Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE L-BUTTRESS 85MM 4H RT

Facility

$1,714.95

Service Code	HCPCS C1713
Hospital Charge Code	270652579
Hospital Revenue Code	278
Min. Negotiated Rate	$257.24
Max. Negotiated Rate	$415.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.02
Rate for Payer: Qualcare PPO/HMO/WC	$257.24

PLATE L-BUTTRESS 85MM 4H RT

Facility

$1,714.95

Service Code	HCPCS C1713
Hospital Charge Code	270652579
Hospital Revenue Code	278
Min. Negotiated Rate	$257.24
Max. Negotiated Rate	$857.48
Rate for Payer: Aetna Commercial	$514.49
Rate for Payer: Aetna Medicare Advantage	$514.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$437.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$437.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$342.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$437.31
Rate for Payer: Cigna Commercial	$857.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.02
Rate for Payer: Qualcare PPO/HMO/WC	$257.24

PLATE LC-DCP 2.0MM 4HOLE 27MM

Facility

$896.10

Service Code	HCPCS C1713
Hospital Charge Code	270654841
Hospital Revenue Code	278
Min. Negotiated Rate	$134.41
Max. Negotiated Rate	$448.05
Rate for Payer: Aetna Commercial	$268.83
Rate for Payer: Aetna Medicare Advantage	$268.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.51
Rate for Payer: Cigna Commercial	$448.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.86
Rate for Payer: Qualcare PPO/HMO/WC	$134.41

PLATE LC-DCP 2.0MM 4HOLE 27MM

Facility

$896.10

Service Code	HCPCS C1713
Hospital Charge Code	270654841
Hospital Revenue Code	278
Min. Negotiated Rate	$134.41
Max. Negotiated Rate	$216.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.86
Rate for Payer: Qualcare PPO/HMO/WC	$134.41

PLATE LC-DCP 2.0MM 6HOLE 39MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270654843
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

PLATE LC-DCP 2.0MM 6HOLE 39MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270654843
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$315.18
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

PLATE LC-DCP 2.0MM 8HOLE 68MM

Facility

$1,205.10

Service Code	HCPCS C1713
Hospital Charge Code	270654856
Hospital Revenue Code	278
Min. Negotiated Rate	$180.76
Max. Negotiated Rate	$291.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.63
Rate for Payer: Qualcare PPO/HMO/WC	$180.76

PLATE LC-DCP 2.0MM 8HOLE 68MM

Facility

$1,205.10

Service Code	HCPCS C1713
Hospital Charge Code	270654856
Hospital Revenue Code	278
Min. Negotiated Rate	$180.76
Max. Negotiated Rate	$602.55
Rate for Payer: Aetna Commercial	$361.53
Rate for Payer: Aetna Medicare Advantage	$361.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.30
Rate for Payer: Cigna Commercial	$602.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.63
Rate for Payer: Qualcare PPO/HMO/WC	$180.76

PLATE LC-DCP 2.4MM 4 HOLE

Facility

$1,242.20

Service Code	HCPCS C1713
Hospital Charge Code	270654867
Hospital Revenue Code	278
Min. Negotiated Rate	$186.33
Max. Negotiated Rate	$300.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.61
Rate for Payer: Qualcare PPO/HMO/WC	$186.33

PLATE LC-DCP 2.4MM 4 HOLE

Facility

$1,242.20

Service Code	HCPCS C1713
Hospital Charge Code	270654867
Hospital Revenue Code	278
Min. Negotiated Rate	$186.33
Max. Negotiated Rate	$621.10
Rate for Payer: Aetna Commercial	$372.66
Rate for Payer: Aetna Medicare Advantage	$372.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.76
Rate for Payer: Cigna Commercial	$621.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.61
Rate for Payer: Qualcare PPO/HMO/WC	$186.33

PLATE LC-DCP 2.4MM 6 HOLE

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270654869
Hospital Revenue Code	278
Min. Negotiated Rate	$210.43
Max. Negotiated Rate	$701.42
Rate for Payer: Aetna Commercial	$420.86
Rate for Payer: Aetna Medicare Advantage	$420.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.73
Rate for Payer: Cigna Commercial	$701.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43

PLATE LC-DCP 2.4MM 6 HOLE

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270654869
Hospital Revenue Code	278
Min. Negotiated Rate	$210.43
Max. Negotiated Rate	$339.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43

PLATE LC-DCP 2.4MM 8 HOLE

Facility

$1,514.10

Service Code	HCPCS C1713
Hospital Charge Code	270654870
Hospital Revenue Code	278
Min. Negotiated Rate	$227.12
Max. Negotiated Rate	$757.05
Rate for Payer: Aetna Commercial	$454.23
Rate for Payer: Aetna Medicare Advantage	$454.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.10
Rate for Payer: Cigna Commercial	$757.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.41
Rate for Payer: Qualcare PPO/HMO/WC	$227.12

PLATE LC-DCP 2.4MM 8 HOLE

Facility

$1,514.10

Service Code	HCPCS C1713
Hospital Charge Code	270654870
Hospital Revenue Code	278
Min. Negotiated Rate	$227.12
Max. Negotiated Rate	$366.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.41
Rate for Payer: Qualcare PPO/HMO/WC	$227.12

PLATE LC-DCP 3.5x103MM 8HOLE

Facility

$700.20

Service Code	HCPCS C1713
Hospital Charge Code	270601897
Hospital Revenue Code	278
Min. Negotiated Rate	$105.03
Max. Negotiated Rate	$350.10
Rate for Payer: Aetna Commercial	$210.06
Rate for Payer: Aetna Medicare Advantage	$210.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.55
Rate for Payer: Cigna Commercial	$350.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.45
Rate for Payer: Qualcare PPO/HMO/WC	$105.03

PLATE LC-DCP 3.5x103MM 8HOLE

Facility

$700.20

Service Code	HCPCS C1713
Hospital Charge Code	270601897
Hospital Revenue Code	278
Min. Negotiated Rate	$105.03
Max. Negotiated Rate	$169.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.45
Rate for Payer: Qualcare PPO/HMO/WC	$105.03

PLATE LC-DCP 3.5x116MM 9HOLE

Facility

$710.70

Service Code	HCPCS C1713
Hospital Charge Code	270603344
Hospital Revenue Code	278
Min. Negotiated Rate	$106.61
Max. Negotiated Rate	$171.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.99
Rate for Payer: Qualcare PPO/HMO/WC	$106.61

PLATE LC-DCP 3.5x116MM 9HOLE

Facility

$710.70

Service Code	HCPCS C1713
Hospital Charge Code	270603344
Hospital Revenue Code	278
Min. Negotiated Rate	$106.61
Max. Negotiated Rate	$355.35
Rate for Payer: Aetna Commercial	$213.21
Rate for Payer: Aetna Medicare Advantage	$213.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.23
Rate for Payer: Cigna Commercial	$355.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.99
Rate for Payer: Qualcare PPO/HMO/WC	$106.61

PLATE LC-DCP 3.5x64MM 5HOLE

Facility

$599.45

Service Code	HCPCS C1713
Hospital Charge Code	270630538
Hospital Revenue Code	278
Min. Negotiated Rate	$89.92
Max. Negotiated Rate	$299.73
Rate for Payer: Aetna Commercial	$179.84
Rate for Payer: Aetna Medicare Advantage	$179.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.86
Rate for Payer: Cigna Commercial	$299.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.07
Rate for Payer: Qualcare PPO/HMO/WC	$89.92

PLATE LC-DCP 3.5x64MM 5HOLE

Facility

$599.45

Service Code	HCPCS C1713
Hospital Charge Code	270630538
Hospital Revenue Code	278
Min. Negotiated Rate	$89.92
Max. Negotiated Rate	$145.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.07
Rate for Payer: Qualcare PPO/HMO/WC	$89.92

PLATE LC-DCP 3.5x77MM 6HOLE

Facility

$1,667.70

Service Code	HCPCS C1713
Hospital Charge Code	270601896
Hospital Revenue Code	278
Min. Negotiated Rate	$250.16
Max. Negotiated Rate	$833.85
Rate for Payer: Aetna Commercial	$500.31
Rate for Payer: Aetna Medicare Advantage	$500.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.26
Rate for Payer: Cigna Commercial	$833.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.58
Rate for Payer: Qualcare PPO/HMO/WC	$250.16

PLATE LC-DCP 3.5x77MM 6HOLE

Facility

$1,667.70

Service Code	HCPCS C1713
Hospital Charge Code	270601896
Hospital Revenue Code	278
Min. Negotiated Rate	$250.16
Max. Negotiated Rate	$403.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.58
Rate for Payer: Qualcare PPO/HMO/WC	$250.16

PLATE LC-DCP 3.5x90MM 7HOLE

Facility

$665.15

Service Code	HCPCS C1713
Hospital Charge Code	270601895
Hospital Revenue Code	278
Min. Negotiated Rate	$99.77
Max. Negotiated Rate	$332.57
Rate for Payer: Aetna Commercial	$199.54
Rate for Payer: Aetna Medicare Advantage	$199.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.61
Rate for Payer: Cigna Commercial	$332.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.97
Rate for Payer: Qualcare PPO/HMO/WC	$99.77

PLATE LC-DCP 3.5x90MM 7HOLE

Facility

$665.15

Service Code	HCPCS C1713
Hospital Charge Code	270601895
Hospital Revenue Code	278
Min. Negotiated Rate	$99.77
Max. Negotiated Rate	$160.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.97
Rate for Payer: Qualcare PPO/HMO/WC	$99.77

PLATE LC DCP 4HOLE 2.4mm 31mm

Facility

$1,402.85

Service Code	HCPCS C1713
Hospital Charge Code	270651720
Hospital Revenue Code	278
Min. Negotiated Rate	$210.43
Max. Negotiated Rate	$701.42
Rate for Payer: Aetna Commercial	$420.86
Rate for Payer: Aetna Medicare Advantage	$420.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.73
Rate for Payer: Cigna Commercial	$701.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.49
Rate for Payer: Qualcare PPO/HMO/WC	$210.43

Know your out-of-pocket cost for care.

All Charges