Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE VOLAR DIST RADIUS 3H/LF

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678459
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE VOLAR DIST RADIUS 3H/LF

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270678459
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE VOLAR DR L54 4 HOLE

Facility

$9,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705669
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 VOLAR DR L54 4 HOLE

Facility

$9,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705669
Hospital Revenue Code	278
Min. Negotiated Rate	$1,361.25
Max. Negotiated Rate	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,361.25
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

PLATE VOLAR RADIUS 3H L STD

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270661791
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE VOLAR RADIUS 3H L STD

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270661791
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE WAISTED COMPR 10H 136MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270671803
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED COMPR 10H 136MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270671803
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$394.50
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED COMPR 8H 4x110MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270664730
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$318.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED COMPR 8H 4x110MM

Facility

$1,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270664730
Hospital Revenue Code	278
Min. Negotiated Rate	$197.25
Max. Negotiated Rate	$657.50
Rate for Payer: Aetna Commercial	$394.50
Rate for Payer: Aetna Medicare Advantage	$394.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.32
Rate for Payer: Cigna Commercial	$657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.23
Rate for Payer: Qualcare PPO/HMO/WC	$197.25

PLATE WAISTED NRW 2H 187MM

Facility

$1,485.00

Hospital Charge Code	270673797
Hospital Revenue Code	278
Min. Negotiated Rate	$222.75
Max. Negotiated Rate	$742.50
Rate for Payer: Aetna Commercial	$445.50
Rate for Payer: Aetna Medicare Advantage	$445.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.68
Rate for Payer: Cigna Commercial	$742.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.37
Rate for Payer: Qualcare PPO/HMO/WC	$222.75

PLATE WAISTED NRW 2H 187MM

Facility

$1,485.00

Hospital Charge Code	270673797
Hospital Revenue Code	278
Min. Negotiated Rate	$222.75
Max. Negotiated Rate	$359.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$297.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.37
Rate for Payer: Qualcare PPO/HMO/WC	$222.75

PLATE WEDGE BASE OPEN 4MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677039
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE WEDGE BASE OPEN 4MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270677039
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

PLATE WIDE LOCKED 28x56mm

Facility

$5,720.00

Service Code	HCPCS C1713
Hospital Charge Code	270672339
Hospital Revenue Code	278
Min. Negotiated Rate	$858.00
Max. Negotiated Rate	$1,384.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.24
Rate for Payer: Qualcare PPO/HMO/WC	$858.00

PLATE WIDE LOCKED 28x56mm

Facility

$5,720.00

Service Code	HCPCS C1713
Hospital Charge Code	270672339
Hospital Revenue Code	278
Min. Negotiated Rate	$858.00
Max. Negotiated Rate	$2,860.00
Rate for Payer: Aetna Commercial	$1,716.00
Rate for Payer: Aetna Medicare Advantage	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,458.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,458.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,458.60
Rate for Payer: Cigna Commercial	$2,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,384.24
Rate for Payer: Qualcare PPO/HMO/WC	$858.00

PLATE WIDE LOCKED RT 28x56MM

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270673691
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 WIDE LOCKED RT 28x56MM

Facility

$4,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270673691
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 WITH BAR STRAIGHT 4 HOLE

Facility

$2,500.00

Hospital Charge Code	270669466
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PLATE WITH BAR STRAIGHT 4 HOLE

Facility

$2,500.00

Hospital Charge Code	270669466
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PLATE WLZ 4H 40 45DEG 01-9672

Facility

$760.85

Hospital Charge Code	270612244
Hospital Revenue Code	278
Min. Negotiated Rate	$114.13
Max. Negotiated Rate	$184.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.13

PLATE WLZ 4H 40 45DEG 01-9672

Facility

$760.85

Hospital Charge Code	270612244
Hospital Revenue Code	278
Min. Negotiated Rate	$114.13
Max. Negotiated Rate	$380.43
Rate for Payer: Aetna Commercial	$228.25
Rate for Payer: Aetna Medicare Advantage	$228.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$152.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.02
Rate for Payer: Cigna Commercial	$380.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.13

PLATE WLZ 4H ST 2.7 01-9641

Facility

$765.65

Hospital Charge Code	270622228
Hospital Revenue Code	278
Min. Negotiated Rate	$114.85
Max. Negotiated Rate	$185.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.29
Rate for Payer: Qualcare PPO/HMO/WC	$114.85

PLATE WLZ 4H ST 2.7 01-9641

Facility

$765.65

Hospital Charge Code	270622228
Hospital Revenue Code	278
Min. Negotiated Rate	$114.85
Max. Negotiated Rate	$382.82
Rate for Payer: Aetna Commercial	$229.69
Rate for Payer: Aetna Medicare Advantage	$229.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.24
Rate for Payer: Cigna Commercial	$382.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.29
Rate for Payer: Qualcare PPO/HMO/WC	$114.85

PLATE WLZ BONE 6H 2MM 019289

Facility

$85.65

Hospital Charge Code	270620854
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$25.70
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

Know your out-of-pocket cost for care.

All Charges