Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LAT DISTAL FEMR 12H-281m

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270671594
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PLATE LAT DIST TIB TI RT 4H

Facility

$7,016.75

Service Code	HCPCS C1713
Hospital Charge Code	270699067
Hospital Revenue Code	278
Min. Negotiated Rate	$1,052.51
Max. Negotiated Rate	$3,508.38
Rate for Payer: Aetna Commercial	$2,105.03
Rate for Payer: Aetna Medicare Advantage	$2,105.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,789.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,789.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,403.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,789.27
Rate for Payer: Cigna Commercial	$3,508.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,698.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.51

PLATE LAT DIST TIB TI RT 4H

Facility

$7,016.75

Service Code	HCPCS C1713
Hospital Charge Code	270699067
Hospital Revenue Code	278
Min. Negotiated Rate	$1,052.51
Max. Negotiated Rate	$1,698.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,403.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,698.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.51

PLATE LATERAL 22MM

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692163
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

PLATE LATERAL 22MM

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692163
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

PLATE LATERAL 2H SZ10 NEXXT

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693627
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

PLATE LATERAL 2H SZ10 NEXXT

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693627
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$5,992.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

PLATE LATERAL FIBULA 3H 77MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270662554
Hospital Revenue Code	278
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$1,195.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: Qualcare PPO/HMO/WC	$741.00

PLATE LATERAL FIBULA 3H 77MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270662554
Hospital Revenue Code	278
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$2,470.00
Rate for Payer: Aetna Commercial	$1,482.00
Rate for Payer: Aetna Medicare Advantage	$1,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.70
Rate for Payer: Cigna Commercial	$2,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: Qualcare PPO/HMO/WC	$741.00

PLATE LATERAL FIBULAR

Facility

$2,320.00

Hospital Charge Code	270658743
Hospital Revenue Code	278
Min. Negotiated Rate	$348.00
Max. Negotiated Rate	$561.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.44
Rate for Payer: Qualcare PPO/HMO/WC	$348.00

PLATE LATERAL FIBULAR

Facility

$2,320.00

Hospital Charge Code	270658743
Hospital Revenue Code	278
Min. Negotiated Rate	$348.00
Max. Negotiated Rate	$1,160.00
Rate for Payer: Aetna Commercial	$696.00
Rate for Payer: Aetna Medicare Advantage	$696.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$591.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$591.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$464.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$591.60
Rate for Payer: Cigna Commercial	$1,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$561.44
Rate for Payer: Qualcare PPO/HMO/WC	$348.00

PLATE LATERAL HOOK LOCK SS 3H

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270671907
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LATERAL HOOK LOCK SS 3H

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270671907
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LATERAL HOOK LOCK SS 5H

Facility

$3,500.00

Hospital Charge Code	270656473
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LATERAL HOOK LOCK SS 5H

Facility

$3,500.00

Hospital Charge Code	270656473
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LATERAL HOOK LOCK SS 7H

Facility

$3,500.00

Hospital Charge Code	270656475
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LATERAL HOOK LOCK SS 7H

Facility

$3,500.00

Hospital Charge Code	270656475
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE LATERAL STRUXXURE 14MM2H

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693947
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$9,987.50
Rate for Payer: Aetna Commercial	$5,992.50
Rate for Payer: Aetna Medicare Advantage	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.62
Rate for Payer: Cigna Commercial	$9,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

PLATE LATERAL STRUXXURE 14MM2H

Facility

$19,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693947
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.25
Max. Negotiated Rate	$4,833.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,833.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.25

PLATE LATERAL TIBIA 2H 95MM RT

Facility

$13,170.00

Service Code	HCPCS C1713
Hospital Charge Code	270673957
Hospital Revenue Code	278
Min. Negotiated Rate	$1,975.50
Max. Negotiated Rate	$3,187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,187.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,975.50

PLATE LATERAL TIBIA 2H 95MM RT

Facility

$13,170.00

Service Code	HCPCS C1713
Hospital Charge Code	270673957
Hospital Revenue Code	278
Min. Negotiated Rate	$1,975.50
Max. Negotiated Rate	$6,585.00
Rate for Payer: Aetna Commercial	$3,951.00
Rate for Payer: Aetna Medicare Advantage	$3,951.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,358.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,358.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,634.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,358.35
Rate for Payer: Cigna Commercial	$6,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,187.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,975.50

PLATE LATFIB ORTHOLOC RT 101MM

Facility

$7,977.50

Service Code	HCPCS C1713
Hospital Charge Code	270699444
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.62
Max. Negotiated Rate	$3,988.75
Rate for Payer: Aetna Commercial	$2,393.25
Rate for Payer: Aetna Medicare Advantage	$2,393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,034.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,034.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,034.26
Rate for Payer: Cigna Commercial	$3,988.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,930.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.62

PLATE LATFIB ORTHOLOC RT 101MM

Facility

$7,977.50

Service Code	HCPCS C1713
Hospital Charge Code	270699444
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.62
Max. Negotiated Rate	$1,930.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,930.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.62

PLATE LAT POST LF 4 HOLE 105MM

Facility

$7,995.00

Hospital Charge Code	270670991
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$3,997.50
Rate for Payer: Aetna Commercial	$2,398.50
Rate for Payer: Aetna Medicare Advantage	$2,398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,038.72
Rate for Payer: Cigna Commercial	$3,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

PLATE LAT POST LF 4 HOLE 105MM

Facility

$7,995.00

Hospital Charge Code	270670991
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$1,934.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

Know your out-of-pocket cost for care.

All Charges