Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE HUM DISTAL 7H RT 147MM

Facility

$4,842.05

Hospital Charge Code	270677666
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 7H RT 147MM

Facility

$4,842.05

Hospital Charge Code	270677666
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 9H LT 153MM

Facility

$4,842.05

Hospital Charge Code	270677641
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 9H LT 153MM

Facility

$4,842.05

Hospital Charge Code	270677641
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 9H RT 153MM

Facility

$4,842.05

Hospital Charge Code	270677638
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 9H RT 153MM

Facility

$4,842.05

Hospital Charge Code	270677638
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 RH RT 111MM

Facility

$4,993.45

Hospital Charge Code	270677630
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$2,496.72
Rate for Payer: Aetna Commercial	$1,498.04
Rate for Payer: Aetna Medicare Advantage	$1,498.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.33
Rate for Payer: Cigna Commercial	$2,496.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: Qualcare PPO/HMO/WC	$749.02

PLATE HUM DISTAL RH RT 111MM

Facility

$4,993.45

Hospital Charge Code	270677630
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$1,208.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.41
Rate for Payer: Qualcare PPO/HMO/WC	$749.02

PLATE HUMERAL PROXIMAL R 4H 9m

Facility

$6,865.00

Hospital Charge Code	270669241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.75
Max. Negotiated Rate	$1,661.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75

PLATE HUMERAL PROXIMAL R 4H 9m

Facility

$6,865.00

Hospital Charge Code	270669241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.75
Max. Negotiated Rate	$3,432.50
Rate for Payer: Aetna Commercial	$2,059.50
Rate for Payer: Aetna Medicare Advantage	$2,059.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,750.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,373.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,750.58
Rate for Payer: Cigna Commercial	$3,432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.75

PLATE HUM PROX HI RT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270697450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.25
Max. Negotiated Rate	$1,716.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25

PLATE HUM PROX HI RT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270697450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.25
Max. Negotiated Rate	$3,547.50
Rate for Payer: Aetna Commercial	$2,128.50
Rate for Payer: Aetna Medicare Advantage	$2,128.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,809.22
Rate for Payer: Cigna Commercial	$3,547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25

PLATE HYBRID COMPRESS 4.5m 7H

Facility

$1,875.00

Hospital Charge Code	270671863
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

PLATE HYBRID COMPRESS 4.5m 7H

Facility

$1,875.00

Hospital Charge Code	270671863
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

PLATE INLINE 6MM

Facility

$9,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270680772
Hospital Revenue Code	278
Min. Negotiated Rate	$1,354.50
Max. Negotiated Rate	$2,185.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,806.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,354.50

PLATE INLINE 6MM

Facility

$9,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270680772
Hospital Revenue Code	278
Min. Negotiated Rate	$1,354.50
Max. Negotiated Rate	$4,515.00
Rate for Payer: Aetna Commercial	$2,709.00
Rate for Payer: Aetna Medicare Advantage	$2,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,302.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,302.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,302.65
Rate for Payer: Cigna Commercial	$4,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,185.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,354.50

PLATE INTERBODIE 7MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

PLATE INTERBODIE 7MM

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$2,475.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

PLATE INTERBODY CERES-C 10MM

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

PLATE INTERBODY CERES-C 10MM

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

PLATE INTERBODY CERES-C 6MM

Facility

$10,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692485
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATE INTERBODY CERES-C 6MM

Facility

$10,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692485
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

PLATEISP 8MM X 34MM

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692541
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLATEISP 8MM X 34MM

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692541
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

PLATE ISP-T FLARED PC 10X36MM

Facility

$20,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270694895
Hospital Revenue Code	278
Min. Negotiated Rate	$3,012.00
Max. Negotiated Rate	$4,859.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,016.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,859.36
Rate for Payer: Qualcare PPO/HMO/WC	$3,012.00

Know your out-of-pocket cost for care.

All Charges