Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$2,135.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,764.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,135.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,323.66

PLATE LCP 2.7/3.5MM FIB 5H LFT

Facility

$2,688.00

Hospital Charge Code	270676814
Hospital Revenue Code	278
Min. Negotiated Rate	$403.20
Max. Negotiated Rate	$650.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.50
Rate for Payer: Qualcare PPO/HMO/WC	$403.20

PLATE LCP 2.7/3.5MM FIB 5H LFT

Facility

$2,688.00

Hospital Charge Code	270676814
Hospital Revenue Code	278
Min. Negotiated Rate	$403.20
Max. Negotiated Rate	$1,344.00
Rate for Payer: Aetna Commercial	$806.40
Rate for Payer: Aetna Medicare Advantage	$806.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.44
Rate for Payer: Cigna Commercial	$1,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.50
Rate for Payer: Qualcare PPO/HMO/WC	$403.20

PLATE LCP 2.7x94MM 10HOLE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270675842
Hospital Revenue Code	278
Min. Negotiated Rate	$263.73
Max. Negotiated Rate	$879.10
Rate for Payer: Aetna Commercial	$527.46
Rate for Payer: Aetna Medicare Advantage	$527.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.34
Rate for Payer: Cigna Commercial	$879.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: Qualcare PPO/HMO/WC	$263.73

PLATE LCP 2.7x94MM 10HOLE

Facility

$1,758.20

Service Code	HCPCS C1713
Hospital Charge Code	270675842
Hospital Revenue Code	278
Min. Negotiated Rate	$263.73
Max. Negotiated Rate	$425.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.48
Rate for Payer: Qualcare PPO/HMO/WC	$263.73

PLATE LCP 2MM 8 HOLE

Facility

$1,011.00

Hospital Charge Code	270673372
Hospital Revenue Code	278
Min. Negotiated Rate	$151.65
Max. Negotiated Rate	$505.50
Rate for Payer: Aetna Commercial	$303.30
Rate for Payer: Aetna Medicare Advantage	$303.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.81
Rate for Payer: Cigna Commercial	$505.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.66
Rate for Payer: Qualcare PPO/HMO/WC	$151.65

PLATE LCP 2MM 8 HOLE

Facility

$1,011.00

Hospital Charge Code	270673372
Hospital Revenue Code	278
Min. Negotiated Rate	$151.65
Max. Negotiated Rate	$244.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$244.66
Rate for Payer: Qualcare PPO/HMO/WC	$151.65

PLATE LCP 3.5 5 HOLE

Facility

$7,154.70

Service Code	HCPCS C1713
Hospital Charge Code	270684399
Hospital Revenue Code	278
Min. Negotiated Rate	$1,073.20
Max. Negotiated Rate	$3,577.35
Rate for Payer: Aetna Commercial	$2,146.41
Rate for Payer: Aetna Medicare Advantage	$2,146.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.45
Rate for Payer: Cigna Commercial	$3,577.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.20

PLATE LCP 3.5 5 HOLE

Facility

$7,154.70

Service Code	HCPCS C1713
Hospital Charge Code	270684399
Hospital Revenue Code	278
Min. Negotiated Rate	$1,073.20
Max. Negotiated Rate	$1,731.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,430.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,731.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.20

PLATE LCP 3.5MM 12H 163MM

Facility

$1,771.80

Service Code	HCPCS C1713
Hospital Charge Code	270671054
Hospital Revenue Code	278
Min. Negotiated Rate	$265.77
Max. Negotiated Rate	$885.90
Rate for Payer: Aetna Commercial	$531.54
Rate for Payer: Aetna Medicare Advantage	$531.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.81
Rate for Payer: Cigna Commercial	$885.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.78
Rate for Payer: Qualcare PPO/HMO/WC	$265.77

PLATE LCP 3.5MM 12H 163MM

Facility

$1,771.80

Service Code	HCPCS C1713
Hospital Charge Code	270671054
Hospital Revenue Code	278
Min. Negotiated Rate	$265.77
Max. Negotiated Rate	$428.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$354.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.78
Rate for Payer: Qualcare PPO/HMO/WC	$265.77

PLATE LCP 3.5MM 4H RT 122MM

Facility

$5,398.25

Service Code	HCPCS C1713
Hospital Charge Code	270679158
Hospital Revenue Code	278
Min. Negotiated Rate	$809.74
Max. Negotiated Rate	$1,306.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.38
Rate for Payer: Qualcare PPO/HMO/WC	$809.74

PLATE LCP 3.5MM 4H RT 122MM

Facility

$5,398.25

Service Code	HCPCS C1713
Hospital Charge Code	270679158
Hospital Revenue Code	278
Min. Negotiated Rate	$809.74
Max. Negotiated Rate	$2,699.12
Rate for Payer: Aetna Commercial	$1,619.47
Rate for Payer: Aetna Medicare Advantage	$1,619.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,376.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,376.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,376.55
Rate for Payer: Cigna Commercial	$2,699.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.38
Rate for Payer: Qualcare PPO/HMO/WC	$809.74

PLATE LCP3.5MMPROXHUM3H109MMLT

Facility

$10,266.60

Service Code	HCPCS C1713
Hospital Charge Code	270698773
Hospital Revenue Code	278
Min. Negotiated Rate	$1,539.99
Max. Negotiated Rate	$2,484.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.99

PLATE LCP3.5MMPROXHUM3H109MMLT

Facility

$10,266.60

Service Code	HCPCS C1713
Hospital Charge Code	270698773
Hospital Revenue Code	278
Min. Negotiated Rate	$1,539.99
Max. Negotiated Rate	$5,133.30
Rate for Payer: Aetna Commercial	$3,079.98
Rate for Payer: Aetna Medicare Advantage	$3,079.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,617.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,617.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,053.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,617.98
Rate for Payer: Cigna Commercial	$5,133.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,484.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,539.99

PLATE LCP 3.5x111MM 8HOLE

Facility

$1,492.70

Service Code	HCPCS C1713
Hospital Charge Code	270636273
Hospital Revenue Code	278
Min. Negotiated Rate	$223.91
Max. Negotiated Rate	$361.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.23
Rate for Payer: Qualcare PPO/HMO/WC	$223.91

PLATE LCP 3.5x111MM 8HOLE

Facility

$1,492.70

Service Code	HCPCS C1713
Hospital Charge Code	270636273
Hospital Revenue Code	278
Min. Negotiated Rate	$223.91
Max. Negotiated Rate	$746.35
Rate for Payer: Aetna Commercial	$447.81
Rate for Payer: Aetna Medicare Advantage	$447.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.64
Rate for Payer: Cigna Commercial	$746.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.23
Rate for Payer: Qualcare PPO/HMO/WC	$223.91

PLATE LCP 3.5x124mm 9 HOLE

Facility

$1,464.00

Hospital Charge Code	270657239
Hospital Revenue Code	278
Min. Negotiated Rate	$219.60
Max. Negotiated Rate	$354.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.29
Rate for Payer: Qualcare PPO/HMO/WC	$219.60

PLATE LCP 3.5x124mm 9 HOLE

Facility

$1,464.00

Hospital Charge Code	270657239
Hospital Revenue Code	278
Min. Negotiated Rate	$219.60
Max. Negotiated Rate	$732.00
Rate for Payer: Aetna Commercial	$439.20
Rate for Payer: Aetna Medicare Advantage	$439.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.32
Rate for Payer: Cigna Commercial	$732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.29
Rate for Payer: Qualcare PPO/HMO/WC	$219.60

PLATE LCP 3.5x190mm 14 HOLE

Facility

$5,325.00

Hospital Charge Code	270668238
Hospital Revenue Code	278
Min. Negotiated Rate	$798.75
Max. Negotiated Rate	$2,662.50
Rate for Payer: Aetna Commercial	$1,597.50
Rate for Payer: Aetna Medicare Advantage	$1,597.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,357.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,357.88
Rate for Payer: Cigna Commercial	$2,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: Qualcare PPO/HMO/WC	$798.75

PLATE LCP 3.5x190mm 14 HOLE

Facility

$5,325.00

Hospital Charge Code	270668238
Hospital Revenue Code	278
Min. Negotiated Rate	$798.75
Max. Negotiated Rate	$1,288.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,288.65
Rate for Payer: Qualcare PPO/HMO/WC	$798.75

PLATE LCP 3.5x72MM 8HOLE

Facility

$1,245.25

Service Code	HCPCS C1713
Hospital Charge Code	270636274
Hospital Revenue Code	278
Min. Negotiated Rate	$186.79
Max. Negotiated Rate	$301.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.35
Rate for Payer: Qualcare PPO/HMO/WC	$186.79

PLATE LCP 3.5x72MM 8HOLE

Facility

$1,245.25

Service Code	HCPCS C1713
Hospital Charge Code	270636274
Hospital Revenue Code	278
Min. Negotiated Rate	$186.79
Max. Negotiated Rate	$622.62
Rate for Payer: Aetna Commercial	$373.57
Rate for Payer: Aetna Medicare Advantage	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.54
Rate for Payer: Cigna Commercial	$622.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.35
Rate for Payer: Qualcare PPO/HMO/WC	$186.79

PLATE LCP 3.5x85MM 6HOLE

Facility

$1,365.35

Service Code	HCPCS C1713
Hospital Charge Code	270651089
Hospital Revenue Code	278
Min. Negotiated Rate	$204.80
Max. Negotiated Rate	$330.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.41
Rate for Payer: Qualcare PPO/HMO/WC	$204.80

PLATE LCP 3.5x85MM 6HOLE

Facility

$1,365.35

Service Code	HCPCS C1713
Hospital Charge Code	270651089
Hospital Revenue Code	278
Min. Negotiated Rate	$204.80
Max. Negotiated Rate	$682.67
Rate for Payer: Aetna Commercial	$409.61
Rate for Payer: Aetna Medicare Advantage	$409.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.16
Rate for Payer: Cigna Commercial	$682.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.41
Rate for Payer: Qualcare PPO/HMO/WC	$204.80

Know your out-of-pocket cost for care.

All Charges