Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLT PERI FIB 4HOLE RT 23471704

Facility

$2,076.30

Hospital Charge Code	270640540
Hospital Revenue Code	278
Min. Negotiated Rate	$311.44
Max. Negotiated Rate	$502.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.46
Rate for Payer: Qualcare PPO/HMO/WC	$311.44

PLT PERI FIB 4HOLE RT 23471704

Facility

$2,076.30

Hospital Charge Code	270640540
Hospital Revenue Code	278
Min. Negotiated Rate	$311.44
Max. Negotiated Rate	$1,038.15
Rate for Payer: Aetna Commercial	$622.89
Rate for Payer: Aetna Medicare Advantage	$622.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$529.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$529.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$529.46
Rate for Payer: Cigna Commercial	$1,038.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.46
Rate for Payer: Qualcare PPO/HMO/WC	$311.44

PLT PERMTR CALCAN FRAC SM RT

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693864
Hospital Revenue Code	278
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$1,642.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

PLT PERMTR CALCAN FRAC SM RT

Facility

$5,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693864
Hospital Revenue Code	278
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$1,324.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,324.95
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

PLT PHER LEUK REDU CMV-NEG IRR

Facility

$4,463.55

Hospital Charge Code	3101529
Hospital Revenue Code	390
Min. Negotiated Rate	$669.53
Max. Negotiated Rate	$669.53
Rate for Payer: Qualcare PPO/HMO/WC	$669.53

PLT PHER LEUK REDU CMV-NEG IRR

Facility

$4,463.55

Hospital Charge Code	3101529
Hospital Revenue Code	390
Min. Negotiated Rate	$580.26
Max. Negotiated Rate	$2,231.78
Rate for Payer: Aetna Commercial	$1,339.07
Rate for Payer: Aetna Medicare Advantage	$1,339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.21
Rate for Payer: Cigna Commercial	$2,231.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.26
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$669.53
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLT PRX HUM HI LT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270693599
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.25
Max. Negotiated Rate	$1,716.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25

PLT PRX HUM HI LT 4H 90MM

Facility

$7,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270693599
Hospital Revenue Code	278
Min. Negotiated Rate	$1,064.25
Max. Negotiated Rate	$3,547.50
Rate for Payer: Aetna Commercial	$2,128.50
Rate for Payer: Aetna Medicare Advantage	$2,128.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,809.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,809.22
Rate for Payer: Cigna Commercial	$3,547.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,716.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,064.25

PLT SPINAL HA MIS FUSION

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693153
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$9,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLT SPINAL HA MIS FUSION

Facility

$40,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693153
Hospital Revenue Code	278
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$20,000.00
Rate for Payer: Aetna Commercial	$12,000.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$20,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,680.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

PLT SPINAL LAT 18X12X55MM 10D

Facility

$29,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693154
Hospital Revenue Code	278
Min. Negotiated Rate	$4,387.50
Max. Negotiated Rate	$14,625.00
Rate for Payer: Aetna Commercial	$8,775.00
Rate for Payer: Aetna Medicare Advantage	$8,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,458.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,458.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,458.75
Rate for Payer: Cigna Commercial	$14,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,078.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,387.50

PLT SPINAL LAT 18X12X55MM 10D

Facility

$29,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693154
Hospital Revenue Code	278
Min. Negotiated Rate	$4,387.50
Max. Negotiated Rate	$7,078.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,078.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,387.50

PLT SYNP Ti FAN 108m 085201215

Facility

$5,100.00

Hospital Charge Code	270640739
Hospital Revenue Code	278
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,234.20
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

PLT SYNP Ti FAN 108m 085201215

Facility

$5,100.00

Hospital Charge Code	270640739
Hospital Revenue Code	278
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$1,234.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,234.20
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

PLT TIB 4.5m PLT 4H RT23470504

Facility

$3,182.65

Hospital Charge Code	270635862
Hospital Revenue Code	278
Min. Negotiated Rate	$477.40
Max. Negotiated Rate	$1,591.33
Rate for Payer: Aetna Commercial	$954.79
Rate for Payer: Aetna Medicare Advantage	$954.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$811.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$811.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$636.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$811.58
Rate for Payer: Cigna Commercial	$1,591.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.20
Rate for Payer: Qualcare PPO/HMO/WC	$477.40

PLT TIB 4.5m PLT 4H RT23470504

Facility

$3,182.65

Hospital Charge Code	270635862
Hospital Revenue Code	278
Min. Negotiated Rate	$477.40
Max. Negotiated Rate	$770.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$636.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.20
Rate for Payer: Qualcare PPO/HMO/WC	$477.40

PLT VA-LCP AC 2.7X3.5MM 9H89MM

Facility

$5,051.60

Service Code	HCPCS C1713
Hospital Charge Code	270693550
Hospital Revenue Code	278
Min. Negotiated Rate	$757.74
Max. Negotiated Rate	$2,525.80
Rate for Payer: Aetna Commercial	$1,515.48
Rate for Payer: Aetna Medicare Advantage	$1,515.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,288.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,288.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,288.16
Rate for Payer: Cigna Commercial	$2,525.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.49
Rate for Payer: Qualcare PPO/HMO/WC	$757.74

PLT VA-LCP AC 2.7X3.5MM 9H89MM

Facility

$5,051.60

Service Code	HCPCS C1713
Hospital Charge Code	270693550
Hospital Revenue Code	278
Min. Negotiated Rate	$757.74
Max. Negotiated Rate	$1,222.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,010.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.49
Rate for Payer: Qualcare PPO/HMO/WC	$757.74

PLUG 10MM FRES H

Facility

$12,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270685328
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

PLUG 10MM FRES H

Facility

$12,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270685328
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

PLUG ACETABULAR DOME HOLE

Facility

$336.00

Hospital Charge Code	270676580
Hospital Revenue Code	278
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$100.80
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.31
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

PLUG ACETABULAR DOME HOLE

Facility

$336.00

Hospital Charge Code	270676580
Hospital Revenue Code	278
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$81.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.31
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

PLUG ATK ACL BONE 909693

Facility

$139.25

Hospital Charge Code	270613295
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

PLUG ATK ACL BONE 909693

Facility

$139.25

Hospital Charge Code	270613295
Hospital Revenue Code	272
Min. Negotiated Rate	$18.10
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$41.77
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.10
Rate for Payer: Oxford Commercial	$69.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$69.62

PLUG BIO-A

Facility

$1,265.00

Hospital Charge Code	270664707
Hospital Revenue Code	270
Min. Negotiated Rate	$189.75
Max. Negotiated Rate	$189.75
Rate for Payer: Qualcare PPO/HMO/WC	$189.75

Know your out-of-pocket cost for care.

All Charges