Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE OLCRNN 10HL LFT S 629350

Facility

$9,250.00

Hospital Charge Code	270648600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$2,775.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

PLATE OLCRNN 10HL LFT S 629350

Facility

$9,250.00

Hospital Charge Code	270648600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

PLATE OLEC 13HOLE LOCK PLLE013

Facility

$3,750.00

Hospital Charge Code	270641009
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PLATE OLEC 13HOLE LOCK PLLE013

Facility

$3,750.00

Hospital Charge Code	270641009
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PLATE OLECRANON

Facility

$15,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270705395
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.00
Max. Negotiated Rate	$7,810.00
Rate for Payer: Aetna Commercial	$4,686.00
Rate for Payer: Aetna Medicare Advantage	$4,686.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,983.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,983.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,983.10
Rate for Payer: Cigna Commercial	$7,810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,780.04
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.00

PLATE OLECRANON

Facility

$13,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270705394
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.75
Max. Negotiated Rate	$6,512.50
Rate for Payer: Aetna Commercial	$3,907.50
Rate for Payer: Aetna Medicare Advantage	$3,907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,321.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,321.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,321.38
Rate for Payer: Cigna Commercial	$6,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.75

PLATE OLECRANON

Facility

$13,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270705394
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.75
Max. Negotiated Rate	$3,152.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.75

PLATE OLECRANON

Facility

$15,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270705395
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.00
Max. Negotiated Rate	$3,780.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,780.04
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.00

PLATE OLECRANON 10 HOLE

Facility

$6,770.00

Hospital Charge Code	270668017
Hospital Revenue Code	278
Min. Negotiated Rate	$1,015.50
Max. Negotiated Rate	$3,385.00
Rate for Payer: Aetna Commercial	$2,031.00
Rate for Payer: Aetna Medicare Advantage	$2,031.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,726.35
Rate for Payer: Cigna Commercial	$3,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.50

PLATE OLECRANON 10 HOLE

Facility

$6,770.00

Hospital Charge Code	270668017
Hospital Revenue Code	278
Min. Negotiated Rate	$1,015.50
Max. Negotiated Rate	$1,638.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.50

PLATE OLECRANON 10 HOLE SMALL

Facility

$6,050.00

Hospital Charge Code	270701882
Hospital Revenue Code	278
Min. Negotiated Rate	$907.50
Max. Negotiated Rate	$1,464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.10
Rate for Payer: Qualcare PPO/HMO/WC	$907.50

PLATE OLECRANON 10 HOLE SMALL

Facility

$6,050.00

Hospital Charge Code	270701882
Hospital Revenue Code	278
Min. Negotiated Rate	$907.50
Max. Negotiated Rate	$3,025.00
Rate for Payer: Aetna Commercial	$1,815.00
Rate for Payer: Aetna Medicare Advantage	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,542.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,542.75
Rate for Payer: Cigna Commercial	$3,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.10
Rate for Payer: Qualcare PPO/HMO/WC	$907.50

PLATE OLECRANON 13H LARGE

Facility

$6,770.00

Hospital Charge Code	270669272
Hospital Revenue Code	278
Min. Negotiated Rate	$1,015.50
Max. Negotiated Rate	$3,385.00
Rate for Payer: Aetna Commercial	$2,031.00
Rate for Payer: Aetna Medicare Advantage	$2,031.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,726.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,726.35
Rate for Payer: Cigna Commercial	$3,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.50

PLATE OLECRANON 13H LARGE

Facility

$6,770.00

Hospital Charge Code	270669272
Hospital Revenue Code	278
Min. Negotiated Rate	$1,015.50
Max. Negotiated Rate	$1,638.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,354.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,638.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,015.50

PLATE OLECRANON 3.5x138 6H RT

Facility

$4,217.85

Service Code	HCPCS C1713
Hospital Charge Code	270641314
Hospital Revenue Code	278
Min. Negotiated Rate	$632.68
Max. Negotiated Rate	$2,108.93
Rate for Payer: Aetna Commercial	$1,265.36
Rate for Payer: Aetna Medicare Advantage	$1,265.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,075.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,075.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$843.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,075.55
Rate for Payer: Cigna Commercial	$2,108.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.72
Rate for Payer: Qualcare PPO/HMO/WC	$632.68

PLATE OLECRANON 3.5x138 6H RT

Facility

$4,217.85

Service Code	HCPCS C1713
Hospital Charge Code	270641314
Hospital Revenue Code	278
Min. Negotiated Rate	$632.68
Max. Negotiated Rate	$1,020.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$843.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.72
Rate for Payer: Qualcare PPO/HMO/WC	$632.68

PLATE OLECRANON 8HL LFT 629348

Facility

$9,250.00

Hospital Charge Code	270648597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$4,625.00
Rate for Payer: Aetna Commercial	$2,775.00
Rate for Payer: Aetna Medicare Advantage	$2,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,358.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,358.75
Rate for Payer: Cigna Commercial	$4,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

PLATE OLECRANON 8HL LFT 629348

Facility

$9,250.00

Hospital Charge Code	270648597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,387.50
Max. Negotiated Rate	$2,238.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,238.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,387.50

PLATE OLECRAN STD 11 HOLE LEFT

Facility

$11,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270697231
Hospital Revenue Code	278
Min. Negotiated Rate	$1,673.25
Max. Negotiated Rate	$2,699.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,699.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,673.25

PLATE OLECRAN STD 11 HOLE LEFT

Facility

$11,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270697231
Hospital Revenue Code	278
Min. Negotiated Rate	$1,673.25
Max. Negotiated Rate	$5,577.50
Rate for Payer: Aetna Commercial	$3,346.50
Rate for Payer: Aetna Medicare Advantage	$3,346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,844.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,844.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,844.53
Rate for Payer: Cigna Commercial	$5,577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,699.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,673.25

PLATE OLECRN 10-H LOCK 2111110

Facility

$4,995.00

Hospital Charge Code	270643578
Hospital Revenue Code	278
Min. Negotiated Rate	$749.25
Max. Negotiated Rate	$2,497.50
Rate for Payer: Aetna Commercial	$1,498.50
Rate for Payer: Aetna Medicare Advantage	$1,498.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$999.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.72
Rate for Payer: Cigna Commercial	$2,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.79
Rate for Payer: Qualcare PPO/HMO/WC	$749.25

PLATE OLECRN 10-H LOCK 2111110

Facility

$4,995.00

Hospital Charge Code	270643578
Hospital Revenue Code	278
Min. Negotiated Rate	$749.25
Max. Negotiated Rate	$1,208.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.79
Rate for Payer: Qualcare PPO/HMO/WC	$749.25

PLATE ONE-THIRD TU 3HOLE 3.5mm

Facility

$1,081.50

Service Code	HCPCS C1713
Hospital Charge Code	270678636
Hospital Revenue Code	278
Min. Negotiated Rate	$162.22
Max. Negotiated Rate	$540.75
Rate for Payer: Aetna Commercial	$324.45
Rate for Payer: Aetna Medicare Advantage	$324.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.78
Rate for Payer: Cigna Commercial	$540.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.72
Rate for Payer: Qualcare PPO/HMO/WC	$162.22

PLATE ONE-THIRD TU 3HOLE 3.5mm

Facility

$1,081.50

Service Code	HCPCS C1713
Hospital Charge Code	270678636
Hospital Revenue Code	278
Min. Negotiated Rate	$162.22
Max. Negotiated Rate	$261.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.72
Rate for Payer: Qualcare PPO/HMO/WC	$162.22

PLATE OPENING WEDGE 0 MM

Facility

$6,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270679185
Hospital Revenue Code	278
Min. Negotiated Rate	$1,039.50
Max. Negotiated Rate	$1,677.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,386.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,677.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.50

Know your out-of-pocket cost for care.

All Charges