Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$1,660.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE HOOK 3 HOLE 3.5MM LCP

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270683790
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$1,188.75
Rate for Payer: Aetna Commercial	$713.25
Rate for Payer: Aetna Medicare Advantage	$713.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.26
Rate for Payer: Cigna Commercial	$1,188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE HOOK 3 HOLE 3.5MM LCP

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270683790
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$575.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE HOOK LG 3DI 70MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,130.17
Max. Negotiated Rate	$3,767.22
Rate for Payer: Aetna Commercial	$2,260.34
Rate for Payer: Aetna Medicare Advantage	$2,260.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,921.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,921.28
Rate for Payer: Cigna Commercial	$3,767.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17

PLATE HOOK LG 3DI 70MM

Facility

$7,534.45

Service Code	HCPCS C1713
Hospital Charge Code	270700376
Hospital Revenue Code	278
Min. Negotiated Rate	$1,130.17
Max. Negotiated Rate	$1,823.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,823.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.17

PLATE HOOK LOCK TI 3 HOLE

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692862
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATE HOOK LOCK TI 3 HOLE

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692862
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,387.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATE HOOK METARARSAL LONG RT

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695549
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$3,187.50
Rate for Payer: Aetna Commercial	$1,912.50
Rate for Payer: Aetna Medicare Advantage	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,625.62
Rate for Payer: Cigna Commercial	$3,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

PLATE HOOK METARARSAL LONG RT

Facility

$6,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695549
Hospital Revenue Code	278
Min. Negotiated Rate	$956.25
Max. Negotiated Rate	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,542.75
Rate for Payer: Qualcare PPO/HMO/WC	$956.25

PLATE HOOK SCREW CANN 4.0X36MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697015
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

PLATE HOOK SCREW CANN 4.0X36MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270697015
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

PLATE HOOK SM ORTLOC SYS

Facility

$6,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270701132
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.00
Max. Negotiated Rate	$1,650.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00

PLATE HOOK SM ORTLOC SYS

Facility

$6,820.00

Service Code	HCPCS C1713
Hospital Charge Code	270701132
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.00
Max. Negotiated Rate	$3,410.00
Rate for Payer: Aetna Commercial	$2,046.00
Rate for Payer: Aetna Medicare Advantage	$2,046.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.10
Rate for Payer: Cigna Commercial	$3,410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,650.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.00

PLATE HUM DISTAL 12 H 23480712

Facility

$1,992.50

Hospital Charge Code	270634818
Hospital Revenue Code	278
Min. Negotiated Rate	$298.88
Max. Negotiated Rate	$996.25
Rate for Payer: Aetna Commercial	$597.75
Rate for Payer: Aetna Medicare Advantage	$597.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.09
Rate for Payer: Cigna Commercial	$996.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.19
Rate for Payer: Qualcare PPO/HMO/WC	$298.88

PLATE HUM DISTAL 12 H 23480712

Facility

$1,992.50

Hospital Charge Code	270634818
Hospital Revenue Code	278
Min. Negotiated Rate	$298.88
Max. Negotiated Rate	$482.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.19
Rate for Payer: Qualcare PPO/HMO/WC	$298.88

PLATE HUM DISTAL 1H LT 69MM

Facility

$4,842.05

Hospital Charge Code	270677667
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,452.62
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

PLATE HUM DISTAL 1H LT 69MM

Facility

$4,842.05

Hospital Charge Code	270677667
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$1,171.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

PLATE HUM DISTAL 1H LT 69MM

Facility

$5,049.05

Service Code	HCPCS C1713
Hospital Charge Code	270676865
Hospital Revenue Code	278
Min. Negotiated Rate	$757.36
Max. Negotiated Rate	$1,221.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,009.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,221.87
Rate for Payer: Qualcare PPO/HMO/WC	$757.36

PLATE HUM DISTAL 1H LT 69MM

Facility

$5,049.05

Service Code	HCPCS C1713
Hospital Charge Code	270676865
Hospital Revenue Code	278
Min. Negotiated Rate	$757.36
Max. Negotiated Rate	$2,524.53
Rate for Payer: Aetna Commercial	$1,514.71
Rate for Payer: Aetna Medicare Advantage	$1,514.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,009.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,287.51
Rate for Payer: Cigna Commercial	$2,524.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,221.87
Rate for Payer: Qualcare PPO/HMO/WC	$757.36

PLATE HUM DISTAL 1H LT 72MM

Facility

$4,993.05

Service Code	HCPCS C1713
Hospital Charge Code	270676238
Hospital Revenue Code	278
Min. Negotiated Rate	$748.96
Max. Negotiated Rate	$1,208.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.32
Rate for Payer: Qualcare PPO/HMO/WC	$748.96

PLATE HUM DISTAL 1H LT 72MM

Facility

$4,993.05

Service Code	HCPCS C1713
Hospital Charge Code	270676238
Hospital Revenue Code	278
Min. Negotiated Rate	$748.96
Max. Negotiated Rate	$2,496.53
Rate for Payer: Aetna Commercial	$1,497.91
Rate for Payer: Aetna Medicare Advantage	$1,497.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.23
Rate for Payer: Cigna Commercial	$2,496.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.32
Rate for Payer: Qualcare PPO/HMO/WC	$748.96

PLATE HUM DISTAL 1H LT 72MM ST

Facility

$5,197.40

Service Code	HCPCS C1713
Hospital Charge Code	270676910
Hospital Revenue Code	278
Min. Negotiated Rate	$779.61
Max. Negotiated Rate	$2,598.70
Rate for Payer: Aetna Commercial	$1,559.22
Rate for Payer: Aetna Medicare Advantage	$1,559.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.34
Rate for Payer: Cigna Commercial	$2,598.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.77
Rate for Payer: Qualcare PPO/HMO/WC	$779.61

PLATE HUM DISTAL 1H LT 72MM ST

Facility

$5,197.40

Service Code	HCPCS C1713
Hospital Charge Code	270676910
Hospital Revenue Code	278
Min. Negotiated Rate	$779.61
Max. Negotiated Rate	$1,257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,257.77
Rate for Payer: Qualcare PPO/HMO/WC	$779.61

PLATE HUM DISTAL 1H RT 69MM

Facility

$4,842.05

Hospital Charge Code	270677663
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$1,171.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

PLATE HUM DISTAL 1H RT 69MM

Facility

$4,842.05

Hospital Charge Code	270677663
Hospital Revenue Code	278
Min. Negotiated Rate	$726.31
Max. Negotiated Rate	$2,421.03
Rate for Payer: Aetna Commercial	$1,452.62
Rate for Payer: Aetna Medicare Advantage	$1,452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,234.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$968.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,234.72
Rate for Payer: Cigna Commercial	$2,421.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.78
Rate for Payer: Qualcare PPO/HMO/WC	$726.31

Know your out-of-pocket cost for care.

All Charges