Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE REGATTA 14MM 2HOLE

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693475
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$6,375.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

PLATE REPLICATOR 1.5MM OFFSET

Facility

$5,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270670755
Hospital Revenue Code	278
Min. Negotiated Rate	$824.25
Max. Negotiated Rate	$1,329.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.79
Rate for Payer: Qualcare PPO/HMO/WC	$824.25

PLATE REPLICATOR 1.5MM OFFSET

Facility

$5,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270670755
Hospital Revenue Code	278
Min. Negotiated Rate	$824.25
Max. Negotiated Rate	$2,747.50
Rate for Payer: Aetna Commercial	$1,648.50
Rate for Payer: Aetna Medicare Advantage	$1,648.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,401.22
Rate for Payer: Cigna Commercial	$2,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.79
Rate for Payer: Qualcare PPO/HMO/WC	$824.25

PLATE REPLICATOR 4.5MM OFFSET

Facility

$5,495.55

Hospital Charge Code	270669869
Hospital Revenue Code	278
Min. Negotiated Rate	$824.33
Max. Negotiated Rate	$1,329.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.92
Rate for Payer: Qualcare PPO/HMO/WC	$824.33

PLATE REPLICATOR 4.5MM OFFSET

Facility

$5,495.55

Hospital Charge Code	270669869
Hospital Revenue Code	278
Min. Negotiated Rate	$824.33
Max. Negotiated Rate	$2,747.78
Rate for Payer: Aetna Commercial	$1,648.66
Rate for Payer: Aetna Medicare Advantage	$1,648.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,401.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,401.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,099.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,401.37
Rate for Payer: Cigna Commercial	$2,747.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,329.92
Rate for Payer: Qualcare PPO/HMO/WC	$824.33

PLATE RIGHT 4 HOLES OLECRANON

Facility

$7,995.00

Hospital Charge Code	270669709
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$1,934.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

PLATE RIGHT 4 HOLES OLECRANON

Facility

$7,995.00

Hospital Charge Code	270669709
Hospital Revenue Code	278
Min. Negotiated Rate	$1,199.25
Max. Negotiated Rate	$3,997.50
Rate for Payer: Aetna Commercial	$2,398.50
Rate for Payer: Aetna Medicare Advantage	$2,398.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,038.72
Rate for Payer: Cigna Commercial	$3,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,934.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,199.25

PLATE RIGHT PRIMARY MPJ FUSION

Facility

$8,500.00

Hospital Charge Code	270669678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

PLATE RIGHT PRIMARY MPJ FUSION

Facility

$8,500.00

Hospital Charge Code	270669678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

PLATE RIGHT T

Facility

$5,865.00

Hospital Charge Code	270702598
Hospital Revenue Code	278
Min. Negotiated Rate	$879.75
Max. Negotiated Rate	$2,932.50
Rate for Payer: Aetna Commercial	$1,759.50
Rate for Payer: Aetna Medicare Advantage	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,495.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,495.58
Rate for Payer: Cigna Commercial	$2,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,419.33
Rate for Payer: Qualcare PPO/HMO/WC	$879.75

PLATE RIGHT T

Facility

$5,865.00

Hospital Charge Code	270702598
Hospital Revenue Code	278
Min. Negotiated Rate	$879.75
Max. Negotiated Rate	$1,419.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,173.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,419.33
Rate for Payer: Qualcare PPO/HMO/WC	$879.75

PLATE ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270679749
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 ROI-C

Facility

$11,666.65

Service Code	HCPCS C1713
Hospital Charge Code	270679749
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 ROI C ANCHORING 12 X 14X

Facility

$20,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691010
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

PLATE ROI C ANCHORING 12 X 14X

Facility

$20,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270691010
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

PLATE ROT 2.0MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689901
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 ROT 2.0MM 5 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689901
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 ROTATION 1.6MM

Facility

$4,094.25

Hospital Charge Code	270703049
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$990.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

PLATE ROTATION 1.6MM

Facility

$4,094.25

Hospital Charge Code	270703049
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$2,047.12
Rate for Payer: Aetna Commercial	$1,228.28
Rate for Payer: Aetna Medicare Advantage	$1,228.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.03
Rate for Payer: Cigna Commercial	$2,047.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

PLATE RT CLAVICLE W LATERA EXT

Facility

$4,660.05

Service Code	HCPCS C1776
Hospital Charge Code	270689729
Hospital Revenue Code	278
Min. Negotiated Rate	$699.01
Max. Negotiated Rate	$2,330.03
Rate for Payer: Aetna Commercial	$1,398.02
Rate for Payer: Aetna Medicare Advantage	$1,398.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,188.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,188.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$932.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,188.31
Rate for Payer: Cigna Commercial	$2,330.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,127.73
Rate for Payer: Qualcare PPO/HMO/WC	$699.01

PLATE RT CLAVICLE W LATERA EXT

Facility

$4,660.05

Service Code	HCPCS C1776
Hospital Charge Code	270689729
Hospital Revenue Code	278
Min. Negotiated Rate	$699.01
Max. Negotiated Rate	$1,127.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$932.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,127.73
Rate for Payer: Qualcare PPO/HMO/WC	$699.01

PLATE RT OLECRANAN 6HOLE

Facility

$36,250.00

Hospital Charge Code	270662024
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$8,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

PLATE RT OLECRANAN 6HOLE

Facility

$36,250.00

Hospital Charge Code	270662024
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$18,125.00
Rate for Payer: Aetna Commercial	$10,875.00
Rate for Payer: Aetna Medicare Advantage	$10,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,243.75
Rate for Payer: Cigna Commercial	$18,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

PLATES ANGLE 2.4 2.7MM LEFT

Facility

$6,216.10

Service Code	HCPCS C1713
Hospital Charge Code	270693994
Hospital Revenue Code	278
Min. Negotiated Rate	$932.41
Max. Negotiated Rate	$3,108.05
Rate for Payer: Aetna Commercial	$1,864.83
Rate for Payer: Aetna Medicare Advantage	$1,864.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,585.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,585.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,243.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,585.11
Rate for Payer: Cigna Commercial	$3,108.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.30
Rate for Payer: Qualcare PPO/HMO/WC	$932.41

PLATES ANGLE 2.4 2.7MM LEFT

Facility

$6,216.10

Service Code	HCPCS C1713
Hospital Charge Code	270693994
Hospital Revenue Code	278
Min. Negotiated Rate	$932.41
Max. Negotiated Rate	$1,504.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,243.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,504.30
Rate for Payer: Qualcare PPO/HMO/WC	$932.41

Know your out-of-pocket cost for care.

All Charges