Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE SYN ADAPT 9 20H 446.10

Facility

$1,433.65

Hospital Charge Code	270621201
Hospital Revenue Code	278
Min. Negotiated Rate	$215.05
Max. Negotiated Rate	$346.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$286.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.94
Rate for Payer: Qualcare PPO/HMO/WC	$215.05

PLATE SYN ADAPT 9 24H 421.10

Facility

$2,216.00

Hospital Charge Code	270617340
Hospital Revenue Code	278
Min. Negotiated Rate	$332.40
Max. Negotiated Rate	$1,108.00
Rate for Payer: Aetna Commercial	$664.80
Rate for Payer: Aetna Medicare Advantage	$664.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$565.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$565.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$565.08
Rate for Payer: Cigna Commercial	$1,108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.27
Rate for Payer: Qualcare PPO/HMO/WC	$332.40

PLATE SYN ADAPT 9 24H 421.10

Facility

$2,216.00

Hospital Charge Code	270617340
Hospital Revenue Code	278
Min. Negotiated Rate	$332.40
Max. Negotiated Rate	$536.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$536.27
Rate for Payer: Qualcare PPO/HMO/WC	$332.40

PLATE SYN BOX 15 X 5 421.095

Facility

$836.85

Hospital Charge Code	270620362
Hospital Revenue Code	278
Min. Negotiated Rate	$125.53
Max. Negotiated Rate	$202.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.52
Rate for Payer: Qualcare PPO/HMO/WC	$125.53

PLATE SYN BOX 15 X 5 421.095

Facility

$836.85

Hospital Charge Code	270620362
Hospital Revenue Code	278
Min. Negotiated Rate	$125.53
Max. Negotiated Rate	$418.43
Rate for Payer: Aetna Commercial	$251.06
Rate for Payer: Aetna Medicare Advantage	$251.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.40
Rate for Payer: Cigna Commercial	$418.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.52
Rate for Payer: Qualcare PPO/HMO/WC	$125.53

PLATE SYN BROAD 9H 226.59

Facility

$1,027.25

Service Code	HCPCS C1713
Hospital Charge Code	270619713
Hospital Revenue Code	278
Min. Negotiated Rate	$154.09
Max. Negotiated Rate	$513.62
Rate for Payer: Aetna Commercial	$308.18
Rate for Payer: Aetna Medicare Advantage	$308.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.95
Rate for Payer: Cigna Commercial	$513.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.59
Rate for Payer: Qualcare PPO/HMO/WC	$154.09

PLATE SYN BROAD 9H 226.59

Facility

$1,027.25

Service Code	HCPCS C1713
Hospital Charge Code	270619713
Hospital Revenue Code	278
Min. Negotiated Rate	$154.09
Max. Negotiated Rate	$248.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.59
Rate for Payer: Qualcare PPO/HMO/WC	$154.09

PLATE SYN CALC 60MM 241.61

Facility

$1,847.25

Hospital Charge Code	270616217
Hospital Revenue Code	278
Min. Negotiated Rate	$277.09
Max. Negotiated Rate	$923.62
Rate for Payer: Aetna Commercial	$554.17
Rate for Payer: Aetna Medicare Advantage	$554.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.05
Rate for Payer: Cigna Commercial	$923.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.03
Rate for Payer: Qualcare PPO/HMO/WC	$277.09

PLATE SYN CALC 60MM 241.61

Facility

$1,847.25

Hospital Charge Code	270616217
Hospital Revenue Code	278
Min. Negotiated Rate	$277.09
Max. Negotiated Rate	$447.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$369.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.03
Rate for Payer: Qualcare PPO/HMO/WC	$277.09

PLATE SYN CALC 60MM 441.61

Facility

$1,892.85

Hospital Charge Code	270603402
Hospital Revenue Code	278
Min. Negotiated Rate	$283.93
Max. Negotiated Rate	$458.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.07
Rate for Payer: Qualcare PPO/HMO/WC	$283.93

PLATE SYN CALC 60MM 441.61

Facility

$1,892.85

Hospital Charge Code	270603402
Hospital Revenue Code	278
Min. Negotiated Rate	$283.93
Max. Negotiated Rate	$946.42
Rate for Payer: Aetna Commercial	$567.86
Rate for Payer: Aetna Medicare Advantage	$567.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$378.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.68
Rate for Payer: Cigna Commercial	$946.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.07
Rate for Payer: Qualcare PPO/HMO/WC	$283.93

PLATE SYN CERVICAL LCK 487.214

Facility

$4,330.45

Hospital Charge Code	270609421
Hospital Revenue Code	278
Min. Negotiated Rate	$649.57
Max. Negotiated Rate	$1,047.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.97
Rate for Payer: Qualcare PPO/HMO/WC	$649.57

PLATE SYN CERVICAL LCK 487.214

Facility

$4,330.45

Hospital Charge Code	270609421
Hospital Revenue Code	278
Min. Negotiated Rate	$649.57
Max. Negotiated Rate	$2,165.22
Rate for Payer: Aetna Commercial	$1,299.13
Rate for Payer: Aetna Medicare Advantage	$1,299.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.26
Rate for Payer: Cigna Commercial	$2,165.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.97
Rate for Payer: Qualcare PPO/HMO/WC	$649.57

PLATE SYN CLVRLF 3H

Facility

$1,058.45

Hospital Charge Code	270604297
Hospital Revenue Code	278
Min. Negotiated Rate	$158.77
Max. Negotiated Rate	$529.23
Rate for Payer: Aetna Commercial	$317.54
Rate for Payer: Aetna Medicare Advantage	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.90
Rate for Payer: Cigna Commercial	$529.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.14
Rate for Payer: Qualcare PPO/HMO/WC	$158.77

PLATE SYN CLVRLF 3H

Facility

$1,058.45

Hospital Charge Code	270604297
Hospital Revenue Code	278
Min. Negotiated Rate	$158.77
Max. Negotiated Rate	$256.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.14
Rate for Payer: Qualcare PPO/HMO/WC	$158.77

PLATE SYN CLVRLF 4H

Facility

$1,135.25

Hospital Charge Code	270604298
Hospital Revenue Code	278
Min. Negotiated Rate	$170.29
Max. Negotiated Rate	$567.62
Rate for Payer: Aetna Commercial	$340.57
Rate for Payer: Aetna Medicare Advantage	$340.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.49
Rate for Payer: Cigna Commercial	$567.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.73
Rate for Payer: Qualcare PPO/HMO/WC	$170.29

PLATE SYN CLVRLF 4H

Facility

$1,135.25

Hospital Charge Code	270604298
Hospital Revenue Code	278
Min. Negotiated Rate	$170.29
Max. Negotiated Rate	$274.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.73
Rate for Payer: Qualcare PPO/HMO/WC	$170.29

PLATE SYN CLVRLF 6H 136 24186

Facility

$1,243.25

Hospital Charge Code	270624542
Hospital Revenue Code	278
Min. Negotiated Rate	$186.49
Max. Negotiated Rate	$300.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.49

PLATE SYN CLVRLF 6H 136 24186

Facility

$1,243.25

Hospital Charge Code	270624542
Hospital Revenue Code	278
Min. Negotiated Rate	$186.49
Max. Negotiated Rate	$621.62
Rate for Payer: Aetna Commercial	$372.98
Rate for Payer: Aetna Medicare Advantage	$372.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.03
Rate for Payer: Cigna Commercial	$621.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.87
Rate for Payer: Qualcare PPO/HMO/WC	$186.49

PLATE SYN CLVRLF TT 3H

Facility

$522.45

Hospital Charge Code	270603396
Hospital Revenue Code	278
Min. Negotiated Rate	$78.37
Max. Negotiated Rate	$126.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: Qualcare PPO/HMO/WC	$78.37

PLATE SYN CLVRLF TT 3H

Facility

$522.45

Hospital Charge Code	270603396
Hospital Revenue Code	278
Min. Negotiated Rate	$78.37
Max. Negotiated Rate	$261.23
Rate for Payer: Aetna Commercial	$156.74
Rate for Payer: Aetna Medicare Advantage	$156.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.22
Rate for Payer: Cigna Commercial	$261.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: Qualcare PPO/HMO/WC	$78.37

PLATE SYN CLVRLF TT 4H

Facility

$544.85

Hospital Charge Code	270603397
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

PLATE SYN CLVRLF TT 4H

Facility

$1,334.45

Hospital Charge Code	270604062
Hospital Revenue Code	278
Min. Negotiated Rate	$200.17
Max. Negotiated Rate	$322.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.94
Rate for Payer: Qualcare PPO/HMO/WC	$200.17

PLATE SYN CLVRLF TT 4H

Facility

$1,334.45

Hospital Charge Code	270604062
Hospital Revenue Code	278
Min. Negotiated Rate	$200.17
Max. Negotiated Rate	$667.23
Rate for Payer: Aetna Commercial	$400.33
Rate for Payer: Aetna Medicare Advantage	$400.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$266.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.28
Rate for Payer: Cigna Commercial	$667.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.94
Rate for Payer: Qualcare PPO/HMO/WC	$200.17

PLATE SYN CLVRLF TT 4H

Facility

$544.85

Hospital Charge Code	270603397
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$163.46
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

Know your out-of-pocket cost for care.

All Charges