Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLTE 1.2MM 16HL STGHT 57-05116

Facility

$2,500.00

Hospital Charge Code	270648754
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

PLTE 1.2MM 16HL STGHT 57-05116

Facility

$2,500.00

Hospital Charge Code	270648754
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

PLTE 16HLE STRGHT LCK 57-10316

Facility

$3,250.00

Hospital Charge Code	270655363
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLTE 16HLE STRGHT LCK 57-10316

Facility

$3,250.00

Hospital Charge Code	270655363
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$975.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PLTE 3HL LFT DSTL SML234801403

Facility

$3,160.10

Hospital Charge Code	270637348
Hospital Revenue Code	278
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$1,580.05
Rate for Payer: Aetna Commercial	$948.03
Rate for Payer: Aetna Medicare Advantage	$948.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$632.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$805.83
Rate for Payer: Cigna Commercial	$1,580.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.74
Rate for Payer: Qualcare PPO/HMO/WC	$474.01

PLTE 3HL LFT DSTL SML234801403

Facility

$3,160.10

Hospital Charge Code	270637348
Hospital Revenue Code	278
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$764.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$632.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.74
Rate for Payer: Qualcare PPO/HMO/WC	$474.01

PLTE 3HL LFT DSTL SML234802203

Facility

$3,160.10

Hospital Charge Code	270637349
Hospital Revenue Code	278
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$1,580.05
Rate for Payer: Aetna Commercial	$948.03
Rate for Payer: Aetna Medicare Advantage	$948.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$632.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$805.83
Rate for Payer: Cigna Commercial	$1,580.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.74
Rate for Payer: Qualcare PPO/HMO/WC	$474.01

PLTE 3HL LFT DSTL SML234802203

Facility

$3,160.10

Hospital Charge Code	270637349
Hospital Revenue Code	278
Min. Negotiated Rate	$474.01
Max. Negotiated Rate	$764.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$632.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$764.74
Rate for Payer: Qualcare PPO/HMO/WC	$474.01

PLT ECT 1/3 TUBULAR 2-HOLE

Facility

$50.90

Hospital Charge Code	1602895
Hospital Revenue Code	274
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$25.45
Rate for Payer: Aetna Commercial	$15.27
Rate for Payer: Aetna Medicare Advantage	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.98
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

PLT ECT 1/3 TUBULAR 2-HOLE

Facility

$50.90

Hospital Charge Code	1602895
Hospital Revenue Code	274
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.63

PLTE LT VOLAR SMART LCK5425376

Facility

$4,995.00

Hospital Charge Code	270640883
Hospital Revenue Code	278
Min. Negotiated Rate	$749.25
Max. Negotiated Rate	$1,208.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.79
Rate for Payer: Qualcare PPO/HMO/WC	$749.25

PLTE LT VOLAR SMART LCK5425376

Facility

$4,995.00

Hospital Charge Code	270640883
Hospital Revenue Code	278
Min. Negotiated Rate	$749.25
Max. Negotiated Rate	$2,497.50
Rate for Payer: Aetna Commercial	$1,498.50
Rate for Payer: Aetna Medicare Advantage	$1,498.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$999.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.72
Rate for Payer: Cigna Commercial	$2,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.79
Rate for Payer: Qualcare PPO/HMO/WC	$749.25

PLT FIB 10 HOLES RT2347-017-10

Facility

$2,422.90

Hospital Charge Code	270634935
Hospital Revenue Code	278
Min. Negotiated Rate	$363.44
Max. Negotiated Rate	$1,211.45
Rate for Payer: Aetna Commercial	$726.87
Rate for Payer: Aetna Medicare Advantage	$726.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.84
Rate for Payer: Cigna Commercial	$1,211.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.34
Rate for Payer: Qualcare PPO/HMO/WC	$363.44

PLT FIB 10 HOLES RT2347-017-10

Facility

$2,422.90

Hospital Charge Code	270634935
Hospital Revenue Code	278
Min. Negotiated Rate	$363.44
Max. Negotiated Rate	$586.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$484.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.34
Rate for Payer: Qualcare PPO/HMO/WC	$363.44

PLT/FRACTURE 4 HOLES W BAR

Facility

$1,969.90

Service Code	HCPCS C1713
Hospital Charge Code	270705883
Hospital Revenue Code	278
Min. Negotiated Rate	$295.49
Max. Negotiated Rate	$984.95
Rate for Payer: Aetna Commercial	$590.97
Rate for Payer: Aetna Medicare Advantage	$590.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$502.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$502.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$502.32
Rate for Payer: Cigna Commercial	$984.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.72
Rate for Payer: Qualcare PPO/HMO/WC	$295.49

PLT/FRACTURE 4 HOLES W BAR

Facility

$1,969.90

Service Code	HCPCS C1713
Hospital Charge Code	270705883
Hospital Revenue Code	278
Min. Negotiated Rate	$295.49
Max. Negotiated Rate	$476.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$393.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$476.72
Rate for Payer: Qualcare PPO/HMO/WC	$295.49

PLT LEUK REDU APH/PHER CMV-NEG

Facility

$3,302.85

Hospital Charge Code	3101531
Hospital Revenue Code	390
Min. Negotiated Rate	$495.43
Max. Negotiated Rate	$495.43
Rate for Payer: Qualcare PPO/HMO/WC	$495.43

PLT LEUK REDU APH/PHER CMV-NEG

Facility

$3,302.85

Hospital Charge Code	3101531
Hospital Revenue Code	390
Min. Negotiated Rate	$429.37
Max. Negotiated Rate	$1,651.42
Rate for Payer: Aetna Commercial	$990.86
Rate for Payer: Aetna Medicare Advantage	$990.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$842.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$842.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$842.23
Rate for Payer: Cigna Commercial	$1,651.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.37
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.43
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLT/MINI 4 HOLES WITH BAR

Facility

$553.45

Service Code	HCPCS C1713
Hospital Charge Code	270705884
Hospital Revenue Code	278
Min. Negotiated Rate	$83.02
Max. Negotiated Rate	$133.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.93
Rate for Payer: Qualcare PPO/HMO/WC	$83.02

PLT/MINI 4 HOLES WITH BAR

Facility

$553.45

Service Code	HCPCS C1713
Hospital Charge Code	270705884
Hospital Revenue Code	278
Min. Negotiated Rate	$83.02
Max. Negotiated Rate	$276.73
Rate for Payer: Aetna Commercial	$166.03
Rate for Payer: Aetna Medicare Advantage	$166.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.13
Rate for Payer: Cigna Commercial	$276.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.93
Rate for Payer: Qualcare PPO/HMO/WC	$83.02

PLT MSH 1.3m RIGID 30m 421.018

Facility

$3,343.25

Hospital Charge Code	270635019
Hospital Revenue Code	278
Min. Negotiated Rate	$501.49
Max. Negotiated Rate	$1,671.62
Rate for Payer: Aetna Commercial	$1,002.98
Rate for Payer: Aetna Medicare Advantage	$1,002.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$852.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$852.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$852.53
Rate for Payer: Cigna Commercial	$1,671.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$809.07
Rate for Payer: Qualcare PPO/HMO/WC	$501.49

PLT MSH 1.3m RIGID 30m 421.018

Facility

$3,343.25

Hospital Charge Code	270635019
Hospital Revenue Code	278
Min. Negotiated Rate	$501.49
Max. Negotiated Rate	$809.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$809.07
Rate for Payer: Qualcare PPO/HMO/WC	$501.49

PLT NARROW SELF COMP 2-5 H***

Facility

$212.00

Hospital Charge Code	1602523
Hospital Revenue Code	274
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

PLT NARROW SELF COMP 2-5 H***

Facility

$212.00

Hospital Charge Code	1602523
Hospital Revenue Code	274
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

PLT NARROW SELF COMP 6-9 H***

Facility

$237.00

Hospital Charge Code	1602531
Hospital Revenue Code	274
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$118.50
Rate for Payer: Aetna Commercial	$71.10
Rate for Payer: Aetna Medicare Advantage	$71.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.44
Rate for Payer: Cigna Commercial	$118.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.35
Rate for Payer: Qualcare PPO/HMO/WC	$35.55

Know your out-of-pocket cost for care.

All Charges