Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 6HOLE 2.4mm 47mm

Facility

$1,575.90

Service Code	HCPCS C1713
Hospital Charge Code	270651721
Hospital Revenue Code	278
Min. Negotiated Rate	$236.38
Max. Negotiated Rate	$787.95
Rate for Payer: Aetna Commercial	$472.77
Rate for Payer: Aetna Medicare Advantage	$472.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.85
Rate for Payer: Cigna Commercial	$787.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.37
Rate for Payer: Qualcare PPO/HMO/WC	$236.38

PLATE LC DCP 6HOLE 2.4mm 47mm

Facility

$1,575.90

Service Code	HCPCS C1713
Hospital Charge Code	270651721
Hospital Revenue Code	278
Min. Negotiated Rate	$236.38
Max. Negotiated Rate	$381.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.37
Rate for Payer: Qualcare PPO/HMO/WC	$236.38

PLATE LC-DCP TITN 3.5MM 10H

Facility

$715.25

Service Code	HCPCS C1713
Hospital Charge Code	270603345
Hospital Revenue Code	278
Min. Negotiated Rate	$107.29
Max. Negotiated Rate	$357.62
Rate for Payer: Aetna Commercial	$214.57
Rate for Payer: Aetna Medicare Advantage	$214.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.39
Rate for Payer: Cigna Commercial	$357.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.09
Rate for Payer: Qualcare PPO/HMO/WC	$107.29

PLATE LC-DCP TITN 3.5MM 10H

Facility

$715.25

Service Code	HCPCS C1713
Hospital Charge Code	270603345
Hospital Revenue Code	278
Min. Negotiated Rate	$107.29
Max. Negotiated Rate	$173.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.09
Rate for Payer: Qualcare PPO/HMO/WC	$107.29

PLATE LC-DCP TITN 3.5MM 11H

Facility

$744.00

Hospital Charge Code	270603347
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$223.20
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

PLATE LC-DCP TITN 3.5MM 11H

Facility

$744.00

Hospital Charge Code	270603347
Hospital Revenue Code	278
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$180.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.05
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

PLATE LC-DCP TITN 3.5MM 12H

Facility

$791.25

Hospital Charge Code	270604055
Hospital Revenue Code	278
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$395.62
Rate for Payer: Aetna Commercial	$237.38
Rate for Payer: Aetna Medicare Advantage	$237.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.77
Rate for Payer: Cigna Commercial	$395.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.48
Rate for Payer: Qualcare PPO/HMO/WC	$118.69

PLATE LC-DCP TITN 3.5MM 12H

Facility

$791.25

Hospital Charge Code	270604055
Hospital Revenue Code	278
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$191.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.48
Rate for Payer: Qualcare PPO/HMO/WC	$118.69

PLATE LC-DCP TITN 3.5MM 12H

Facility

$791.25

Hospital Charge Code	270603349
Hospital Revenue Code	278
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$191.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.48
Rate for Payer: Qualcare PPO/HMO/WC	$118.69

PLATE LC-DCP TITN 3.5MM 12H

Facility

$791.25

Hospital Charge Code	270603349
Hospital Revenue Code	278
Min. Negotiated Rate	$118.69
Max. Negotiated Rate	$395.62
Rate for Payer: Aetna Commercial	$237.38
Rate for Payer: Aetna Medicare Advantage	$237.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.77
Rate for Payer: Cigna Commercial	$395.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.48
Rate for Payer: Qualcare PPO/HMO/WC	$118.69

PLATE LC-DCP TITN 3.5MM 14H

Facility

$1,503.25

Hospital Charge Code	270603350
Hospital Revenue Code	278
Min. Negotiated Rate	$225.49
Max. Negotiated Rate	$363.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.79
Rate for Payer: Qualcare PPO/HMO/WC	$225.49

PLATE LC-DCP TITN 3.5MM 14H

Facility

$1,503.25

Hospital Charge Code	270603350
Hospital Revenue Code	278
Min. Negotiated Rate	$225.49
Max. Negotiated Rate	$751.62
Rate for Payer: Aetna Commercial	$450.98
Rate for Payer: Aetna Medicare Advantage	$450.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.33
Rate for Payer: Cigna Commercial	$751.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.79
Rate for Payer: Qualcare PPO/HMO/WC	$225.49

PLATE LC-DCP TITN 3.5MM 15H

Facility

$1,609.65

Hospital Charge Code	270604056
Hospital Revenue Code	278
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$804.83
Rate for Payer: Aetna Commercial	$482.89
Rate for Payer: Aetna Medicare Advantage	$482.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.46
Rate for Payer: Cigna Commercial	$804.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

PLATE LC-DCP TITN 3.5MM 15H

Facility

$1,609.65

Hospital Charge Code	270604056
Hospital Revenue Code	278
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$389.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

PLATE LC-DCP TITN 3.5MM 16H

Facility

$1,724.85

Hospital Charge Code	270604058
Hospital Revenue Code	278
Min. Negotiated Rate	$258.73
Max. Negotiated Rate	$862.42
Rate for Payer: Aetna Commercial	$517.46
Rate for Payer: Aetna Medicare Advantage	$517.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.84
Rate for Payer: Cigna Commercial	$862.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.41
Rate for Payer: Qualcare PPO/HMO/WC	$258.73

PLATE LC-DCP TITN 3.5MM 16H

Facility

$1,724.85

Hospital Charge Code	270604058
Hospital Revenue Code	278
Min. Negotiated Rate	$258.73
Max. Negotiated Rate	$417.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$344.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.41
Rate for Payer: Qualcare PPO/HMO/WC	$258.73

PLATE LC-DCP TITN 3.5MM 18H

Facility

$1,940.00

Hospital Charge Code	270603358
Hospital Revenue Code	278
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$970.00
Rate for Payer: Aetna Commercial	$582.00
Rate for Payer: Aetna Medicare Advantage	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.70
Rate for Payer: Cigna Commercial	$970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.48
Rate for Payer: Qualcare PPO/HMO/WC	$291.00

PLATE LC-DCP TITN 3.5MM 18H

Facility

$1,940.00

Hospital Charge Code	270603358
Hospital Revenue Code	278
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$469.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.48
Rate for Payer: Qualcare PPO/HMO/WC	$291.00

PLATE LC-DCP TITN 3.5MM 20H

Facility

$2,154.45

Hospital Charge Code	270603360
Hospital Revenue Code	278
Min. Negotiated Rate	$323.17
Max. Negotiated Rate	$521.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$430.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.38
Rate for Payer: Qualcare PPO/HMO/WC	$323.17

PLATE LC-DCP TITN 3.5MM 20H

Facility

$2,154.45

Hospital Charge Code	270603360
Hospital Revenue Code	278
Min. Negotiated Rate	$323.17
Max. Negotiated Rate	$1,077.22
Rate for Payer: Aetna Commercial	$646.34
Rate for Payer: Aetna Medicare Advantage	$646.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$549.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$549.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$430.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$549.38
Rate for Payer: Cigna Commercial	$1,077.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.38
Rate for Payer: Qualcare PPO/HMO/WC	$323.17

PLATE LCP 10HOLE 3.5x137MM

Facility

$1,509.00

Hospital Charge Code	270677336
Hospital Revenue Code	278
Min. Negotiated Rate	$226.35
Max. Negotiated Rate	$365.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.18
Rate for Payer: Qualcare PPO/HMO/WC	$226.35

PLATE LCP 10HOLE 3.5x137MM

Facility

$1,509.00

Hospital Charge Code	270677336
Hospital Revenue Code	278
Min. Negotiated Rate	$226.35
Max. Negotiated Rate	$754.50
Rate for Payer: Aetna Commercial	$452.70
Rate for Payer: Aetna Medicare Advantage	$452.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.80
Rate for Payer: Cigna Commercial	$754.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.18
Rate for Payer: Qualcare PPO/HMO/WC	$226.35

PLATE LCP 1/3 TUBULAR 4H 57MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270671206
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$178.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: Qualcare PPO/HMO/WC	$110.76

PLATE LCP 1/3 TUBULAR 4H 57MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270671206
Hospital Revenue Code	278
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$369.20
Rate for Payer: Aetna Commercial	$221.52
Rate for Payer: Aetna Medicare Advantage	$221.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.29
Rate for Payer: Cigna Commercial	$369.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.69
Rate for Payer: Qualcare PPO/HMO/WC	$110.76

Know your out-of-pocket cost for care.

All Charges