Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

PLATE LCP HOOK 3.5MM 3HOLE ST

Facility

$8,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270667999
Hospital Revenue Code	278
Min. Negotiated Rate	$1,327.50
Max. Negotiated Rate	$2,141.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,141.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,327.50

PLATE LCP HOOK 3.5MM 3HOLE ST

Facility

$8,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270667999
Hospital Revenue Code	278
Min. Negotiated Rate	$1,327.50
Max. Negotiated Rate	$4,425.00
Rate for Payer: Aetna Commercial	$2,655.00
Rate for Payer: Aetna Medicare Advantage	$2,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,256.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,256.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,256.75
Rate for Payer: Cigna Commercial	$4,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,141.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,327.50

PLATE LCP HUM 3.5x196MM 8H ST

Facility

$7,484.00

Hospital Charge Code	270669506
Hospital Revenue Code	278
Min. Negotiated Rate	$1,122.60
Max. Negotiated Rate	$1,811.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,496.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,811.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,122.60

PLATE LCP HUM 3.5x196MM 8H ST

Facility

$7,484.00

Hospital Charge Code	270669506
Hospital Revenue Code	278
Min. Negotiated Rate	$1,122.60
Max. Negotiated Rate	$3,742.00
Rate for Payer: Aetna Commercial	$2,245.20
Rate for Payer: Aetna Medicare Advantage	$2,245.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,908.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,908.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,496.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,908.42
Rate for Payer: Cigna Commercial	$3,742.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,811.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,122.60

PLATE LCP HUM 3.5x232MM 10H ST

Facility

$7,750.90

Service Code	HCPCS C1713
Hospital Charge Code	270660600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.63
Max. Negotiated Rate	$1,875.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.63

PLATE LCP HUM 3.5x232MM 10H ST

Facility

$7,750.90

Service Code	HCPCS C1713
Hospital Charge Code	270660600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.63
Max. Negotiated Rate	$3,875.45
Rate for Payer: Aetna Commercial	$2,325.27
Rate for Payer: Aetna Medicare Advantage	$2,325.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.48
Rate for Payer: Cigna Commercial	$3,875.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.63

PLATE LCP HUMERUS 12H 3.5x268

Facility

$8,255.90

Service Code	HCPCS C1713
Hospital Charge Code	270683625
Hospital Revenue Code	278
Min. Negotiated Rate	$1,238.38
Max. Negotiated Rate	$4,127.95
Rate for Payer: Aetna Commercial	$2,476.77
Rate for Payer: Aetna Medicare Advantage	$2,476.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,651.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,105.25
Rate for Payer: Cigna Commercial	$4,127.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,997.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.38

PLATE LCP HUMERUS 12H 3.5x268

Facility

$8,255.90

Service Code	HCPCS C1713
Hospital Charge Code	270683625
Hospital Revenue Code	278
Min. Negotiated Rate	$1,238.38
Max. Negotiated Rate	$1,997.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,651.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,997.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,238.38

PLATE LCP HUMERUS 3.5x160MM 6H

Facility

$7,008.10

Service Code	HCPCS C1713
Hospital Charge Code	270645878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,051.21
Max. Negotiated Rate	$1,695.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,401.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,695.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,051.21

PLATE LCP HUMERUS 3.5x160MM 6H

Facility

$7,008.10

Service Code	HCPCS C1713
Hospital Charge Code	270645878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,051.21
Max. Negotiated Rate	$3,504.05
Rate for Payer: Aetna Commercial	$2,102.43
Rate for Payer: Aetna Medicare Advantage	$2,102.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,787.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,787.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,787.07
Rate for Payer: Cigna Commercial	$3,504.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,695.96
Rate for Payer: Qualcare PPO/HMO/WC	$1,051.21

PLATE LCP HUMERUS 3H 3.5x90MM

Facility

$6,470.45

Service Code	HCPCS C1713
Hospital Charge Code	270634386
Hospital Revenue Code	278
Min. Negotiated Rate	$970.57
Max. Negotiated Rate	$3,235.22
Rate for Payer: Aetna Commercial	$1,941.13
Rate for Payer: Aetna Medicare Advantage	$1,941.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,649.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,649.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,649.96
Rate for Payer: Cigna Commercial	$3,235.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.85
Rate for Payer: Qualcare PPO/HMO/WC	$970.57

PLATE LCP HUMERUS 3H 3.5x90MM

Facility

$6,470.45

Service Code	HCPCS C1713
Hospital Charge Code	270634386
Hospital Revenue Code	278
Min. Negotiated Rate	$970.57
Max. Negotiated Rate	$1,565.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.85
Rate for Payer: Qualcare PPO/HMO/WC	$970.57

PLATE LCP HUMERUS 5H 3.5x114MM

Facility

$6,874.65

Service Code	HCPCS C1713
Hospital Charge Code	270633522
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.20
Max. Negotiated Rate	$1,663.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,374.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.20

PLATE LCP HUMERUS 5H 3.5x114MM

Facility

$6,874.65

Service Code	HCPCS C1713
Hospital Charge Code	270633522
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.20
Max. Negotiated Rate	$3,437.32
Rate for Payer: Aetna Commercial	$2,062.39
Rate for Payer: Aetna Medicare Advantage	$2,062.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,374.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.04
Rate for Payer: Cigna Commercial	$3,437.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.20

PLATE LCP LAT 2.7/3.5 3H LFT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270660821
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$1,299.35
Rate for Payer: Aetna Commercial	$779.61
Rate for Payer: Aetna Medicare Advantage	$779.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$662.67
Rate for Payer: Cigna Commercial	$1,299.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 3H LFT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270660821
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$628.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 3H RT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270672038
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$628.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 3H RT

Facility

$2,598.70

Service Code	HCPCS C1713
Hospital Charge Code	270672038
Hospital Revenue Code	278
Min. Negotiated Rate	$389.81
Max. Negotiated Rate	$1,299.35
Rate for Payer: Aetna Commercial	$779.61
Rate for Payer: Aetna Medicare Advantage	$779.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$662.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$662.67
Rate for Payer: Cigna Commercial	$1,299.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.89
Rate for Payer: Qualcare PPO/HMO/WC	$389.81

PLATE LCP LAT 2.7/3.5 4H LT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270653045
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$689.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 4H LT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270653045
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$1,424.50
Rate for Payer: Aetna Commercial	$854.70
Rate for Payer: Aetna Medicare Advantage	$854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.50
Rate for Payer: Cigna Commercial	$1,424.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 4H RT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270646021
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$1,424.50
Rate for Payer: Aetna Commercial	$854.70
Rate for Payer: Aetna Medicare Advantage	$854.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.50
Rate for Payer: Cigna Commercial	$1,424.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 4H RT ST

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270646021
Hospital Revenue Code	278
Min. Negotiated Rate	$427.35
Max. Negotiated Rate	$689.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.46
Rate for Payer: Qualcare PPO/HMO/WC	$427.35

PLATE LCP LAT 2.7/3.5 5H LT ST

Facility

$2,886.05

Service Code	HCPCS C1713
Hospital Charge Code	270642838
Hospital Revenue Code	278
Min. Negotiated Rate	$432.91
Max. Negotiated Rate	$698.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.42
Rate for Payer: Qualcare PPO/HMO/WC	$432.91

PLATE LCP LAT 2.7/3.5 5H LT ST

Facility

$2,886.05

Service Code	HCPCS C1713
Hospital Charge Code	270642838
Hospital Revenue Code	278
Min. Negotiated Rate	$432.91
Max. Negotiated Rate	$1,443.03
Rate for Payer: Aetna Commercial	$865.82
Rate for Payer: Aetna Medicare Advantage	$865.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$735.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$735.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$577.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$735.94
Rate for Payer: Cigna Commercial	$1,443.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$698.42
Rate for Payer: Qualcare PPO/HMO/WC	$432.91

Know your out-of-pocket cost for care.

All Charges