Heights University Hospital

All Charges

Charge

Type

Setting

Price

T-PLATE 2.0MM 3HOLE/8HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654827
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$265.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

TPLATE 2.0 TITANIUM 3-H 447233

Facility

$1,030.00

Hospital Charge Code	270634475
Hospital Revenue Code	272
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$154.50
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

TPLATE 2.0 TITANIUM 3-H 447233

Facility

$1,030.00

Hospital Charge Code	270634475
Hospital Revenue Code	272
Min. Negotiated Rate	$133.90
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$309.00
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.90
Rate for Payer: Oxford Commercial	$515.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.50
Rate for Payer: UnitedHealthcare Commercial	$515.00

T-PLATE 2.0x18MM 2HOLE 18MM

Facility

$234.85

Service Code	HCPCS C1713
Hospital Charge Code	270604348
Hospital Revenue Code	278
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$117.42
Rate for Payer: Aetna Commercial	$70.45
Rate for Payer: Aetna Medicare Advantage	$70.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.89
Rate for Payer: Cigna Commercial	$117.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$35.23

T-PLATE 2.0x18MM 2HOLE 18MM

Facility

$234.85

Service Code	HCPCS C1713
Hospital Charge Code	270604348
Hospital Revenue Code	278
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$56.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.83
Rate for Payer: Qualcare PPO/HMO/WC	$35.23

T-PLATE 2.4MM 2HOLE/8HOLE

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270654860
Hospital Revenue Code	278
Min. Negotiated Rate	$165.47
Max. Negotiated Rate	$266.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: Qualcare PPO/HMO/WC	$165.47

T-PLATE 2.4MM 2HOLE/8HOLE

Facility

$1,103.15

Service Code	HCPCS C1713
Hospital Charge Code	270654860
Hospital Revenue Code	278
Min. Negotiated Rate	$165.47
Max. Negotiated Rate	$551.58
Rate for Payer: Aetna Commercial	$330.94
Rate for Payer: Aetna Medicare Advantage	$330.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.30
Rate for Payer: Cigna Commercial	$551.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.96
Rate for Payer: Qualcare PPO/HMO/WC	$165.47

T-PLATE 2.4MM 3HOLE/8HOLE

Facility

$1,174.20

Service Code	HCPCS C1713
Hospital Charge Code	270654861
Hospital Revenue Code	278
Min. Negotiated Rate	$176.13
Max. Negotiated Rate	$587.10
Rate for Payer: Aetna Commercial	$352.26
Rate for Payer: Aetna Medicare Advantage	$352.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.42
Rate for Payer: Cigna Commercial	$587.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.16
Rate for Payer: Qualcare PPO/HMO/WC	$176.13

T-PLATE 2.4MM 3HOLE/8HOLE

Facility

$1,174.20

Service Code	HCPCS C1713
Hospital Charge Code	270654861
Hospital Revenue Code	278
Min. Negotiated Rate	$176.13
Max. Negotiated Rate	$284.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.16
Rate for Payer: Qualcare PPO/HMO/WC	$176.13

T-PLATE 2.4MM 6 HOLE

Facility

$4,306.25

Service Code	HCPCS C1713
Hospital Charge Code	270700108
Hospital Revenue Code	278
Min. Negotiated Rate	$645.94
Max. Negotiated Rate	$2,153.12
Rate for Payer: Aetna Commercial	$1,291.88
Rate for Payer: Aetna Medicare Advantage	$1,291.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,098.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,098.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$861.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,098.09
Rate for Payer: Cigna Commercial	$2,153.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.11
Rate for Payer: Qualcare PPO/HMO/WC	$645.94

T-PLATE 2.4MM 6 HOLE

Facility

$4,306.25

Service Code	HCPCS C1713
Hospital Charge Code	270700108
Hospital Revenue Code	278
Min. Negotiated Rate	$645.94
Max. Negotiated Rate	$1,042.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$861.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.11
Rate for Payer: Qualcare PPO/HMO/WC	$645.94

T-PLATE 2.4MM 6 HOLE

Facility

$4,306.25

Service Code	HCPCS C1713
Hospital Charge Code	270700083
Hospital Revenue Code	278
Min. Negotiated Rate	$645.94
Max. Negotiated Rate	$1,042.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$861.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.11
Rate for Payer: Qualcare PPO/HMO/WC	$645.94

T-PLATE 2.4MM 6 HOLE

Facility

$4,306.25

Service Code	HCPCS C1713
Hospital Charge Code	270700083
Hospital Revenue Code	278
Min. Negotiated Rate	$645.94
Max. Negotiated Rate	$2,153.12
Rate for Payer: Aetna Commercial	$1,291.88
Rate for Payer: Aetna Medicare Advantage	$1,291.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,098.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,098.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$861.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,098.09
Rate for Payer: Cigna Commercial	$2,153.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,042.11
Rate for Payer: Qualcare PPO/HMO/WC	$645.94

T-PLATE 2H HEAD 8H SHAFT 53MM

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270653004
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$503.68
Rate for Payer: Aetna Commercial	$302.20
Rate for Payer: Aetna Medicare Advantage	$302.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.87
Rate for Payer: Cigna Commercial	$503.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

T-PLATE 2H HEAD 8H SHAFT 53MM

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270653004
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$243.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

T-PLATE2 HOLE LCP 2.4MM 7HOLE

Facility

$3,150.85

Service Code	HCPCS C1713
Hospital Charge Code	270685438
Hospital Revenue Code	278
Min. Negotiated Rate	$472.63
Max. Negotiated Rate	$1,575.42
Rate for Payer: Aetna Commercial	$945.25
Rate for Payer: Aetna Medicare Advantage	$945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.47
Rate for Payer: Cigna Commercial	$1,575.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.51
Rate for Payer: Qualcare PPO/HMO/WC	$472.63

T-PLATE2 HOLE LCP 2.4MM 7HOLE

Facility

$3,150.85

Service Code	HCPCS C1713
Hospital Charge Code	270685438
Hospital Revenue Code	278
Min. Negotiated Rate	$472.63
Max. Negotiated Rate	$762.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.51
Rate for Payer: Qualcare PPO/HMO/WC	$472.63

T-PLATE 3.5MM 3H/3H OBL ANG

Facility

$936.25

Service Code	HCPCS C1713
Hospital Charge Code	270603405
Hospital Revenue Code	278
Min. Negotiated Rate	$140.44
Max. Negotiated Rate	$226.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.57
Rate for Payer: Qualcare PPO/HMO/WC	$140.44

T-PLATE 3.5MM 3H/3H OBL ANG

Facility

$936.25

Service Code	HCPCS C1713
Hospital Charge Code	270603405
Hospital Revenue Code	278
Min. Negotiated Rate	$140.44
Max. Negotiated Rate	$468.12
Rate for Payer: Aetna Commercial	$280.88
Rate for Payer: Aetna Medicare Advantage	$280.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.74
Rate for Payer: Cigna Commercial	$468.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.57
Rate for Payer: Qualcare PPO/HMO/WC	$140.44

T-PLATE 3.5MM 3H/3H RT ANG

Facility

$546.95

Service Code	HCPCS C1713
Hospital Charge Code	270603398
Hospital Revenue Code	278
Min. Negotiated Rate	$82.04
Max. Negotiated Rate	$273.48
Rate for Payer: Aetna Commercial	$164.09
Rate for Payer: Aetna Medicare Advantage	$164.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.47
Rate for Payer: Cigna Commercial	$273.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.36
Rate for Payer: Qualcare PPO/HMO/WC	$82.04

T-PLATE 3.5MM 3H/3H RT ANG

Facility

$546.95

Service Code	HCPCS C1713
Hospital Charge Code	270603398
Hospital Revenue Code	278
Min. Negotiated Rate	$82.04
Max. Negotiated Rate	$132.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.36
Rate for Payer: Qualcare PPO/HMO/WC	$82.04

T-PLATE 3.5MM 3H/5H OBL ANG

Facility

$1,019.70

Service Code	HCPCS C1713
Hospital Charge Code	270603407
Hospital Revenue Code	278
Min. Negotiated Rate	$152.96
Max. Negotiated Rate	$509.85
Rate for Payer: Aetna Commercial	$305.91
Rate for Payer: Aetna Medicare Advantage	$305.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.02
Rate for Payer: Cigna Commercial	$509.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96

T-PLATE 3.5MM 3H/5H OBL ANG

Facility

$1,019.70

Service Code	HCPCS C1713
Hospital Charge Code	270603407
Hospital Revenue Code	278
Min. Negotiated Rate	$152.96
Max. Negotiated Rate	$246.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.77
Rate for Payer: Qualcare PPO/HMO/WC	$152.96

T-PLATE 3.5MM 3H/5H RT ANG

Facility

$642.95

Service Code	HCPCS C1713
Hospital Charge Code	270601901
Hospital Revenue Code	278
Min. Negotiated Rate	$96.44
Max. Negotiated Rate	$321.48
Rate for Payer: Aetna Commercial	$192.88
Rate for Payer: Aetna Medicare Advantage	$192.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.95
Rate for Payer: Cigna Commercial	$321.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.59
Rate for Payer: Qualcare PPO/HMO/WC	$96.44

T-PLATE 3.5MM 3H/5H RT ANG

Facility

$642.95

Service Code	HCPCS C1713
Hospital Charge Code	270601901
Hospital Revenue Code	278
Min. Negotiated Rate	$96.44
Max. Negotiated Rate	$155.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.59
Rate for Payer: Qualcare PPO/HMO/WC	$96.44

Know your out-of-pocket cost for care.

All Charges