Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SYN 1/3 TUB 10H

Facility

$307.25

Hospital Charge Code	270601913
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$92.17
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

PLATE SYN 1/3 TUB 10H

Facility

$307.25

Hospital Charge Code	270601913
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$74.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

PLATE SYN 1/3 TUB 10H

Facility

$248.85

Hospital Charge Code	270604307
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$60.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN 1/3 TUB 10H

Facility

$248.85

Hospital Charge Code	270604307
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$74.66
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN 1/3 TUB 2H

Facility

$233.65

Hospital Charge Code	270601905
Hospital Revenue Code	278
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$116.83
Rate for Payer: Aetna Commercial	$70.09
Rate for Payer: Aetna Medicare Advantage	$70.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.58
Rate for Payer: Cigna Commercial	$116.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.54
Rate for Payer: Qualcare PPO/HMO/WC	$35.05

PLATE SYN 1/3 TUB 2H

Facility

$192.85

Hospital Charge Code	270604299
Hospital Revenue Code	278
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$46.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

PLATE SYN 1/3 TUB 2H

Facility

$192.85

Hospital Charge Code	270604299
Hospital Revenue Code	278
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$96.42
Rate for Payer: Aetna Commercial	$57.85
Rate for Payer: Aetna Medicare Advantage	$57.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.18
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.67
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

PLATE SYN 1/3 TUB 2H

Facility

$233.65

Hospital Charge Code	270601905
Hospital Revenue Code	278
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$56.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.54
Rate for Payer: Qualcare PPO/HMO/WC	$35.05

PLATE SYN 1/3 TUB 3H

Facility

$240.85

Hospital Charge Code	270601906
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 3H

Facility

$200.85

Hospital Charge Code	270604300
Hospital Revenue Code	278
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$48.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

PLATE SYN 1/3 TUB 3H

Facility

$200.85

Hospital Charge Code	270604300
Hospital Revenue Code	278
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$100.42
Rate for Payer: Aetna Commercial	$60.26
Rate for Payer: Aetna Medicare Advantage	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$100.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

PLATE SYN 1/3 TUB 3H

Facility

$240.85

Hospital Charge Code	270601906
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$120.42
Rate for Payer: Aetna Commercial	$72.25
Rate for Payer: Aetna Medicare Advantage	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.42
Rate for Payer: Cigna Commercial	$120.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 4H

Facility

$233.65

Hospital Charge Code	270604301
Hospital Revenue Code	278
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$116.83
Rate for Payer: Aetna Commercial	$70.09
Rate for Payer: Aetna Medicare Advantage	$70.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.58
Rate for Payer: Cigna Commercial	$116.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.54
Rate for Payer: Qualcare PPO/HMO/WC	$35.05

PLATE SYN 1/3 TUB 4H

Facility

$233.65

Hospital Charge Code	270604301
Hospital Revenue Code	278
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$56.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.54
Rate for Payer: Qualcare PPO/HMO/WC	$35.05

PLATE SYN 1/3 TUB 5H 241.35

Facility

$254.45

Hospital Charge Code	270604302
Hospital Revenue Code	278
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$76.33
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.58
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

PLATE SYN 1/3 TUB 5H 241.35

Facility

$254.45

Hospital Charge Code	270604302
Hospital Revenue Code	278
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$61.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.58
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

PLATE SYN 1/3 TUB 6H

Facility

$240.85

Hospital Charge Code	270604303
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 6H

Facility

$240.85

Hospital Charge Code	270604303
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$120.42
Rate for Payer: Aetna Commercial	$72.25
Rate for Payer: Aetna Medicare Advantage	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.42
Rate for Payer: Cigna Commercial	$120.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 7H

Facility

$240.85

Hospital Charge Code	270604304
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 7H

Facility

$240.85

Hospital Charge Code	270604304
Hospital Revenue Code	278
Min. Negotiated Rate	$36.13
Max. Negotiated Rate	$120.42
Rate for Payer: Aetna Commercial	$72.25
Rate for Payer: Aetna Medicare Advantage	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.42
Rate for Payer: Cigna Commercial	$120.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.13

PLATE SYN 1/3 TUB 8H

Facility

$248.85

Hospital Charge Code	270604305
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$124.42
Rate for Payer: Aetna Commercial	$74.66
Rate for Payer: Aetna Medicare Advantage	$74.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.46
Rate for Payer: Cigna Commercial	$124.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN 1/3 TUB 8H

Facility

$248.85

Hospital Charge Code	270604305
Hospital Revenue Code	278
Min. Negotiated Rate	$37.33
Max. Negotiated Rate	$60.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: Qualcare PPO/HMO/WC	$37.33

PLATE SYN 1/3 TUB 8H 236108

Facility

$222.30

Service Code	HCPCS C1713
Hospital Charge Code	270607164
Hospital Revenue Code	278
Min. Negotiated Rate	$33.34
Max. Negotiated Rate	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.80
Rate for Payer: Qualcare PPO/HMO/WC	$33.34

PLATE SYN 1/3 TUB 8H 236108

Facility

$222.30

Service Code	HCPCS C1713
Hospital Charge Code	270607164
Hospital Revenue Code	278
Min. Negotiated Rate	$33.34
Max. Negotiated Rate	$111.15
Rate for Payer: Aetna Commercial	$66.69
Rate for Payer: Aetna Medicare Advantage	$66.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.69
Rate for Payer: Cigna Commercial	$111.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.80
Rate for Payer: Qualcare PPO/HMO/WC	$33.34

PLATE SYN 1/3 TUB 9H

Facility

$307.25

Hospital Charge Code	270601909
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$92.17
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

Know your out-of-pocket cost for care.

All Charges