Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP 9HOLE 4.5x170mm BRD

Facility

$2,424.00

Service Code	HCPCS C1713
Hospital Charge Code	270666771
Hospital Revenue Code	278
Min. Negotiated Rate	$363.60
Max. Negotiated Rate	$586.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.61
Rate for Payer: Qualcare PPO/HMO/WC	$363.60

PLATE LCP ANT 6 HOLE 100MM

Facility

$4,532.15

Service Code	HCPCS C1713
Hospital Charge Code	270684726
Hospital Revenue Code	278
Min. Negotiated Rate	$679.82
Max. Negotiated Rate	$1,096.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.78
Rate for Payer: Qualcare PPO/HMO/WC	$679.82

PLATE LCP ANT 6 HOLE 100MM

Facility

$4,532.15

Service Code	HCPCS C1713
Hospital Charge Code	270684726
Hospital Revenue Code	278
Min. Negotiated Rate	$679.82
Max. Negotiated Rate	$2,266.07
Rate for Payer: Aetna Commercial	$1,359.64
Rate for Payer: Aetna Medicare Advantage	$1,359.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$906.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,155.70
Rate for Payer: Cigna Commercial	$2,266.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.78
Rate for Payer: Qualcare PPO/HMO/WC	$679.82

PLATE LCP BRDCRVD 12H4.5x229MM

Facility

$3,241.40

Service Code	HCPCS C1713
Hospital Charge Code	270679265
Hospital Revenue Code	278
Min. Negotiated Rate	$486.21
Max. Negotiated Rate	$784.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$648.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$784.42
Rate for Payer: Qualcare PPO/HMO/WC	$486.21

PLATE LCP BRDCRVD 12H4.5x229MM

Facility

$3,241.40

Service Code	HCPCS C1713
Hospital Charge Code	270679265
Hospital Revenue Code	278
Min. Negotiated Rate	$486.21
Max. Negotiated Rate	$1,620.70
Rate for Payer: Aetna Commercial	$972.42
Rate for Payer: Aetna Medicare Advantage	$972.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$648.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.56
Rate for Payer: Cigna Commercial	$1,620.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$784.42
Rate for Payer: Qualcare PPO/HMO/WC	$486.21

PLATE LCP BROAD 14H 4.5x247MM

Facility

$3,423.70

Service Code	HCPCS C1713
Hospital Charge Code	270678078
Hospital Revenue Code	278
Min. Negotiated Rate	$513.55
Max. Negotiated Rate	$1,711.85
Rate for Payer: Aetna Commercial	$1,027.11
Rate for Payer: Aetna Medicare Advantage	$1,027.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.04
Rate for Payer: Cigna Commercial	$1,711.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.54
Rate for Payer: Qualcare PPO/HMO/WC	$513.55

PLATE LCP BROAD 14H 4.5x247MM

Facility

$3,423.70

Service Code	HCPCS C1713
Hospital Charge Code	270678078
Hospital Revenue Code	278
Min. Negotiated Rate	$513.55
Max. Negotiated Rate	$828.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$684.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.54
Rate for Payer: Qualcare PPO/HMO/WC	$513.55

PLATE LCP BROAD 9H 4.5x152MM

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270685043
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$575.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE LCP BROAD 9H 4.5x152MM

Facility

$2,377.50

Service Code	HCPCS C1713
Hospital Charge Code	270685043
Hospital Revenue Code	278
Min. Negotiated Rate	$356.62
Max. Negotiated Rate	$1,188.75
Rate for Payer: Aetna Commercial	$713.25
Rate for Payer: Aetna Medicare Advantage	$713.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$606.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$606.26
Rate for Payer: Cigna Commercial	$1,188.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$575.36
Rate for Payer: Qualcare PPO/HMO/WC	$356.62

PLATE LCP CLAV 3.5x100MM 6H RT

Facility

$4,299.85

Service Code	HCPCS C1713
Hospital Charge Code	270688178
Hospital Revenue Code	278
Min. Negotiated Rate	$644.98
Max. Negotiated Rate	$1,040.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$859.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.56
Rate for Payer: Qualcare PPO/HMO/WC	$644.98

PLATE LCP CLAV 3.5x100MM 6H RT

Facility

$4,299.85

Service Code	HCPCS C1713
Hospital Charge Code	270688178
Hospital Revenue Code	278
Min. Negotiated Rate	$644.98
Max. Negotiated Rate	$2,149.93
Rate for Payer: Aetna Commercial	$1,289.95
Rate for Payer: Aetna Medicare Advantage	$1,289.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$859.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.46
Rate for Payer: Cigna Commercial	$2,149.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.56
Rate for Payer: Qualcare PPO/HMO/WC	$644.98

PLATE LCP CLAV 3.5x100MM 7H LF

Facility

$3,942.85

Service Code	HCPCS C1713
Hospital Charge Code	270670741
Hospital Revenue Code	278
Min. Negotiated Rate	$591.43
Max. Negotiated Rate	$954.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.17
Rate for Payer: Qualcare PPO/HMO/WC	$591.43

PLATE LCP CLAV 3.5x100MM 7H LF

Facility

$3,942.85

Service Code	HCPCS C1713
Hospital Charge Code	270670741
Hospital Revenue Code	278
Min. Negotiated Rate	$591.43
Max. Negotiated Rate	$1,971.42
Rate for Payer: Aetna Commercial	$1,182.86
Rate for Payer: Aetna Medicare Advantage	$1,182.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,005.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,005.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,005.43
Rate for Payer: Cigna Commercial	$1,971.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.17
Rate for Payer: Qualcare PPO/HMO/WC	$591.43

PLATE LCP CLAV 3.5x100MM 7H LT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270675952
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$1,004.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H LT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270675952
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$2,074.93
Rate for Payer: Aetna Commercial	$1,244.95
Rate for Payer: Aetna Medicare Advantage	$1,244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.21
Rate for Payer: Cigna Commercial	$2,074.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H RT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270676235
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$2,074.93
Rate for Payer: Aetna Commercial	$1,244.95
Rate for Payer: Aetna Medicare Advantage	$1,244.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.21
Rate for Payer: Cigna Commercial	$2,074.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x100MM 7H RT

Facility

$4,149.85

Service Code	HCPCS C1713
Hospital Charge Code	270676235
Hospital Revenue Code	278
Min. Negotiated Rate	$622.48
Max. Negotiated Rate	$1,004.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$829.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,004.26
Rate for Payer: Qualcare PPO/HMO/WC	$622.48

PLATE LCP CLAV 3.5x105MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270677248
Hospital Revenue Code	278
Min. Negotiated Rate	$607.18
Max. Negotiated Rate	$979.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$809.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.59
Rate for Payer: Qualcare PPO/HMO/WC	$607.18

PLATE LCP CLAV 3.5x105MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270677248
Hospital Revenue Code	278
Min. Negotiated Rate	$607.18
Max. Negotiated Rate	$2,023.95
Rate for Payer: Aetna Commercial	$1,214.37
Rate for Payer: Aetna Medicare Advantage	$1,214.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$809.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.21
Rate for Payer: Cigna Commercial	$2,023.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$979.59
Rate for Payer: Qualcare PPO/HMO/WC	$607.18

PLATE LCP CLAV 3.5x115MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270677247
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$2,125.93
Rate for Payer: Aetna Commercial	$1,275.56
Rate for Payer: Aetna Medicare Advantage	$1,275.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.22
Rate for Payer: Cigna Commercial	$2,125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

PLATE LCP CLAV 3.5x115MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270677247
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$1,028.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

PLATE LCP CLAV 3.5x120MM 6H LT

Facility

$4,044.80

Service Code	HCPCS C1713
Hospital Charge Code	270676301
Hospital Revenue Code	278
Min. Negotiated Rate	$606.72
Max. Negotiated Rate	$2,022.40
Rate for Payer: Aetna Commercial	$1,213.44
Rate for Payer: Aetna Medicare Advantage	$1,213.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,031.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,031.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,031.42
Rate for Payer: Cigna Commercial	$2,022.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.84
Rate for Payer: Qualcare PPO/HMO/WC	$606.72

PLATE LCP CLAV 3.5x120MM 6H LT

Facility

$4,044.80

Service Code	HCPCS C1713
Hospital Charge Code	270676301
Hospital Revenue Code	278
Min. Negotiated Rate	$606.72
Max. Negotiated Rate	$978.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$978.84
Rate for Payer: Qualcare PPO/HMO/WC	$606.72

PLATE LCP CLAV 3.5x120MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270665696
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$1,028.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

PLATE LCP CLAV 3.5x120MM 8H RT

Facility

$4,251.85

Service Code	HCPCS C1713
Hospital Charge Code	270665696
Hospital Revenue Code	278
Min. Negotiated Rate	$637.78
Max. Negotiated Rate	$2,125.93
Rate for Payer: Aetna Commercial	$1,275.56
Rate for Payer: Aetna Medicare Advantage	$1,275.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.22
Rate for Payer: Cigna Commercial	$2,125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.95
Rate for Payer: Qualcare PPO/HMO/WC	$637.78

Know your out-of-pocket cost for care.

All Charges