Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP CLAV 3.5x69MM 3H LT/

Facility

$4,000.65

Service Code	HCPCS C1713
Hospital Charge Code	270681461
Hospital Revenue Code	278
Min. Negotiated Rate	$600.10
Max. Negotiated Rate	$968.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.16
Rate for Payer: Qualcare PPO/HMO/WC	$600.10

PLATE LCP CLAV 3.5x69MM 3H LT/

Facility

$4,000.65

Service Code	HCPCS C1713
Hospital Charge Code	270681461
Hospital Revenue Code	278
Min. Negotiated Rate	$600.10
Max. Negotiated Rate	$2,000.33
Rate for Payer: Aetna Commercial	$1,200.19
Rate for Payer: Aetna Medicare Advantage	$1,200.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.17
Rate for Payer: Cigna Commercial	$2,000.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.16
Rate for Payer: Qualcare PPO/HMO/WC	$600.10

PLATE LCP CLAV 3.5x79MM 6H

Facility

$4,044.80

Service Code	HCPCS C1713
Hospital Charge Code	270676302
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 3.5x79MM 6H

Facility

$4,044.80

Service Code	HCPCS C1713
Hospital Charge Code	270676302
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 3.5x85MM 6H RT

Facility

$3,840.85

Hospital Charge Code	270677754
Hospital Revenue Code	278
Min. Negotiated Rate	$576.13
Max. Negotiated Rate	$929.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$929.49
Rate for Payer: Qualcare PPO/HMO/WC	$576.13

PLATE LCP CLAV 3.5x85MM 6H RT

Facility

$3,840.85

Hospital Charge Code	270677754
Hospital Revenue Code	278
Min. Negotiated Rate	$576.13
Max. Negotiated Rate	$1,920.42
Rate for Payer: Aetna Commercial	$1,152.26
Rate for Payer: Aetna Medicare Advantage	$1,152.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$979.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$979.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$979.42
Rate for Payer: Cigna Commercial	$1,920.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$929.49
Rate for Payer: Qualcare PPO/HMO/WC	$576.13

PLATE LCP CLAV 3.5x85MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270671684
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 3.5x85MM 6H RT

Facility

$4,047.90

Service Code	HCPCS C1713
Hospital Charge Code	270671684
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 3.5x94MM 5H RT

Facility

$3,797.60

Service Code	HCPCS C1713
Hospital Charge Code	270672277
Hospital Revenue Code	278
Min. Negotiated Rate	$569.64
Max. Negotiated Rate	$1,898.80
Rate for Payer: Aetna Commercial	$1,139.28
Rate for Payer: Aetna Medicare Advantage	$1,139.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$968.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$968.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$759.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$968.39
Rate for Payer: Cigna Commercial	$1,898.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.02
Rate for Payer: Qualcare PPO/HMO/WC	$569.64

PLATE LCP CLAV 3.5x94MM 5H RT

Facility

$3,797.60

Service Code	HCPCS C1713
Hospital Charge Code	270672277
Hospital Revenue Code	278
Min. Negotiated Rate	$569.64
Max. Negotiated Rate	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$759.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.02
Rate for Payer: Qualcare PPO/HMO/WC	$569.64

PLATE LCP CONDYLAR 7H 2.4x59MM

Facility

$2,499.80

Service Code	HCPCS C1713
Hospital Charge Code	270667136
Hospital Revenue Code	278
Min. Negotiated Rate	$374.97
Max. Negotiated Rate	$1,249.90
Rate for Payer: Aetna Commercial	$749.94
Rate for Payer: Aetna Medicare Advantage	$749.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.45
Rate for Payer: Cigna Commercial	$1,249.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.95
Rate for Payer: Qualcare PPO/HMO/WC	$374.97

PLATE LCP CONDYLAR 7H 2.4x59MM

Facility

$2,499.80

Service Code	HCPCS C1713
Hospital Charge Code	270667136
Hospital Revenue Code	278
Min. Negotiated Rate	$374.97
Max. Negotiated Rate	$604.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.95
Rate for Payer: Qualcare PPO/HMO/WC	$374.97

PLATE LCP DIA-2.4/3.5 5HOLE LF

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270679665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.40
Max. Negotiated Rate	$3,411.35
Rate for Payer: Aetna Commercial	$2,046.81
Rate for Payer: Aetna Medicare Advantage	$2,046.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.79
Rate for Payer: Cigna Commercial	$3,411.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40

PLATE LCP DIA-2.4/3.5 5HOLE LF

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270679665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.40
Max. Negotiated Rate	$1,651.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40

PLATE LCP DIA-META 5HOLE RT

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270671709
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.40
Max. Negotiated Rate	$1,651.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40

PLATE LCP DIA-META 5HOLE RT

Facility

$6,822.70

Service Code	HCPCS C1713
Hospital Charge Code	270671709
Hospital Revenue Code	278
Min. Negotiated Rate	$1,023.40
Max. Negotiated Rate	$3,411.35
Rate for Payer: Aetna Commercial	$2,046.81
Rate for Payer: Aetna Medicare Advantage	$2,046.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,739.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,364.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,739.79
Rate for Payer: Cigna Commercial	$3,411.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,651.09
Rate for Payer: Qualcare PPO/HMO/WC	$1,023.40

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Hospital Charge Code	270677875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$1,689.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270671711
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$3,491.70
Rate for Payer: Aetna Commercial	$2,095.02
Rate for Payer: Aetna Medicare Advantage	$2,095.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.77
Rate for Payer: Cigna Commercial	$3,491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Hospital Charge Code	270677875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$3,491.70
Rate for Payer: Aetna Commercial	$2,095.02
Rate for Payer: Aetna Medicare Advantage	$2,095.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.77
Rate for Payer: Cigna Commercial	$3,491.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

PLATE LCP DIA-META 7HOLE RT

Facility

$6,983.40

Service Code	HCPCS C1713
Hospital Charge Code	270671711
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.51
Max. Negotiated Rate	$1,689.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.51

PLATE LCP DISTAL 2.0MM 7HOLE

Facility

$3,497.90

Service Code	HCPCS C1713
Hospital Charge Code	270666014
Hospital Revenue Code	278
Min. Negotiated Rate	$524.68
Max. Negotiated Rate	$1,748.95
Rate for Payer: Aetna Commercial	$1,049.37
Rate for Payer: Aetna Medicare Advantage	$1,049.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$891.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$891.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$699.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$891.96
Rate for Payer: Cigna Commercial	$1,748.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$846.49
Rate for Payer: Qualcare PPO/HMO/WC	$524.68

PLATE LCP DISTAL 2.0MM 7HOLE

Facility

$3,497.90

Service Code	HCPCS C1713
Hospital Charge Code	270666014
Hospital Revenue Code	278
Min. Negotiated Rate	$524.68
Max. Negotiated Rate	$846.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$699.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$846.49
Rate for Payer: Qualcare PPO/HMO/WC	$524.68

PLATE LCP DIST RADL LT 242.492

Facility

$3,605.00

Hospital Charge Code	270637233
Hospital Revenue Code	278
Min. Negotiated Rate	$540.75
Max. Negotiated Rate	$1,802.50
Rate for Payer: Aetna Commercial	$1,081.50
Rate for Payer: Aetna Medicare Advantage	$1,081.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.27
Rate for Payer: Cigna Commercial	$1,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: Qualcare PPO/HMO/WC	$540.75

PLATE LCP DIST RADL LT 242.492

Facility

$3,605.00

Hospital Charge Code	270637233
Hospital Revenue Code	278
Min. Negotiated Rate	$540.75
Max. Negotiated Rate	$872.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: Qualcare PPO/HMO/WC	$540.75

PLATE LCP-HK 3.5mm 3/H STER

Facility

$155.15

Service Code	HCPCS C1713
Hospital Charge Code	270682564
Hospital Revenue Code	278
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$77.58
Rate for Payer: Aetna Commercial	$46.55
Rate for Payer: Aetna Medicare Advantage	$46.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.56
Rate for Payer: Cigna Commercial	$77.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

Know your out-of-pocket cost for care.

All Charges