Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PLATE WLZ CURVED 6H 2MM 019224

Facility

$805.65

Hospital Charge Code	270620857
Hospital Revenue Code	278
Min. Negotiated Rate	$120.85
Max. Negotiated Rate	$402.82
Rate for Payer: Aetna Commercial	$241.69
Rate for Payer: Aetna Medicare Advantage	$241.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.44
Rate for Payer: Cigna Commercial	$402.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.97
Rate for Payer: Qualcare PPO/HMO/WC	$120.85

PLATE WLZ CURVED 6H 2MM 019224

Facility

$805.65

Hospital Charge Code	270620857
Hospital Revenue Code	278
Min. Negotiated Rate	$120.85
Max. Negotiated Rate	$194.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.97
Rate for Payer: Qualcare PPO/HMO/WC	$120.85

PLATE WLZ L RT 2X2 HL 01-8015

Facility

$690.45

Hospital Charge Code	270607815
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

PLATE WLZ L RT 2X2 HL 01-8015

Facility

$690.45

Hospital Charge Code	270607815
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

PLATE WLZ L RT 2X2 HL 01-8052

Facility

$690.45

Hospital Charge Code	270607814
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

PLATE WLZ L RT 2X2 HL 01-8052

Facility

$690.45

Hospital Charge Code	270607814
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

PLATE WLZ MICRSYS 4H 01-9640

Facility

$959.25

Hospital Charge Code	270610839
Hospital Revenue Code	278
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$232.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

PLATE WLZ MICRSYS 4H 01-9640

Facility

$959.25

Hospital Charge Code	270610839
Hospital Revenue Code	278
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$287.77
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.14
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

PLATE WLZ ORB 4H 01-8010

Facility

$299.25

Hospital Charge Code	270622192
Hospital Revenue Code	278
Min. Negotiated Rate	$44.89
Max. Negotiated Rate	$149.62
Rate for Payer: Aetna Commercial	$89.78
Rate for Payer: Aetna Medicare Advantage	$89.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.31
Rate for Payer: Cigna Commercial	$149.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.42
Rate for Payer: Qualcare PPO/HMO/WC	$44.89

PLATE WLZ ORB 4H 01-8010

Facility

$299.25

Hospital Charge Code	270622192
Hospital Revenue Code	278
Min. Negotiated Rate	$44.89
Max. Negotiated Rate	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.42
Rate for Payer: Qualcare PPO/HMO/WC	$44.89

PLATE WLZ ORB 8H 01-8019

Facility

$551.25

Hospital Charge Code	270621847
Hospital Revenue Code	278
Min. Negotiated Rate	$82.69
Max. Negotiated Rate	$133.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.40
Rate for Payer: Qualcare PPO/HMO/WC	$82.69

PLATE WLZ ORB 8H 01-8019

Facility

$551.25

Hospital Charge Code	270621847
Hospital Revenue Code	278
Min. Negotiated Rate	$82.69
Max. Negotiated Rate	$275.62
Rate for Payer: Aetna Commercial	$165.38
Rate for Payer: Aetna Medicare Advantage	$165.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.57
Rate for Payer: Cigna Commercial	$275.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.40
Rate for Payer: Qualcare PPO/HMO/WC	$82.69

PLATE WLZ ORB MED 5MM 915-2808

Facility

$2,440.00

Hospital Charge Code	270621790
Hospital Revenue Code	278
Min. Negotiated Rate	$366.00
Max. Negotiated Rate	$1,220.00
Rate for Payer: Aetna Commercial	$732.00
Rate for Payer: Aetna Medicare Advantage	$732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.20
Rate for Payer: Cigna Commercial	$1,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.48
Rate for Payer: Qualcare PPO/HMO/WC	$366.00

PLATE WLZ ORB MED 5MM 915-2808

Facility

$2,440.00

Hospital Charge Code	270621790
Hospital Revenue Code	278
Min. Negotiated Rate	$366.00
Max. Negotiated Rate	$590.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.48
Rate for Payer: Qualcare PPO/HMO/WC	$366.00

PLATE X LORDTIR

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688431
Hospital Revenue Code	278
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$3,206.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

PLATE X LORDTIR

Facility

$13,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688431
Hospital Revenue Code	278
Min. Negotiated Rate	$1,987.50
Max. Negotiated Rate	$6,625.00
Rate for Payer: Aetna Commercial	$3,975.00
Rate for Payer: Aetna Medicare Advantage	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,378.75
Rate for Payer: Cigna Commercial	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,206.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.50

PLATE X MED TI 3.0MM

Facility

$4,285.50

Service Code	HCPCS C1713
Hospital Charge Code	270698367
Hospital Revenue Code	278
Min. Negotiated Rate	$642.83
Max. Negotiated Rate	$2,142.75
Rate for Payer: Aetna Commercial	$1,285.65
Rate for Payer: Aetna Medicare Advantage	$1,285.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$857.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.80
Rate for Payer: Cigna Commercial	$2,142.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,037.09
Rate for Payer: Qualcare PPO/HMO/WC	$642.83

PLATE X MED TI 3.0MM

Facility

$4,285.50

Service Code	HCPCS C1713
Hospital Charge Code	270698367
Hospital Revenue Code	278
Min. Negotiated Rate	$642.83
Max. Negotiated Rate	$1,037.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$857.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,037.09
Rate for Payer: Qualcare PPO/HMO/WC	$642.83

PLATE Y 7mm MTRX 04.503.377

Facility

$1,239.00

Hospital Charge Code	270640449
Hospital Revenue Code	278
Min. Negotiated Rate	$185.85
Max. Negotiated Rate	$619.50
Rate for Payer: Aetna Commercial	$371.70
Rate for Payer: Aetna Medicare Advantage	$371.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.94
Rate for Payer: Cigna Commercial	$619.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.84
Rate for Payer: Qualcare PPO/HMO/WC	$185.85

PLATE Y 7mm MTRX 04.503.377

Facility

$1,239.00

Hospital Charge Code	270640449
Hospital Revenue Code	278
Min. Negotiated Rate	$185.85
Max. Negotiated Rate	$299.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$247.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.84
Rate for Payer: Qualcare PPO/HMO/WC	$185.85

PLATE Y LONG 5HOLE

Facility

$1,680.00

Hospital Charge Code	270677109
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$504.00
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

PLATE Y LONG 5HOLE

Facility

$1,680.00

Hospital Charge Code	270677109
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

PLATE Y LONG DBL 6HOLE

Facility

$1,700.00

Hospital Charge Code	270677108
Hospital Revenue Code	278
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$510.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

PLATE Y LONG DBL 6HOLE

Facility

$1,700.00

Hospital Charge Code	270677108
Hospital Revenue Code	278
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$411.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.40
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

Know your out-of-pocket cost for care.

All Charges