Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TITAN 1/3 TUBULAR 9HOLE

Facility

$318.25

Service Code	HCPCS C1713
Hospital Charge Code	270603384
Hospital Revenue Code	278
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$159.12
Rate for Payer: Aetna Commercial	$95.47
Rate for Payer: Aetna Medicare Advantage	$95.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.15
Rate for Payer: Cigna Commercial	$159.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.02
Rate for Payer: Qualcare PPO/HMO/WC	$47.74

PLATE TITAN 1/3 TUBULAR 9HOLE

Facility

$318.25

Service Code	HCPCS C1713
Hospital Charge Code	270603384
Hospital Revenue Code	278
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$77.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.02
Rate for Payer: Qualcare PPO/HMO/WC	$47.74

PLATE TITAN 1/4 TUBULAR 4HOLE

Facility

$562.40

Service Code	HCPCS C1713
Hospital Charge Code	270603409
Hospital Revenue Code	278
Min. Negotiated Rate	$84.36
Max. Negotiated Rate	$136.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.10
Rate for Payer: Qualcare PPO/HMO/WC	$84.36

PLATE TITAN 1/4 TUBULAR 4HOLE

Facility

$562.40

Service Code	HCPCS C1713
Hospital Charge Code	270603409
Hospital Revenue Code	278
Min. Negotiated Rate	$84.36
Max. Negotiated Rate	$281.20
Rate for Payer: Aetna Commercial	$168.72
Rate for Payer: Aetna Medicare Advantage	$168.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.41
Rate for Payer: Cigna Commercial	$281.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.10
Rate for Payer: Qualcare PPO/HMO/WC	$84.36

PLATE TITAN 1/4 TUBULAR 6HOLE

Facility

$726.15

Service Code	HCPCS C1713
Hospital Charge Code	270603411
Hospital Revenue Code	278
Min. Negotiated Rate	$108.92
Max. Negotiated Rate	$363.07
Rate for Payer: Qualcare PPO/HMO/WC	$108.92
Rate for Payer: Aetna Commercial	$217.84
Rate for Payer: Aetna Medicare Advantage	$217.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.17
Rate for Payer: Cigna Commercial	$363.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.73

PLATE TITAN 1/4 TUBULAR 6HOLE

Facility

$726.15

Service Code	HCPCS C1713
Hospital Charge Code	270603411
Hospital Revenue Code	278
Min. Negotiated Rate	$108.92
Max. Negotiated Rate	$175.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.73
Rate for Payer: Qualcare PPO/HMO/WC	$108.92

PLATE TITAN 2.7mm L OBLIQ.LEFT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603414
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$132.10
Rate for Payer: Aetna Commercial	$79.26
Rate for Payer: Aetna Medicare Advantage	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.37
Rate for Payer: Cigna Commercial	$132.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE TITAN 2.7mm L OBLIQ.LEFT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603414
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE TITAN 2.7mm OBLIQ.RIGHT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603415
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$132.10
Rate for Payer: Aetna Commercial	$79.26
Rate for Payer: Aetna Medicare Advantage	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.37
Rate for Payer: Cigna Commercial	$132.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE TITAN 2.7mm OBLIQ.RIGHT

Facility

$264.20

Service Code	HCPCS C1713
Hospital Charge Code	270603415
Hospital Revenue Code	278
Min. Negotiated Rate	$39.63
Max. Negotiated Rate	$63.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.94
Rate for Payer: Qualcare PPO/HMO/WC	$39.63

PLATE TITAN CALCANEAL 70mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603403
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$573.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE TITAN CALCANEAL 70mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603403
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$1,185.03
Rate for Payer: Aetna Commercial	$711.01
Rate for Payer: Aetna Medicare Advantage	$711.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.36
Rate for Payer: Cigna Commercial	$1,185.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE TITAN CALCANEAL Y 87mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603404
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$1,185.03
Rate for Payer: Aetna Commercial	$711.01
Rate for Payer: Aetna Medicare Advantage	$711.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.36
Rate for Payer: Cigna Commercial	$1,185.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE TITAN CALCANEAL Y 87mm

Facility

$2,370.05

Service Code	HCPCS C1713
Hospital Charge Code	270603404
Hospital Revenue Code	278
Min. Negotiated Rate	$355.51
Max. Negotiated Rate	$573.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$474.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.55
Rate for Payer: Qualcare PPO/HMO/WC	$355.51

PLATE TITAN H 1.5mm

Facility

$905.35

Service Code	HCPCS C1713
Hospital Charge Code	270604102
Hospital Revenue Code	278
Min. Negotiated Rate	$135.80
Max. Negotiated Rate	$219.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.09
Rate for Payer: Qualcare PPO/HMO/WC	$135.80

PLATE TITAN H 1.5mm

Facility

$905.35

Service Code	HCPCS C1713
Hospital Charge Code	270604102
Hospital Revenue Code	278
Min. Negotiated Rate	$135.80
Max. Negotiated Rate	$452.68
Rate for Payer: Aetna Commercial	$271.61
Rate for Payer: Aetna Medicare Advantage	$271.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.86
Rate for Payer: Cigna Commercial	$452.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.09
Rate for Payer: Qualcare PPO/HMO/WC	$135.80

PLATE TITAN H 2.0mm

Facility

$930.10

Service Code	HCPCS C1713
Hospital Charge Code	270603546
Hospital Revenue Code	278
Min. Negotiated Rate	$139.51
Max. Negotiated Rate	$225.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.08
Rate for Payer: Qualcare PPO/HMO/WC	$139.51

PLATE TITAN H 2.0mm

Facility

$930.10

Service Code	HCPCS C1713
Hospital Charge Code	270603546
Hospital Revenue Code	278
Min. Negotiated Rate	$139.51
Max. Negotiated Rate	$465.05
Rate for Payer: Aetna Commercial	$279.03
Rate for Payer: Aetna Medicare Advantage	$279.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.18
Rate for Payer: Cigna Commercial	$465.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.08
Rate for Payer: Qualcare PPO/HMO/WC	$139.51

PLATE TITAN STR 1.5mm 20HOLE

Facility

$1,022.80

Service Code	HCPCS C1713
Hospital Charge Code	270604091
Hospital Revenue Code	278
Min. Negotiated Rate	$153.42
Max. Negotiated Rate	$511.40
Rate for Payer: Aetna Commercial	$306.84
Rate for Payer: Aetna Medicare Advantage	$306.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.81
Rate for Payer: Cigna Commercial	$511.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.52
Rate for Payer: Qualcare PPO/HMO/WC	$153.42

PLATE TITAN STR 1.5mm 20HOLE

Facility

$1,022.80

Service Code	HCPCS C1713
Hospital Charge Code	270604091
Hospital Revenue Code	278
Min. Negotiated Rate	$153.42
Max. Negotiated Rate	$247.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.52
Rate for Payer: Qualcare PPO/HMO/WC	$153.42

PLATE TITAN STR 2.0mm 20HOLE

Facility

$1,072.25

Service Code	HCPCS C1713
Hospital Charge Code	270603535
Hospital Revenue Code	278
Min. Negotiated Rate	$160.84
Max. Negotiated Rate	$536.12
Rate for Payer: Aetna Commercial	$321.68
Rate for Payer: Aetna Medicare Advantage	$321.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.42
Rate for Payer: Cigna Commercial	$536.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.48
Rate for Payer: Qualcare PPO/HMO/WC	$160.84

PLATE TITAN STR 2.0mm 20HOLE

Facility

$1,072.25

Service Code	HCPCS C1713
Hospital Charge Code	270603535
Hospital Revenue Code	278
Min. Negotiated Rate	$160.84
Max. Negotiated Rate	$259.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.48
Rate for Payer: Qualcare PPO/HMO/WC	$160.84

PLATE TIT CLOVRLF 3HOLE 441.83

Facility

$728.00

Hospital Charge Code	1605583
Hospital Revenue Code	274
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$176.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.18
Rate for Payer: Qualcare PPO/HMO/WC	$109.20

PLATE TIT CLOVRLF 3HOLE 441.83

Facility

$728.00

Hospital Charge Code	1605583
Hospital Revenue Code	274
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$364.00
Rate for Payer: Aetna Commercial	$218.40
Rate for Payer: Aetna Medicare Advantage	$218.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.64
Rate for Payer: Cigna Commercial	$364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.18
Rate for Payer: Qualcare PPO/HMO/WC	$109.20

PLATE TITIUM ADATON 20 449.020

Facility

$1,682.45

Hospital Charge Code	270625802
Hospital Revenue Code	278
Min. Negotiated Rate	$252.37
Max. Negotiated Rate	$841.23
Rate for Payer: Aetna Commercial	$504.74
Rate for Payer: Aetna Medicare Advantage	$504.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.02
Rate for Payer: Cigna Commercial	$841.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.15
Rate for Payer: Qualcare PPO/HMO/WC	$252.37

Know your out-of-pocket cost for care.

All Charges