Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SELF COMP 2.7 5-HOLE

Facility

$207.00

Hospital Charge Code	1602853
Hospital Revenue Code	274
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$103.50
Rate for Payer: Aetna Commercial	$62.10
Rate for Payer: Aetna Medicare Advantage	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.78
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.09
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

PLATE SELF COMP 2.7 5-HOLE

Facility

$207.00

Hospital Charge Code	1602853
Hospital Revenue Code	274
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$50.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.09
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

PLATE SELF COMP 2.7 6-HOLE

Facility

$229.00

Hospital Charge Code	1602861
Hospital Revenue Code	274
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$114.50
Rate for Payer: Aetna Commercial	$68.70
Rate for Payer: Aetna Medicare Advantage	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.40
Rate for Payer: Cigna Commercial	$114.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.42
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

PLATE SELF COMP 2.7 6-HOLE

Facility

$229.00

Hospital Charge Code	1602861
Hospital Revenue Code	274
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$55.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.42
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

PLATE SELF COMP 2.7 7-HOLE

Facility

$250.00

Hospital Charge Code	1602879
Hospital Revenue Code	274
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

PLATE SELF COMP 2.7 7-HOLE

Facility

$250.00

Hospital Charge Code	1602879
Hospital Revenue Code	274
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

PLATE SELF COMP 2.7 8-HOLE

Facility

$278.00

Hospital Charge Code	1602887
Hospital Revenue Code	274
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

PLATE SELF COMP 2.7 8-HOLE

Facility

$278.00

Hospital Charge Code	1602887
Hospital Revenue Code	274
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$83.40
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

PLATE SEMI TUBULAR 10-HOLE****

Facility

$147.00

Hospital Charge Code	1602499
Hospital Revenue Code	274
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$35.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

PLATE SEMI TUBULAR 10-HOLE****

Facility

$147.00

Hospital Charge Code	1602499
Hospital Revenue Code	274
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$44.10
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

PLATE SEMI TUBULAR 11-HOLE***

Facility

$153.00

Hospital Charge Code	1602507
Hospital Revenue Code	274
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

PLATE SEMI TUBULAR 11-HOLE***

Facility

$153.00

Hospital Charge Code	1602507
Hospital Revenue Code	274
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$45.90
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

PLATE SEMI TUBULAR 12-HOLE***

Facility

$158.00

Hospital Charge Code	1602515
Hospital Revenue Code	274
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$38.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.24
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

PLATE SEMI TUBULAR 12-HOLE***

Facility

$158.00

Hospital Charge Code	1602515
Hospital Revenue Code	274
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$47.40
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.24
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

PLATE SEMI TUBULAR 2-HOLE***

Facility

$93.00

Hospital Charge Code	1602416
Hospital Revenue Code	274
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

PLATE SEMI TUBULAR 2-HOLE***

Facility

$93.00

Hospital Charge Code	1602416
Hospital Revenue Code	274
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$46.50
Rate for Payer: Aetna Commercial	$27.90
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

PLATE SEMI TUBULAR 3-HOLE***

Facility

$98.00

Hospital Charge Code	1602424
Hospital Revenue Code	274
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$49.00
Rate for Payer: Aetna Commercial	$29.40
Rate for Payer: Aetna Medicare Advantage	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.72
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

PLATE SEMI TUBULAR 3-HOLE***

Facility

$98.00

Hospital Charge Code	1602424
Hospital Revenue Code	274
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$23.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.72
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

PLATE SEMI TUBULAR 4-HOLE***

Facility

$103.00

Hospital Charge Code	1602432
Hospital Revenue Code	274
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$24.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.93
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

PLATE SEMI TUBULAR 4-HOLE***

Facility

$103.00

Hospital Charge Code	1602432
Hospital Revenue Code	274
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$51.50
Rate for Payer: Aetna Commercial	$30.90
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.93
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

PLATE SEMI TUBULAR 5-HOLE***

Facility

$109.00

Hospital Charge Code	1602440
Hospital Revenue Code	274
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.38
Rate for Payer: Qualcare PPO/HMO/WC	$16.35

PLATE SEMI TUBULAR 5-HOLE***

Facility

$109.00

Hospital Charge Code	1602440
Hospital Revenue Code	274
Min. Negotiated Rate	$16.35
Max. Negotiated Rate	$54.50
Rate for Payer: Aetna Commercial	$32.70
Rate for Payer: Aetna Medicare Advantage	$32.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.80
Rate for Payer: Cigna Commercial	$54.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.38
Rate for Payer: Qualcare PPO/HMO/WC	$16.35

PLATE SEMI TUBULAR 6-HOLE***

Facility

$117.00

Hospital Charge Code	1602457
Hospital Revenue Code	274
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

PLATE SEMI TUBULAR 6-HOLE***

Facility

$117.00

Hospital Charge Code	1602457
Hospital Revenue Code	274
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$35.10
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

PLATE SEMI TUBULAR 7-HOLE***

Facility

$123.00

Hospital Charge Code	1602465
Hospital Revenue Code	274
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

Know your out-of-pocket cost for care.

All Charges