Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP 1/3 TUBULAR 6H 69MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270648519
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

PLATE LCP 1/3 TUBULAR 6H 69MM

Facility

$738.40

Service Code	HCPCS C1713
Hospital Charge Code	270648519
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 7H 81MM

Facility

$754.30

Service Code	HCPCS C1713
Hospital Charge Code	270645152
Hospital Revenue Code	278
Min. Negotiated Rate	$113.14
Max. Negotiated Rate	$182.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.54
Rate for Payer: Qualcare PPO/HMO/WC	$113.14

PLATE LCP 1/3 TUBULAR 7H 81MM

Facility

$754.30

Service Code	HCPCS C1713
Hospital Charge Code	270645152
Hospital Revenue Code	278
Min. Negotiated Rate	$113.14
Max. Negotiated Rate	$377.15
Rate for Payer: Aetna Commercial	$226.29
Rate for Payer: Aetna Medicare Advantage	$226.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.35
Rate for Payer: Cigna Commercial	$377.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.54
Rate for Payer: Qualcare PPO/HMO/WC	$113.14

PLATE LCP 1/3 TUBULAR 8H 93MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270637257
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULAR 8H 93MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270637257
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$238.71
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULR 10H 117MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270653166
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULR 10H 117MM

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270653166
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$238.71
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

PLATE LCP 1/3 TUBULR 12H 141MM

Facility

$797.20

Hospital Charge Code	270656708
Hospital Revenue Code	278
Min. Negotiated Rate	$119.58
Max. Negotiated Rate	$398.60
Rate for Payer: Aetna Commercial	$239.16
Rate for Payer: Aetna Medicare Advantage	$239.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.29
Rate for Payer: Cigna Commercial	$398.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: Qualcare PPO/HMO/WC	$119.58

PLATE LCP 1/3 TUBULR 12H 141MM

Facility

$797.20

Hospital Charge Code	270656708
Hospital Revenue Code	278
Min. Negotiated Rate	$119.58
Max. Negotiated Rate	$192.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.92
Rate for Payer: Qualcare PPO/HMO/WC	$119.58

PLATE LCP 1.5MM 6HOLE W/GUIDES

Facility

$1,112.40

Service Code	HCPCS C1713
Hospital Charge Code	270666006
Hospital Revenue Code	278
Min. Negotiated Rate	$166.86
Max. Negotiated Rate	$269.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.86

PLATE LCP 1.5MM 6HOLE W/GUIDES

Facility

$1,112.40

Service Code	HCPCS C1713
Hospital Charge Code	270666006
Hospital Revenue Code	278
Min. Negotiated Rate	$166.86
Max. Negotiated Rate	$556.20
Rate for Payer: Aetna Commercial	$333.72
Rate for Payer: Aetna Medicare Advantage	$333.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$283.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$283.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$283.66
Rate for Payer: Cigna Commercial	$556.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.20
Rate for Payer: Qualcare PPO/HMO/WC	$166.86

PLATE LCP 2.0 6 HOLE

Facility

$1,515.80

Hospital Charge Code	270671710
Hospital Revenue Code	278
Min. Negotiated Rate	$227.37
Max. Negotiated Rate	$757.90
Rate for Payer: Aetna Commercial	$454.74
Rate for Payer: Aetna Medicare Advantage	$454.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$386.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$386.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$386.53
Rate for Payer: Cigna Commercial	$757.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.82
Rate for Payer: Qualcare PPO/HMO/WC	$227.37

PLATE LCP 2.0 6 HOLE

Facility

$1,515.80

Hospital Charge Code	270671710
Hospital Revenue Code	278
Min. Negotiated Rate	$227.37
Max. Negotiated Rate	$366.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$303.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.82
Rate for Payer: Qualcare PPO/HMO/WC	$227.37

PLATE LCP 2.0x38MM 5HOLE

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270671287
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$520.67
Rate for Payer: Aetna Commercial	$312.40
Rate for Payer: Aetna Medicare Advantage	$312.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.54
Rate for Payer: Cigna Commercial	$520.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.20

PLATE LCP 2.0x38MM 5HOLE

Facility

$1,041.35

Service Code	HCPCS C1713
Hospital Charge Code	270671287
Hospital Revenue Code	278
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$252.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.01
Rate for Payer: Qualcare PPO/HMO/WC	$156.20

PLATE LCP 2.0x45MM 6HOLE

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270667131
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$259.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89

PLATE LCP 2.0x45MM 6HOLE

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270667131
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$536.30
Rate for Payer: Aetna Commercial	$321.78
Rate for Payer: Aetna Medicare Advantage	$321.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.51
Rate for Payer: Cigna Commercial	$536.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89

PLATE LCP 2.0x52MM 7H

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270675499
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$259.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89

PLATE LCP 2.0x52MM 7H

Facility

$1,072.60

Service Code	HCPCS C1713
Hospital Charge Code	270675499
Hospital Revenue Code	278
Min. Negotiated Rate	$160.89
Max. Negotiated Rate	$536.30
Rate for Payer: Aetna Commercial	$321.78
Rate for Payer: Aetna Medicare Advantage	$321.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.51
Rate for Payer: Cigna Commercial	$536.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.57
Rate for Payer: Qualcare PPO/HMO/WC	$160.89

PLATE LCP 2.4MM RAD HD 2H RT

Facility

$2,595.60

Service Code	HCPCS C1713
Hospital Charge Code	270675285
Hospital Revenue Code	278
Min. Negotiated Rate	$389.34
Max. Negotiated Rate	$628.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.14
Rate for Payer: Qualcare PPO/HMO/WC	$389.34

PLATE LCP 2.4MM RAD HD 2H RT

Facility

$2,595.60

Service Code	HCPCS C1713
Hospital Charge Code	270675285
Hospital Revenue Code	278
Min. Negotiated Rate	$389.34
Max. Negotiated Rate	$1,297.80
Rate for Payer: Aetna Commercial	$778.68
Rate for Payer: Aetna Medicare Advantage	$778.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.88
Rate for Payer: Cigna Commercial	$1,297.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.14
Rate for Payer: Qualcare PPO/HMO/WC	$389.34

PLATE LCP 2.4x44MM 5HOLE

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270659768
Hospital Revenue Code	278
Min. Negotiated Rate	$249.82
Max. Negotiated Rate	$832.75
Rate for Payer: Aetna Commercial	$499.65
Rate for Payer: Aetna Medicare Advantage	$499.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$424.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$424.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$424.70
Rate for Payer: Cigna Commercial	$832.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.05
Rate for Payer: Qualcare PPO/HMO/WC	$249.82

PLATE LCP 2.4x44MM 5HOLE

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270659768
Hospital Revenue Code	278
Min. Negotiated Rate	$249.82
Max. Negotiated Rate	$403.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$333.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.05
Rate for Payer: Qualcare PPO/HMO/WC	$249.82

PLATE LCP 2.73/3.5MM

Facility

$8,824.40

Service Code	HCPCS C1713
Hospital Charge Code	270688202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,323.66
Max. Negotiated Rate	$4,412.20
Rate for Payer: Aetna Commercial	$2,647.32
Rate for Payer: Aetna Medicare Advantage	$2,647.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,250.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,250.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,250.22
Rate for Payer: Cigna Commercial	$4,412.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.66

Know your out-of-pocket cost for care.

All Charges