Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP LAT 2.7/3.5 5H RT

Facility

$2,759.40

Service Code	HCPCS C1713
Hospital Charge Code	270642551
Hospital Revenue Code	278
Min. Negotiated Rate	$413.91
Max. Negotiated Rate	$667.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.77
Rate for Payer: Qualcare PPO/HMO/WC	$413.91

PLATE LCP LAT 2.7/3.5 5H RT

Facility

$2,759.40

Service Code	HCPCS C1713
Hospital Charge Code	270642551
Hospital Revenue Code	278
Min. Negotiated Rate	$413.91
Max. Negotiated Rate	$1,379.70
Rate for Payer: Aetna Commercial	$827.82
Rate for Payer: Aetna Medicare Advantage	$827.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$703.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$703.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$703.65
Rate for Payer: Cigna Commercial	$1,379.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.77
Rate for Payer: Qualcare PPO/HMO/WC	$413.91

PLATE LCP LAT 2.7/3.5 6H LFT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270642839
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$1,400.40
Rate for Payer: Aetna Commercial	$840.24
Rate for Payer: Aetna Medicare Advantage	$840.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.20
Rate for Payer: Cigna Commercial	$1,400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H LFT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270642839
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$677.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H LT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270646023
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$708.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H LT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270646023
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$1,463.12
Rate for Payer: Aetna Commercial	$877.88
Rate for Payer: Aetna Medicare Advantage	$877.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.19
Rate for Payer: Cigna Commercial	$1,463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H RT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270645183
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$677.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H RT

Facility

$2,800.80

Service Code	HCPCS C1713
Hospital Charge Code	270645183
Hospital Revenue Code	278
Min. Negotiated Rate	$420.12
Max. Negotiated Rate	$1,400.40
Rate for Payer: Aetna Commercial	$840.24
Rate for Payer: Aetna Medicare Advantage	$840.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.20
Rate for Payer: Cigna Commercial	$1,400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.79
Rate for Payer: Qualcare PPO/HMO/WC	$420.12

PLATE LCP LAT 2.7/3.5 6H RT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270675622
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$708.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 6H RT ST

Facility

$2,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270675622
Hospital Revenue Code	278
Min. Negotiated Rate	$438.94
Max. Negotiated Rate	$1,463.12
Rate for Payer: Aetna Commercial	$877.88
Rate for Payer: Aetna Medicare Advantage	$877.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.19
Rate for Payer: Cigna Commercial	$1,463.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.15
Rate for Payer: Qualcare PPO/HMO/WC	$438.94

PLATE LCP LAT 2.7/3.5 7H LT ST

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644879
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$1,378.15
Rate for Payer: Aetna Commercial	$826.89
Rate for Payer: Aetna Medicare Advantage	$826.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.86
Rate for Payer: Cigna Commercial	$1,378.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 7H LT ST

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644879
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$667.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 7H RT

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644814
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$1,378.15
Rate for Payer: Aetna Commercial	$826.89
Rate for Payer: Aetna Medicare Advantage	$826.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$702.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$702.86
Rate for Payer: Cigna Commercial	$1,378.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 7H RT

Facility

$2,756.30

Service Code	HCPCS C1713
Hospital Charge Code	270644814
Hospital Revenue Code	278
Min. Negotiated Rate	$413.44
Max. Negotiated Rate	$667.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$551.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$667.02
Rate for Payer: Qualcare PPO/HMO/WC	$413.44

PLATE LCP LAT 2.7/3.5 9H RT ST

Facility

$3,099.25

Service Code	HCPCS C1713
Hospital Charge Code	270645138
Hospital Revenue Code	278
Min. Negotiated Rate	$464.89
Max. Negotiated Rate	$1,549.62
Rate for Payer: Aetna Commercial	$929.77
Rate for Payer: Aetna Medicare Advantage	$929.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$619.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.31
Rate for Payer: Cigna Commercial	$1,549.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.02
Rate for Payer: Qualcare PPO/HMO/WC	$464.89

PLATE LCP LAT 2.7/3.5 9H RT ST

Facility

$3,099.25

Service Code	HCPCS C1713
Hospital Charge Code	270645138
Hospital Revenue Code	278
Min. Negotiated Rate	$464.89
Max. Negotiated Rate	$750.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$619.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.02
Rate for Payer: Qualcare PPO/HMO/WC	$464.89

PLATE LCP NARROW 10H 4.5x188MM

Facility

$2,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270637792
Hospital Revenue Code	278
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$560.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.84
Rate for Payer: Qualcare PPO/HMO/WC	$347.62

PLATE LCP NARROW 10H 4.5x188MM

Facility

$2,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270637792
Hospital Revenue Code	278
Min. Negotiated Rate	$347.62
Max. Negotiated Rate	$1,158.75
Rate for Payer: Aetna Commercial	$695.25
Rate for Payer: Aetna Medicare Advantage	$695.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.96
Rate for Payer: Cigna Commercial	$1,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$560.84
Rate for Payer: Qualcare PPO/HMO/WC	$347.62

PLATE LCP NARROW 11H 4.5x206MM

Facility

$2,424.00

Hospital Charge Code	270677246
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 NARROW 11H 4.5x206MM

Facility

$2,424.00

Hospital Charge Code	270677246
Hospital Revenue Code	278
Min. Negotiated Rate	$363.60
Max. Negotiated Rate	$1,212.00
Rate for Payer: Aetna Commercial	$727.20
Rate for Payer: Aetna Medicare Advantage	$727.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.12
Rate for Payer: Cigna Commercial	$1,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.61
Rate for Payer: Qualcare PPO/HMO/WC	$363.60

PLATE LCP NARROW 6H 4.5x116MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270646168
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 NARROW 6H 4.5x116MM

Facility

$1,665.50

Service Code	HCPCS C1713
Hospital Charge Code	270646168
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 NARROW 9H 4.5X170MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695092
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

PLATE LCP NARROW 9H 4.5X170MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695092
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

PLATE LCP POST 2.7/3.5MM 3H LT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676810
Hospital Revenue Code	278
Min. Negotiated Rate	$403.25
Max. Negotiated Rate	$1,344.15
Rate for Payer: Aetna Commercial	$806.49
Rate for Payer: Aetna Medicare Advantage	$806.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$685.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$685.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$685.52
Rate for Payer: Cigna Commercial	$1,344.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25

Know your out-of-pocket cost for care.

All Charges