Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TIB SLP 9.0 AR13200ST090

Facility

$5,183.25

Hospital Charge Code	270636941
Hospital Revenue Code	278
Min. Negotiated Rate	$777.49
Max. Negotiated Rate	$1,254.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,036.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.35
Rate for Payer: Qualcare PPO/HMO/WC	$777.49

PLATE TI FIBULA LKG 4 HOLE RT

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692739
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLATE TI FIBULA LKG 4 HOLE RT

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692739
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$975.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLATE TI INTERSPINOUS 6X34MM

Facility

$20,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270697851
Hospital Revenue Code	278
Min. Negotiated Rate	$3,012.00
Max. Negotiated Rate	$4,859.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,016.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,859.36
Rate for Payer: Qualcare PPO/HMO/WC	$3,012.00

PLATE TI INTERSPINOUS 6X34MM

Facility

$20,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270697851
Hospital Revenue Code	278
Min. Negotiated Rate	$3,012.00
Max. Negotiated Rate	$10,040.00
Rate for Payer: Aetna Commercial	$6,024.00
Rate for Payer: Aetna Medicare Advantage	$6,024.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,120.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,120.40
Rate for Payer: Cigna Commercial	$10,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,859.36
Rate for Payer: Qualcare PPO/HMO/WC	$3,012.00

PLATE TI LISS 5 HOLE RT 156MM

Facility

$6,804.00

Hospital Charge Code	270671201
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$1,646.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE TI LISS 5 HOLE RT 156MM

Facility

$6,804.00

Hospital Charge Code	270671201
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$3,402.00
Rate for Payer: Aetna Commercial	$2,041.20
Rate for Payer: Aetna Medicare Advantage	$2,041.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.02
Rate for Payer: Cigna Commercial	$3,402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE TI LISS 9 HOLE RT 236MM

Facility

$6,804.00

Hospital Charge Code	270671202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$1,646.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE TI LISS 9 HOLE RT 236MM

Facility

$6,804.00

Hospital Charge Code	270671202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.60
Max. Negotiated Rate	$3,402.00
Rate for Payer: Aetna Commercial	$2,041.20
Rate for Payer: Aetna Medicare Advantage	$2,041.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,735.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,735.02
Rate for Payer: Cigna Commercial	$3,402.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.60

PLATE TI MATRIXNEURO ADAPT 20H

Facility

$5,185.00

Service Code	HCPCS C1713
Hospital Charge Code	270700169
Hospital Revenue Code	278
Min. Negotiated Rate	$777.75
Max. Negotiated Rate	$2,592.50
Rate for Payer: Aetna Commercial	$1,555.50
Rate for Payer: Aetna Medicare Advantage	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,322.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,322.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,037.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,322.17
Rate for Payer: Cigna Commercial	$2,592.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.77
Rate for Payer: Qualcare PPO/HMO/WC	$777.75

PLATE TI MATRIXNEURO ADAPT 20H

Facility

$5,185.00

Service Code	HCPCS C1713
Hospital Charge Code	270700169
Hospital Revenue Code	278
Min. Negotiated Rate	$777.75
Max. Negotiated Rate	$1,254.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,037.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.77
Rate for Payer: Qualcare PPO/HMO/WC	$777.75

PLATETIMATRIXNEURODBL 6H21MM

Facility

$2,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270697739
Hospital Revenue Code	278
Min. Negotiated Rate	$321.00
Max. Negotiated Rate	$1,070.00
Rate for Payer: Aetna Commercial	$642.00
Rate for Payer: Aetna Medicare Advantage	$642.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$545.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$545.70
Rate for Payer: Cigna Commercial	$1,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.88
Rate for Payer: Qualcare PPO/HMO/WC	$321.00

PLATETIMATRIXNEURODBL 6H21MM

Facility

$2,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270697739
Hospital Revenue Code	278
Min. Negotiated Rate	$321.00
Max. Negotiated Rate	$517.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.88
Rate for Payer: Qualcare PPO/HMO/WC	$321.00

PLATE TI MATRIXNEURODBLY6H21MM

Facility

$2,340.00

Service Code	HCPCS C1713
Hospital Charge Code	270700166
Hospital Revenue Code	278
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$566.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$468.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

PLATE TI MATRIXNEURODBLY6H21MM

Facility

$2,340.00

Service Code	HCPCS C1713
Hospital Charge Code	270700166
Hospital Revenue Code	278
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$1,170.00
Rate for Payer: Aetna Commercial	$702.00
Rate for Payer: Aetna Medicare Advantage	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$596.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$596.70
Rate for Payer: Cigna Commercial	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$566.28
Rate for Payer: Qualcare PPO/HMO/WC	$351.00

PLATE TI MATRIXNEURO STRUT 8H

Facility

$5,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270700167
Hospital Revenue Code	278
Min. Negotiated Rate	$864.00
Max. Negotiated Rate	$2,880.00
Rate for Payer: Aetna Commercial	$1,728.00
Rate for Payer: Aetna Medicare Advantage	$1,728.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,468.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,468.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,152.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,468.80
Rate for Payer: Cigna Commercial	$2,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,393.92
Rate for Payer: Qualcare PPO/HMO/WC	$864.00

PLATE TI MATRIXNEURO STRUT 8H

Facility

$5,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270700167
Hospital Revenue Code	278
Min. Negotiated Rate	$864.00
Max. Negotiated Rate	$1,393.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,393.92
Rate for Payer: Qualcare PPO/HMO/WC	$864.00

PLATE TITAN 1/3 TUBULAR 12HOLE

Facility

$343.00

Service Code	HCPCS C1713
Hospital Charge Code	270604060
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$83.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.01
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

PLATE TITAN 1/3 TUBULAR 12HOLE

Facility

$343.00

Service Code	HCPCS C1713
Hospital Charge Code	270604060
Hospital Revenue Code	278
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$171.50
Rate for Payer: Aetna Commercial	$102.90
Rate for Payer: Aetna Medicare Advantage	$102.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.47
Rate for Payer: Cigna Commercial	$171.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.01
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

PLATE TITAN 1/3 TUBULAR4HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603379
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

PLATE TITAN 1/3 TUBULAR4HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603379
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$148.32
Rate for Payer: Aetna Commercial	$89.00
Rate for Payer: Aetna Medicare Advantage	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.65
Rate for Payer: Cigna Commercial	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

PLATE TITAN 1/3 TUBULAR 5HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603380
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

PLATE TITAN 1/3 TUBULAR 5HOLE

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270603380
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$148.32
Rate for Payer: Aetna Commercial	$89.00
Rate for Payer: Aetna Medicare Advantage	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.65
Rate for Payer: Cigna Commercial	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

PLATE TITAN 1/3 TUBULAR 7HOLE

Facility

$307.45

Service Code	HCPCS C1713
Hospital Charge Code	270603382
Hospital Revenue Code	278
Min. Negotiated Rate	$46.12
Max. Negotiated Rate	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.12

PLATE TITAN 1/3 TUBULAR 7HOLE

Facility

$307.45

Service Code	HCPCS C1713
Hospital Charge Code	270603382
Hospital Revenue Code	278
Min. Negotiated Rate	$46.12
Max. Negotiated Rate	$153.72
Rate for Payer: Aetna Commercial	$92.23
Rate for Payer: Aetna Medicare Advantage	$92.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.40
Rate for Payer: Cigna Commercial	$153.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.12

Know your out-of-pocket cost for care.

All Charges