Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 LTL 9-H RT 1312-18-201

Facility

$6,415.00

Hospital Charge Code	270658886
Hospital Revenue Code	278
Min. Negotiated Rate	$962.25
Max. Negotiated Rate	$3,207.50
Rate for Payer: Aetna Commercial	$1,924.50
Rate for Payer: Aetna Medicare Advantage	$1,924.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,635.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,635.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,283.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,635.83
Rate for Payer: Cigna Commercial	$3,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,552.43
Rate for Payer: Qualcare PPO/HMO/WC	$962.25

PLATE LTL 9-H RT 1312-18-201

Facility

$6,415.00

Hospital Charge Code	270658886
Hospital Revenue Code	278
Min. Negotiated Rate	$962.25
Max. Negotiated Rate	$1,552.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,283.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,552.43
Rate for Payer: Qualcare PPO/HMO/WC	$962.25

PLATE LUMBAR 24MM

Facility

$40,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697266
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$20,375.00
Rate for Payer: Aetna Commercial	$12,225.00
Rate for Payer: Aetna Medicare Advantage	$12,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,391.25
Rate for Payer: Cigna Commercial	$20,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

PLATE LUMBAR 24MM

Facility

$40,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697266
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$9,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

PLATE LUMBAR LAT 2 SCR 17MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695203
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$10,375.00
Rate for Payer: Aetna Commercial	$6,225.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$10,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

PLATE LUMBAR LAT 2 SCR 17MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695203
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

PLATE LUMBAR LATERAL 15MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695245
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$10,375.00
Rate for Payer: Aetna Commercial	$6,225.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$10,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

PLATE LUMBAR LATERAL 15MM

Facility

$20,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695245
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

PLATEMATRIXNEUROCRANIAL12MM2H

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695476
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

PLATEMATRIXNEUROCRANIAL12MM2H

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695476
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

PLATE MATRIXNEURO DBL Y 18MM6H

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270695275
Hospital Revenue Code	278
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$496.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

PLATE MATRIXNEURO DBL Y 18MM6H

Facility

$2,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270695275
Hospital Revenue Code	278
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$615.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$410.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$496.10
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

PLATE MATRIXNEURO TI STR 4H

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270698656
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$166.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

PLATE MATRIXNEURO TI STR 4H

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270698656
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$207.00
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

PLATE MAXFORCE MTP 0-0 RT

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698095
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PLATE MAXFORCE MTP 0-0 RT

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698095
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PLATE MAXFORCE MTP 6-5 LEFT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694413
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$4,987.50
Rate for Payer: Aetna Commercial	$2,992.50
Rate for Payer: Aetna Medicare Advantage	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,543.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,543.62
Rate for Payer: Cigna Commercial	$4,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

PLATE MAXFORCE MTP 6-5 LEFT

Facility

$9,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694413
Hospital Revenue Code	278
Min. Negotiated Rate	$1,496.25
Max. Negotiated Rate	$2,413.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,413.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,496.25

PLATE MAXFRAME FOOT 150MM

Facility

$7,015.65

Hospital Charge Code	270693737
Hospital Revenue Code	272
Min. Negotiated Rate	$912.03
Max. Negotiated Rate	$3,507.82
Rate for Payer: Aetna Commercial	$2,104.70
Rate for Payer: Aetna Medicare Advantage	$2,104.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,788.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,788.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,788.99
Rate for Payer: Cigna Commercial	$3,507.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$912.03
Rate for Payer: Oxford Commercial	$3,507.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.35
Rate for Payer: UnitedHealthcare Commercial	$3,507.82

PLATE MAXFRAME FOOT 150MM

Facility

$7,015.65

Hospital Charge Code	270693737
Hospital Revenue Code	272
Min. Negotiated Rate	$1,052.35
Max. Negotiated Rate	$1,052.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.35

PLATE MC5 RIGHT 5 HOLE

Facility

$3,680.00

Hospital Charge Code	270669579
Hospital Revenue Code	278
Min. Negotiated Rate	$552.00
Max. Negotiated Rate	$1,840.00
Rate for Payer: Aetna Commercial	$1,104.00
Rate for Payer: Aetna Medicare Advantage	$1,104.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$938.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$938.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$736.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$938.40
Rate for Payer: Cigna Commercial	$1,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$890.56
Rate for Payer: Qualcare PPO/HMO/WC	$552.00

PLATE MC5 RIGHT 5 HOLE

Facility

$3,680.00

Hospital Charge Code	270669579
Hospital Revenue Code	278
Min. Negotiated Rate	$552.00
Max. Negotiated Rate	$890.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$736.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$890.56
Rate for Payer: Qualcare PPO/HMO/WC	$552.00

PLATE MDL 10-H RT 1312-18-701

Facility

$6,415.00

Hospital Charge Code	270658885
Hospital Revenue Code	278
Min. Negotiated Rate	$962.25
Max. Negotiated Rate	$3,207.50
Rate for Payer: Aetna Commercial	$1,924.50
Rate for Payer: Aetna Medicare Advantage	$1,924.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,635.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,635.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,283.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,635.83
Rate for Payer: Cigna Commercial	$3,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,552.43
Rate for Payer: Qualcare PPO/HMO/WC	$962.25

PLATE MDL 10-H RT 1312-18-701

Facility

$6,415.00

Hospital Charge Code	270658885
Hospital Revenue Code	278
Min. Negotiated Rate	$962.25
Max. Negotiated Rate	$1,552.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,283.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,552.43
Rate for Payer: Qualcare PPO/HMO/WC	$962.25

Know your out-of-pocket cost for care.

All Charges