate for Payer: Aetna Medicare Advantage	$3,475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,954.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,954.18
Rate for Payer: Cigna Commercial	$5,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

PLATE FUSION WRIST NEUTRAL

Facility

$11,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270691338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.75
Max. Negotiated Rate	$2,803.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,317.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,803.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,737.75

PLATE GEMINUS HOOK

Facility

$2,275.00

Hospital Charge Code	270664439
Hospital Revenue Code	278
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$1,137.50
Rate for Payer: Aetna Commercial	$682.50
Rate for Payer: Aetna Medicare Advantage	$682.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.12
Rate for Payer: Cigna Commercial	$1,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

PLATE GEMINUS HOOK

Facility

$2,275.00

Hospital Charge Code	270664439
Hospital Revenue Code	278
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$550.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

PLATE GLENOID REVERSE SHOULDER

Facility

$7,952.40

Service Code	HCPCS C1713
Hospital Charge Code	270668552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.86
Max. Negotiated Rate	$1,924.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.86

PLATE GLENOID REVERSE SHOULDER

Facility

$7,952.40

Service Code	HCPCS C1713
Hospital Charge Code	270668552
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.86
Max. Negotiated Rate	$3,976.20
Rate for Payer: Aetna Commercial	$2,385.72
Rate for Payer: Aetna Medicare Advantage	$2,385.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.86
Rate for Payer: Cigna Commercial	$3,976.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,924.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.86

PLATE GORILLA MTP MED RT 5D

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270700642
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$1,573.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

PLATE GORILLA MTP MED RT 5D

Facility

$6,503.75

Service Code	HCPCS C1713
Hospital Charge Code	270700642
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$3,251.88
Rate for Payer: Aetna Commercial	$1,951.12
Rate for Payer: Aetna Medicare Advantage	$1,951.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,658.46
Rate for Payer: Cigna Commercial	$3,251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

PLATE GRIDLOCK VLC 2HOLE

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680717
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE GRIDLOCK VLC 2HOLE

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270680717
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE GRIP THROC. MED 200MM

Facility

$13,012.00

Hospital Charge Code	270670738
Hospital Revenue Code	272
Min. Negotiated Rate	$1,951.80
Max. Negotiated Rate	$1,951.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80

PLATE GRIP THROC. MED 200MM

Facility

$13,012.00

Hospital Charge Code	270670738
Hospital Revenue Code	272
Min. Negotiated Rate	$1,691.56
Max. Negotiated Rate	$6,506.00
Rate for Payer: Aetna Commercial	$3,903.60
Rate for Payer: Aetna Medicare Advantage	$3,903.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,318.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,318.06
Rate for Payer: Cigna Commercial	$6,506.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.56
Rate for Payer: Oxford Commercial	$6,506.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,951.80
Rate for Payer: UnitedHealthcare Commercial	$6,506.00

PLATE GRUVE 20MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699044
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE GRUVE 20MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699044
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PLATE HA REMOVABLE END 12

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692076
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 HA REMOVABLE END 12

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692076
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 HELIX R, 40MM 2 LEVEL

Facility

$8,545.00

Hospital Charge Code	270667692
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE HELIX R, 40MM 2 LEVEL

Facility

$8,545.00

Hospital Charge Code	270667692
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$4,272.50
Rate for Payer: Aetna Commercial	$2,563.50
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE HELIX R, 44MM 2-LEVEL

Facility

$8,545.00

Hospital Charge Code	270666087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$2,067.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE HELIX R, 44MM 2-LEVEL

Facility

$8,545.00

Hospital Charge Code	270666087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,281.75
Max. Negotiated Rate	$4,272.50
Rate for Payer: Cigna Commercial	$4,272.50
Rate for Payer: Aetna Commercial	$2,563.50
Rate for Payer: Aetna Medicare Advantage	$2,563.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,178.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,178.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,067.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,281.75

PLATE HMD DISTAL 6H 5224-1006

Facility

$4,213.65

Hospital Charge Code	270620191
Hospital Revenue Code	278
Min. Negotiated Rate	$632.05
Max. Negotiated Rate	$2,106.82
Rate for Payer: Aetna Commercial	$1,264.10
Rate for Payer: Aetna Medicare Advantage	$1,264.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,074.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,074.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$842.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,074.48
Rate for Payer: Cigna Commercial	$2,106.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,019.70
Rate for Payer: Qualcare PPO/HMO/WC	$632.05

PLATE HMD DISTAL 6H 5224-1006

Facility

$4,213.65

Hospital Charge Code	270620191
Hospital Revenue Code	278
Min. Negotiated Rate	$632.05
Max. Negotiated Rate	$1,019.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$842.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,019.70
Rate for Payer: Qualcare PPO/HMO/WC	$632.05

PLATE HOLDING TAC

Facility

$350.00

Hospital Charge Code	270669668
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$105.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PLATE HOLDING TAC

Facility

$350.00

Hospital Charge Code	270669668
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$84.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.70
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

PLATE HOLE 13 ANATOMIC LEFT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270701531
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$3,430.62
Rate for Payer: Aetna Commercial	$2,058.38
Rate for Payer: Aetna Medicare Advantage	$2,058.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,749.62
Rate for Payer: Cigna Commercial	$3,430.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

Know your out-of-pocket cost for care.

All Charges