Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VA LKG CLC 2.7x70MM LTST

Facility

$4,712.25

Hospital Charge Code	270678308
Hospital Revenue Code	278
Min. Negotiated Rate	$706.84
Max. Negotiated Rate	$2,356.12
Rate for Payer: Aetna Commercial	$1,413.67
Rate for Payer: Aetna Medicare Advantage	$1,413.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,201.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,201.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$942.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,201.62
Rate for Payer: Cigna Commercial	$2,356.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.36
Rate for Payer: Qualcare PPO/HMO/WC	$706.84

PLATE VARIAX COMPR STR 8H102MM

Facility

$4,555.35

Service Code	HCPCS C1713
Hospital Charge Code	270692172
Hospital Revenue Code	278
Min. Negotiated Rate	$683.30
Max. Negotiated Rate	$2,277.68
Rate for Payer: Aetna Commercial	$1,366.61
Rate for Payer: Aetna Medicare Advantage	$1,366.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$911.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,161.61
Rate for Payer: Cigna Commercial	$2,277.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.39
Rate for Payer: Qualcare PPO/HMO/WC	$683.30

PLATE VARIAX COMPR STR 8H102MM

Facility

$4,555.35

Service Code	HCPCS C1713
Hospital Charge Code	270692172
Hospital Revenue Code	278
Min. Negotiated Rate	$683.30
Max. Negotiated Rate	$1,102.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$911.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.39
Rate for Payer: Qualcare PPO/HMO/WC	$683.30

PLATE VARIAX FIBULA 5 HOLES

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270667255
Hospital Revenue Code	278
Min. Negotiated Rate	$686.25
Max. Negotiated Rate	$1,107.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,107.15
Rate for Payer: Qualcare PPO/HMO/WC	$686.25

PLATE VARIAX FIBULA 5 HOLES

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270667255
Hospital Revenue Code	278
Min. Negotiated Rate	$686.25
Max. Negotiated Rate	$2,287.50
Rate for Payer: Aetna Commercial	$1,372.50
Rate for Payer: Aetna Medicare Advantage	$1,372.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,166.62
Rate for Payer: Cigna Commercial	$2,287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,107.15
Rate for Payer: Qualcare PPO/HMO/WC	$686.25

PLATE VDF 6 HOLE

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664947
Hospital Revenue Code	278
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$1,148.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: Qualcare PPO/HMO/WC	$711.75

PLATE VDF 6 HOLE

Facility

$4,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664947
Hospital Revenue Code	278
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$2,372.50
Rate for Payer: Aetna Commercial	$1,423.50
Rate for Payer: Aetna Medicare Advantage	$1,423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,209.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$949.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,209.97
Rate for Payer: Cigna Commercial	$2,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,148.29
Rate for Payer: Qualcare PPO/HMO/WC	$711.75

PLATE VDF 9 HOLES 149mm

Facility

$5,155.00

Hospital Charge Code	270665756
Hospital Revenue Code	278
Min. Negotiated Rate	$773.25
Max. Negotiated Rate	$2,577.50
Rate for Payer: Aetna Commercial	$1,546.50
Rate for Payer: Aetna Medicare Advantage	$1,546.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,314.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,314.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,031.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,314.53
Rate for Payer: Cigna Commercial	$2,577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,247.51
Rate for Payer: Qualcare PPO/HMO/WC	$773.25

PLATE VDF 9 HOLES 149mm

Facility

$5,155.00

Hospital Charge Code	270665756
Hospital Revenue Code	278
Min. Negotiated Rate	$773.25
Max. Negotiated Rate	$1,247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,031.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,247.51
Rate for Payer: Qualcare PPO/HMO/WC	$773.25

PLATE VDR 4HOLE

Facility

$9,075.00

Hospital Charge Code	270703377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$2,196.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

PLATE VDR 4HOLE

Facility

$9,075.00

Hospital Charge Code	270703377
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$4,537.50
Rate for Payer: Aetna Commercial	$2,722.50
Rate for Payer: Aetna Medicare Advantage	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,314.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,314.12
Rate for Payer: Cigna Commercial	$4,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,196.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25

PLATE VDR RT NARROW

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270647991
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$1,372.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

PLATE VDR RT NARROW

Facility

$5,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270647991
Hospital Revenue Code	278
Min. Negotiated Rate	$850.50
Max. Negotiated Rate	$2,835.00
Rate for Payer: Aetna Commercial	$1,701.00
Rate for Payer: Aetna Medicare Advantage	$1,701.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,445.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,134.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,445.85
Rate for Payer: Cigna Commercial	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.14
Rate for Payer: Qualcare PPO/HMO/WC	$850.50

PLATE VERSA FX 4H 86MM 135 ANG

Facility

$2,126.25

Hospital Charge Code	270673058
Hospital Revenue Code	278
Min. Negotiated Rate	$318.94
Max. Negotiated Rate	$1,063.12
Rate for Payer: Aetna Commercial	$637.88
Rate for Payer: Aetna Medicare Advantage	$637.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$542.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$542.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$542.19
Rate for Payer: Cigna Commercial	$1,063.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.55
Rate for Payer: Qualcare PPO/HMO/WC	$318.94

PLATE VERSA FX 4H 86MM 135 ANG

Facility

$2,126.25

Hospital Charge Code	270673058
Hospital Revenue Code	278
Min. Negotiated Rate	$318.94
Max. Negotiated Rate	$514.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.55
Rate for Payer: Qualcare PPO/HMO/WC	$318.94

PLATE VHS 6 HOLE KEYLESS

Facility

$1,675.00

Hospital Charge Code	270658680
Hospital Revenue Code	278
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$502.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

PLATE VHS 6 HOLE KEYLESS

Facility

$1,675.00

Hospital Charge Code	270658680
Hospital Revenue Code	278
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$405.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.35
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

PLATE VHS 6HOLE KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	270635311
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$905.23
Rate for Payer: Aetna Commercial	$543.13
Rate for Payer: Aetna Medicare Advantage	$543.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.66
Rate for Payer: Cigna Commercial	$905.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

PLATE VHS 6HOLE KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	270635311
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$438.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

PLATE VHS 6-HOL KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	70635311
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$438.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

PLATE VHS 6-HOL KEYLESS 200306

Facility

$1,810.45

Hospital Charge Code	70635311
Hospital Revenue Code	278
Min. Negotiated Rate	$271.57
Max. Negotiated Rate	$905.23
Rate for Payer: Aetna Commercial	$543.13
Rate for Payer: Aetna Medicare Advantage	$543.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$362.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.66
Rate for Payer: Cigna Commercial	$905.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.13
Rate for Payer: Qualcare PPO/HMO/WC	$271.57

PLATE VOLAR 3H SHORT RT DVRASR

Facility

$3,447.25

Hospital Charge Code	270636495
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$1,723.62
Rate for Payer: Aetna Commercial	$1,034.17
Rate for Payer: Aetna Medicare Advantage	$1,034.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.05
Rate for Payer: Cigna Commercial	$1,723.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

PLATE VOLAR 3H SHORT RT DVRASR

Facility

$3,447.25

Hospital Charge Code	270636495
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$834.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

PLATE VOLAR DBL TIER RT DVR AR

Facility

$3,447.25

Hospital Charge Code	270635656
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$1,723.62
Rate for Payer: Aetna Commercial	$1,034.17
Rate for Payer: Aetna Medicare Advantage	$1,034.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.05
Rate for Payer: Cigna Commercial	$1,723.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

PLATE VOLAR DBL TIER RT DVR AR

Facility

$3,447.25

Hospital Charge Code	270635656
Hospital Revenue Code	278
Min. Negotiated Rate	$517.09
Max. Negotiated Rate	$834.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$689.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.23
Rate for Payer: Qualcare PPO/HMO/WC	$517.09

Know your out-of-pocket cost for care.

All Charges