Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VA-LCP 2.7MM 5HOLE RIGHT

Facility

$3,757.45

Service Code	HCPCS C1713
Hospital Charge Code	270659119
Hospital Revenue Code	278
Min. Negotiated Rate	$563.62
Max. Negotiated Rate	$909.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.30
Rate for Payer: Qualcare PPO/HMO/WC	$563.62

PLATE VA-LCP 2.7MM 5HOLE RIGHT

Facility

$3,757.45

Service Code	HCPCS C1713
Hospital Charge Code	270659119
Hospital Revenue Code	278
Min. Negotiated Rate	$563.62
Max. Negotiated Rate	$1,878.72
Rate for Payer: Aetna Commercial	$1,127.23
Rate for Payer: Aetna Medicare Advantage	$1,127.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$958.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$958.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$751.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$958.15
Rate for Payer: Cigna Commercial	$1,878.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.30
Rate for Payer: Qualcare PPO/HMO/WC	$563.62

PLATE VA-LCP 2.7MM 6H LT STER

Facility

$4,156.05

Service Code	HCPCS C1713
Hospital Charge Code	270675144
Hospital Revenue Code	278
Min. Negotiated Rate	$623.41
Max. Negotiated Rate	$1,005.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$831.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.76
Rate for Payer: Qualcare PPO/HMO/WC	$623.41

PLATE VA-LCP 2.7MM 6H LT STER

Facility

$4,156.05

Service Code	HCPCS C1713
Hospital Charge Code	270675144
Hospital Revenue Code	278
Min. Negotiated Rate	$623.41
Max. Negotiated Rate	$2,078.03
Rate for Payer: Aetna Commercial	$1,246.82
Rate for Payer: Aetna Medicare Advantage	$1,246.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,059.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,059.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$831.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,059.79
Rate for Payer: Cigna Commercial	$2,078.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,005.76
Rate for Payer: Qualcare PPO/HMO/WC	$623.41

PLATE VA-LCP 2.7MM 6HOLE LEFT

Facility

$3,834.00

Hospital Charge Code	270676464
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$1,917.00
Rate for Payer: Aetna Commercial	$1,150.20
Rate for Payer: Aetna Medicare Advantage	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.67
Rate for Payer: Cigna Commercial	$1,917.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: Qualcare PPO/HMO/WC	$575.10

PLATE VA-LCP 2.7MM 6HOLE LEFT

Facility

$3,834.00

Hospital Charge Code	270676464
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$927.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: Qualcare PPO/HMO/WC	$575.10

PLATE VA-LCP 2.7MM 6HOLE RT

Facility

$3,834.00

Hospital Charge Code	270676463
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$927.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: Qualcare PPO/HMO/WC	$575.10

PLATE VA-LCP 2.7MM 6HOLE RT

Facility

$3,834.00

Hospital Charge Code	270676463
Hospital Revenue Code	278
Min. Negotiated Rate	$575.10
Max. Negotiated Rate	$1,917.00
Rate for Payer: Aetna Commercial	$1,150.20
Rate for Payer: Aetna Medicare Advantage	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$977.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$766.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$977.67
Rate for Payer: Cigna Commercial	$1,917.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$927.83
Rate for Payer: Qualcare PPO/HMO/WC	$575.10

PLATE VA-LCP 2.7MM 6H RT STER

Facility

$4,280.75

Service Code	HCPCS C1713
Hospital Charge Code	270668008
Hospital Revenue Code	278
Min. Negotiated Rate	$642.11
Max. Negotiated Rate	$1,035.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.94
Rate for Payer: Qualcare PPO/HMO/WC	$642.11

PLATE VA-LCP 2.7MM 6H RT STER

Facility

$4,280.75

Service Code	HCPCS C1713
Hospital Charge Code	270668008
Hospital Revenue Code	278
Min. Negotiated Rate	$642.11
Max. Negotiated Rate	$2,140.38
Rate for Payer: Aetna Commercial	$1,284.22
Rate for Payer: Aetna Medicare Advantage	$1,284.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,091.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,091.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,091.59
Rate for Payer: Cigna Commercial	$2,140.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.94
Rate for Payer: Qualcare PPO/HMO/WC	$642.11

PLATE VA-LCP 2.7MM 7HOLE LEFT

Facility

$4,014.00

Hospital Charge Code	270676466
Hospital Revenue Code	278
Min. Negotiated Rate	$602.10
Max. Negotiated Rate	$2,007.00
Rate for Payer: Aetna Commercial	$1,204.20
Rate for Payer: Aetna Medicare Advantage	$1,204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.57
Rate for Payer: Cigna Commercial	$2,007.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.39
Rate for Payer: Qualcare PPO/HMO/WC	$602.10

PLATE VA-LCP 2.7MM 7HOLE LEFT

Facility

$4,014.00

Hospital Charge Code	270676466
Hospital Revenue Code	278
Min. Negotiated Rate	$602.10
Max. Negotiated Rate	$971.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.39
Rate for Payer: Qualcare PPO/HMO/WC	$602.10

PLATE VA-LCP 2.7x73MM 2H RT ST

Facility

$4,125.15

Service Code	HCPCS C1713
Hospital Charge Code	270675394
Hospital Revenue Code	278
Min. Negotiated Rate	$618.77
Max. Negotiated Rate	$998.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.29
Rate for Payer: Qualcare PPO/HMO/WC	$618.77

PLATE VA-LCP 2.7x73MM 2H RT ST

Facility

$4,125.15

Service Code	HCPCS C1713
Hospital Charge Code	270675394
Hospital Revenue Code	278
Min. Negotiated Rate	$618.77
Max. Negotiated Rate	$2,062.57
Rate for Payer: Aetna Commercial	$1,237.55
Rate for Payer: Aetna Medicare Advantage	$1,237.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.91
Rate for Payer: Cigna Commercial	$2,062.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.29
Rate for Payer: Qualcare PPO/HMO/WC	$618.77

PLATE VA-LCP 4HOLE LEFT 3.5

Facility

$6,912.85

Service Code	HCPCS C1713
Hospital Charge Code	270664331
Hospital Revenue Code	278
Min. Negotiated Rate	$1,036.93
Max. Negotiated Rate	$3,456.43
Rate for Payer: Aetna Commercial	$2,073.86
Rate for Payer: Aetna Medicare Advantage	$2,073.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,762.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,762.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,382.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,762.78
Rate for Payer: Cigna Commercial	$3,456.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,672.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,036.93

PLATE VA-LCP 4HOLE LEFT 3.5

Facility

$6,912.85

Service Code	HCPCS C1713
Hospital Charge Code	270664331
Hospital Revenue Code	278
Min. Negotiated Rate	$1,036.93
Max. Negotiated Rate	$1,672.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,382.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,672.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,036.93

PLATE VA LCP CALCANEAL LEFT 2.

Facility

$4,656.25

Service Code	HCPCS C1713
Hospital Charge Code	270680485
Hospital Revenue Code	278
Min. Negotiated Rate	$698.44
Max. Negotiated Rate	$1,126.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$931.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,126.81
Rate for Payer: Qualcare PPO/HMO/WC	$698.44

PLATE VA LCP CALCANEAL LEFT 2.

Facility

$4,656.25

Service Code	HCPCS C1713
Hospital Charge Code	270680485
Hospital Revenue Code	278
Min. Negotiated Rate	$698.44
Max. Negotiated Rate	$2,328.12
Rate for Payer: Aetna Commercial	$1,396.88
Rate for Payer: Aetna Medicare Advantage	$1,396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,187.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,187.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$931.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,187.34
Rate for Payer: Cigna Commercial	$2,328.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,126.81
Rate for Payer: Qualcare PPO/HMO/WC	$698.44

PLATE VA LCP CONDYL 4.5 10H LT

Facility

$7,564.30

Service Code	HCPCS C1713
Hospital Charge Code	270676131
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.64
Max. Negotiated Rate	$1,830.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.64

PLATE VA LCP CONDYL 4.5 10H LT

Facility

$7,564.30

Service Code	HCPCS C1713
Hospital Charge Code	270676131
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.64
Max. Negotiated Rate	$3,782.15
Rate for Payer: Aetna Commercial	$2,269.29
Rate for Payer: Aetna Medicare Advantage	$2,269.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,928.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,928.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,928.90
Rate for Payer: Cigna Commercial	$3,782.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.64

PLATE VA-LCP DISTAL 4H/2.7mm S

Facility

$3,943.35

Service Code	HCPCS C1713
Hospital Charge Code	270681946
Hospital Revenue Code	278
Min. Negotiated Rate	$591.50
Max. Negotiated Rate	$954.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.29
Rate for Payer: Qualcare PPO/HMO/WC	$591.50

PLATE VA-LCP DISTAL 4H/2.7mm S

Facility

$3,943.35

Service Code	HCPCS C1713
Hospital Charge Code	270681946
Hospital Revenue Code	278
Min. Negotiated Rate	$591.50
Max. Negotiated Rate	$1,971.67
Rate for Payer: Aetna Commercial	$1,183.01
Rate for Payer: Aetna Medicare Advantage	$1,183.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,005.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,005.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$788.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,005.55
Rate for Payer: Cigna Commercial	$1,971.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.29
Rate for Payer: Qualcare PPO/HMO/WC	$591.50

PLATE VA-LCP DRP 7H HD 2H SH

Facility

$10,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270699102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,596.00
Max. Negotiated Rate	$2,574.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,596.00

PLATE VA-LCP DRP 7H HD 2H SH

Facility

$10,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270699102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,596.00
Max. Negotiated Rate	$5,320.00
Rate for Payer: Aetna Commercial	$3,192.00
Rate for Payer: Aetna Medicare Advantage	$3,192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,713.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,713.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,713.20
Rate for Payer: Cigna Commercial	$5,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,574.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,596.00

PLATE VA-LCP DRSL 2.4 2H/3H+90

Facility

$2,506.00

Service Code	HCPCS C1713
Hospital Charge Code	270661606
Hospital Revenue Code	278
Min. Negotiated Rate	$375.90
Max. Negotiated Rate	$1,253.00
Rate for Payer: Aetna Commercial	$751.80
Rate for Payer: Aetna Medicare Advantage	$751.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.03
Rate for Payer: Cigna Commercial	$1,253.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.45
Rate for Payer: Qualcare PPO/HMO/WC	$375.90

Know your out-of-pocket cost for care.

All Charges