Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LOCKING TUBUL 3RD TI 4H

Facility

$1,150.00

Hospital Charge Code	270702504
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

PLATE LOCKING TUBUL 3RD TI 4H

Facility

$1,150.00

Hospital Charge Code	270702504
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

PLATE LOCK LAT HOOK TI 3H

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696717
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$1,119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATE LOCK LAT HOOK TI 3H

Facility

$4,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696717
Hospital Revenue Code	278
Min. Negotiated Rate	$693.75
Max. Negotiated Rate	$2,312.50
Rate for Payer: Aetna Commercial	$1,387.50
Rate for Payer: Aetna Medicare Advantage	$1,387.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.38
Rate for Payer: Cigna Commercial	$2,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.25
Rate for Payer: Qualcare PPO/HMO/WC	$693.75

PLATELONG FOOT MAX 180 MM ALUM

Facility

$8,157.00

Hospital Charge Code	270681230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,223.55
Max. Negotiated Rate	$1,223.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.55

PLATELONG FOOT MAX 180 MM ALUM

Facility

$8,157.00

Hospital Charge Code	270681230
Hospital Revenue Code	272
Min. Negotiated Rate	$1,060.41
Max. Negotiated Rate	$4,078.50
Rate for Payer: Aetna Commercial	$2,447.10
Rate for Payer: Aetna Medicare Advantage	$2,447.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,080.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,080.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,080.03
Rate for Payer: Cigna Commercial	$4,078.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,060.41
Rate for Payer: Oxford Commercial	$4,078.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,223.55
Rate for Payer: UnitedHealthcare Commercial	$4,078.50

PLATELONG MAXFRAME 150MM

Facility

$6,933.00

Hospital Charge Code	270681231
Hospital Revenue Code	272
Min. Negotiated Rate	$901.29
Max. Negotiated Rate	$3,466.50
Rate for Payer: Aetna Commercial	$2,079.90
Rate for Payer: Aetna Medicare Advantage	$2,079.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,767.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,767.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,767.91
Rate for Payer: Cigna Commercial	$3,466.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.29
Rate for Payer: Oxford Commercial	$3,466.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.95
Rate for Payer: UnitedHealthcare Commercial	$3,466.50

PLATELONG MAXFRAME 150MM

Facility

$6,933.00

Hospital Charge Code	270681231
Hospital Revenue Code	272
Min. Negotiated Rate	$1,039.95
Max. Negotiated Rate	$1,039.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.95

PLATE LONG ROI-C FOR H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$2,823.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE LONG ROI-C FOR H8

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270678667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$5,833.32
Rate for Payer: Aetna Commercial	$3,499.99
Rate for Payer: Aetna Medicare Advantage	$3,499.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,333.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,975.00
Rate for Payer: Cigna Commercial	$5,833.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,823.33
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.00

PLATE LORDOTIC 10X28X11MM ST

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$7,260.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDOTIC 10X28X11MM ST

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDOTIC 10X29X9MM COAL

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692450
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDOTIC 10X29X9MM COAL

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270692450
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$7,260.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

PLATE LORDTIC 28 MM

Facility

$6,590.00

Service Code	HCPCS C1889
Hospital Charge Code	270690569
Hospital Revenue Code	278
Min. Negotiated Rate	$988.50
Max. Negotiated Rate	$1,594.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,318.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,594.78
Rate for Payer: Qualcare PPO/HMO/WC	$988.50

PLATE LORDTIC 28 MM

Facility

$6,590.00

Service Code	HCPCS C1889
Hospital Charge Code	270690569
Hospital Revenue Code	278
Min. Negotiated Rate	$988.50
Max. Negotiated Rate	$3,295.00
Rate for Payer: Aetna Commercial	$1,977.00
Rate for Payer: Aetna Medicare Advantage	$1,977.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,680.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,680.45
Rate for Payer: Cigna Commercial	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,594.78
Rate for Payer: Qualcare PPO/HMO/WC	$988.50

PLATE LORDTIC 30MM

Facility

$6,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270690567
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

PLATE LORDTIC 30MM

Facility

$6,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270690567
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$1,980.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

PLATE LOW PRO 2 HOLE 15MM

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270704118
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PLATE LOW PRO 2 HOLE 15MM

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270704118
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PLATE LOW PROFILE COTTON 6MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270674305
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE LOW PROFILE COTTON 6MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270674305
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE LOW PROFILE LAPIDUS 4 HO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685384
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE LOW PROFILE LAPIDUS 4 HO

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685384
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE LP-PRO MTPCONT STD.TI

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690794
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

Know your out-of-pocket cost for care.

All Charges