Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$650.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25

PLATE LCP POST 2.7/3.5MM 3H RT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676809
Hospital Revenue Code	278
Min. Negotiated Rate	$403.25
Max. Negotiated Rate	$650.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$537.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.57
Rate for Payer: Qualcare PPO/HMO/WC	$403.25

PLATE LCP POST 2.7/3.5MM 3H RT

Facility

$2,688.30

Service Code	HCPCS C1713
Hospital Charge Code	270676809
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

PLATE LCP POST 2.7/3.5MM 4H LT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676812
Hospital Revenue Code	278
Min. Negotiated Rate	$409.73
Max. Negotiated Rate	$1,365.78
Rate for Payer: Aetna Commercial	$819.47
Rate for Payer: Aetna Medicare Advantage	$819.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.55
Rate for Payer: Cigna Commercial	$1,365.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73

PLATE LCP POST 2.7/3.5MM 4H LT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676812
Hospital Revenue Code	278
Min. Negotiated Rate	$409.73
Max. Negotiated Rate	$661.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73

PLATE LCP POST 2.7/3.5MM 4H RT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676811
Hospital Revenue Code	278
Min. Negotiated Rate	$409.73
Max. Negotiated Rate	$1,365.78
Rate for Payer: Aetna Commercial	$819.47
Rate for Payer: Aetna Medicare Advantage	$819.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.55
Rate for Payer: Cigna Commercial	$1,365.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73

PLATE LCP POST 2.7/3.5MM 4H RT

Facility

$2,731.55

Service Code	HCPCS C1713
Hospital Charge Code	270676811
Hospital Revenue Code	278
Min. Negotiated Rate	$409.73
Max. Negotiated Rate	$661.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$661.04
Rate for Payer: Qualcare PPO/HMO/WC	$409.73

PLATE LCP POST 2.7/3.5MM 5H RT

Facility

$2,768.65

Service Code	HCPCS C1713
Hospital Charge Code	270676813
Hospital Revenue Code	278
Min. Negotiated Rate	$415.30
Max. Negotiated Rate	$670.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$553.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$670.01
Rate for Payer: Qualcare PPO/HMO/WC	$415.30

PLATE LCP POST 2.7/3.5MM 5H RT

Facility

$2,768.65

Service Code	HCPCS C1713
Hospital Charge Code	270676813
Hospital Revenue Code	278
Min. Negotiated Rate	$415.30
Max. Negotiated Rate	$1,384.33
Rate for Payer: Aetna Commercial	$830.60
Rate for Payer: Aetna Medicare Advantage	$830.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$706.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$706.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$553.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$706.01
Rate for Payer: Cigna Commercial	$1,384.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$670.01
Rate for Payer: Qualcare PPO/HMO/WC	$415.30

PLATE LCP POST 2.7/3.5MM 6H LT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270671205
Hospital Revenue Code	278
Min. Negotiated Rate	$421.79
Max. Negotiated Rate	$680.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79

PLATE LCP POST 2.7/3.5MM 6H LT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270671205
Hospital Revenue Code	278
Min. Negotiated Rate	$421.79
Max. Negotiated Rate	$1,405.95
Rate for Payer: Aetna Commercial	$843.57
Rate for Payer: Aetna Medicare Advantage	$843.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.03
Rate for Payer: Cigna Commercial	$1,405.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79

PLATE LCP POST 2.7/3.5MM 6H RT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270676815
Hospital Revenue Code	278
Min. Negotiated Rate	$421.79
Max. Negotiated Rate	$680.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79

PLATE LCP POST 2.7/3.5MM 6H RT

Facility

$2,811.90

Service Code	HCPCS C1713
Hospital Charge Code	270676815
Hospital Revenue Code	278
Min. Negotiated Rate	$421.79
Max. Negotiated Rate	$1,405.95
Rate for Payer: Aetna Commercial	$843.57
Rate for Payer: Aetna Medicare Advantage	$843.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$562.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$717.03
Rate for Payer: Cigna Commercial	$1,405.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$680.48
Rate for Payer: Qualcare PPO/HMO/WC	$421.79

PLATE LCP POST 2.7/3.5MM 7H LT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676817
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 POST 2.7/3.5MM 7H LT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676817
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 POST 2.7/3.5MM 7H RT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676816
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 POST 2.7/3.5MM 7H RT

Facility

$2,849.00

Service Code	HCPCS C1713
Hospital Charge Code	270676816
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 PROX 8HOLE 4.5MM

Facility

$6,665.15

Service Code	HCPCS C1713
Hospital Charge Code	270676321
Hospital Revenue Code	278
Min. Negotiated Rate	$999.77
Max. Negotiated Rate	$3,332.57
Rate for Payer: Aetna Commercial	$1,999.55
Rate for Payer: Aetna Medicare Advantage	$1,999.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,699.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,699.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,333.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,699.61
Rate for Payer: Cigna Commercial	$3,332.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.97
Rate for Payer: Qualcare PPO/HMO/WC	$999.77

PLATE LCP PROX 8HOLE 4.5MM

Facility

$6,665.15

Service Code	HCPCS C1713
Hospital Charge Code	270676321
Hospital Revenue Code	278
Min. Negotiated Rate	$999.77
Max. Negotiated Rate	$1,612.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,333.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.97
Rate for Payer: Qualcare PPO/HMO/WC	$999.77

PLATE LCP RECON 3.5x140MM 10 H

Facility

$2,407.10

Service Code	HCPCS C1713
Hospital Charge Code	270645929
Hospital Revenue Code	278
Min. Negotiated Rate	$361.06
Max. Negotiated Rate	$582.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$481.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.52
Rate for Payer: Qualcare PPO/HMO/WC	$361.06

PLATE LCP RECON 3.5x140MM 10 H

Facility

$2,407.10

Service Code	HCPCS C1713
Hospital Charge Code	270645929
Hospital Revenue Code	278
Min. Negotiated Rate	$361.06
Max. Negotiated Rate	$1,203.55
Rate for Payer: Aetna Commercial	$722.13
Rate for Payer: Aetna Medicare Advantage	$722.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$613.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$613.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$481.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$613.81
Rate for Payer: Cigna Commercial	$1,203.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$582.52
Rate for Payer: Qualcare PPO/HMO/WC	$361.06

PLATE LCP RECON 3.5x84MM 6H

Facility

$2,119.75

Service Code	HCPCS C1713
Hospital Charge Code	270641802
Hospital Revenue Code	278
Min. Negotiated Rate	$317.96
Max. Negotiated Rate	$1,059.88
Rate for Payer: Aetna Commercial	$635.92
Rate for Payer: Aetna Medicare Advantage	$635.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$540.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$540.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$540.54
Rate for Payer: Cigna Commercial	$1,059.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.98
Rate for Payer: Qualcare PPO/HMO/WC	$317.96

PLATE LCP RECON 3.5x84MM 6H

Facility

$2,119.75

Service Code	HCPCS C1713
Hospital Charge Code	270641802
Hospital Revenue Code	278
Min. Negotiated Rate	$317.96
Max. Negotiated Rate	$512.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$423.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$512.98
Rate for Payer: Qualcare PPO/HMO/WC	$317.96

PLATE LCP RECON 3.5x98MM 7HOLE

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270641801
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$1,112.40
Rate for Payer: Aetna Commercial	$667.44
Rate for Payer: Aetna Medicare Advantage	$667.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.32
Rate for Payer: Cigna Commercial	$1,112.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

PLATE LCP RECON 3.5x98MM 7HOLE

Facility

$2,224.80

Service Code	HCPCS C1713
Hospital Charge Code	270641801
Hospital Revenue Code	278
Min. Negotiated Rate	$333.72
Max. Negotiated Rate	$538.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$444.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.40
Rate for Payer: Qualcare PPO/HMO/WC	$333.72

Know your out-of-pocket cost for care.

All Charges