Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ZAVATION 2MM

Facility

$13,000.00

Hospital Charge Code	270675884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$6,500.00
Rate for Payer: Aetna Commercial	$3,900.00
Rate for Payer: Aetna Medicare Advantage	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,315.00
Rate for Payer: Cigna Commercial	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

PLATE ZAVATION 2MM

Facility

$13,000.00

Hospital Charge Code	270675884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$3,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

PLATE ZAVATION CERV 2LEVEL26MM

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698829
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

PLATE ZAVATION CERV 2LEVEL26MM

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698829
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

PLATE ZEVO 35MM 2 LVL

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698646
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

PLATE ZEVO 35MM 2 LVL

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698646
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

PLATE ZEVO 39MM 2 LVL

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

PLATE ZEVO 39MM 2 LVL

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$3,375.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

PLATE ZEVO 3 LEVEL 57MM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697834
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$3,375.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

PLATE ZEVO 3 LEVEL 57MM

Facility

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697834
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

PLATE ZEVO 78MM 4 LEVEL

Facility

$12,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697821
Hospital Revenue Code	278
Min. Negotiated Rate	$1,912.50
Max. Negotiated Rate	$6,375.00
Rate for Payer: Aetna Commercial	$3,825.00
Rate for Payer: Aetna Medicare Advantage	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,251.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,251.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,251.25
Rate for Payer: Cigna Commercial	$6,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,085.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.50

PLATE ZEVO 78MM 4 LEVEL

Facility

$12,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697821
Hospital Revenue Code	278
Min. Negotiated Rate	$1,912.50
Max. Negotiated Rate	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,085.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,912.50

PLATE ZEVO ANT CERV LEV3 53MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695967
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

PLATE ZEVO ANT CERV LEV3 53MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695967
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

PLATE ZIM 1/3 TUB 6H 236106

Facility

$320.85

Hospital Charge Code	270610254
Hospital Revenue Code	278
Min. Negotiated Rate	$48.13
Max. Negotiated Rate	$77.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.13

PLATE ZIM 1/3 TUB 6H 236106

Facility

$320.85

Hospital Charge Code	270610254
Hospital Revenue Code	278
Min. Negotiated Rate	$48.13
Max. Negotiated Rate	$160.43
Rate for Payer: Aetna Commercial	$96.25
Rate for Payer: Aetna Medicare Advantage	$96.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.82
Rate for Payer: Cigna Commercial	$160.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.13

PLATE ZIM 1/3 TUB 7H 236107

Facility

$150.45

Hospital Charge Code	270607163
Hospital Revenue Code	278
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$75.22
Rate for Payer: Aetna Commercial	$45.13
Rate for Payer: Aetna Medicare Advantage	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.36
Rate for Payer: Cigna Commercial	$75.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.41
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

PLATE ZIM 1/3 TUB 7H 236107

Facility

$150.45

Hospital Charge Code	270607163
Hospital Revenue Code	278
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$36.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.41
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

PLATE ZIM CB 246 8H 2232-03-02

Facility

$3,725.65

Hospital Charge Code	270617129
Hospital Revenue Code	278
Min. Negotiated Rate	$558.85
Max. Negotiated Rate	$901.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.61
Rate for Payer: Qualcare PPO/HMO/WC	$558.85

PLATE ZIM CB 246 8H 2232-03-02

Facility

$3,725.65

Hospital Charge Code	270617129
Hospital Revenue Code	278
Min. Negotiated Rate	$558.85
Max. Negotiated Rate	$1,862.83
Rate for Payer: Aetna Commercial	$1,117.69
Rate for Payer: Aetna Medicare Advantage	$1,117.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$950.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$950.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$950.04
Rate for Payer: Cigna Commercial	$1,862.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.61
Rate for Payer: Qualcare PPO/HMO/WC	$558.85

PLATE ZIM FRL 10 135 118113510

Facility

$2,368.85

Hospital Charge Code	270617282
Hospital Revenue Code	278
Min. Negotiated Rate	$355.33
Max. Negotiated Rate	$1,184.42
Rate for Payer: Aetna Commercial	$710.65
Rate for Payer: Aetna Medicare Advantage	$710.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$473.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.06
Rate for Payer: Cigna Commercial	$1,184.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.26
Rate for Payer: Qualcare PPO/HMO/WC	$355.33

PLATE ZIM FRL 10 135 118113510

Facility

$2,368.85

Hospital Charge Code	270617282
Hospital Revenue Code	278
Min. Negotiated Rate	$355.33
Max. Negotiated Rate	$573.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$473.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.26
Rate for Payer: Qualcare PPO/HMO/WC	$355.33

PLATE ZIM FRL 4H 130 118113004

Facility

$1,609.65

Hospital Charge Code	270607312
Hospital Revenue Code	278
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$389.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

PLATE ZIM FRL 4H 130 118113004

Facility

$1,609.65

Hospital Charge Code	270607312
Hospital Revenue Code	278
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$804.83
Rate for Payer: Aetna Commercial	$482.89
Rate for Payer: Aetna Medicare Advantage	$482.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.46
Rate for Payer: Cigna Commercial	$804.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

PLATE ZIM FRL 4H 135 118113504

Facility

$1,585.05

Service Code	HCPCS C1713
Hospital Charge Code	270601785
Hospital Revenue Code	278
Min. Negotiated Rate	$237.76
Max. Negotiated Rate	$383.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.58
Rate for Payer: Qualcare PPO/HMO/WC	$237.76

Know your out-of-pocket cost for care.

All Charges