Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE FIB PIT 13 HI ANTMCL RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270702043
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$1,660.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE FIB PIT 13 HI ANTMCL RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270702043
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$3,430.62
Rate for Payer: Aetna Commercial	$2,058.38
Rate for Payer: Aetna Medicare Advantage	$2,058.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,749.62
Rate for Payer: Cigna Commercial	$3,430.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE FIBULA 11 HOLE 2.7

Facility

$4,602.00

Hospital Charge Code	270664325
Hospital Revenue Code	278
Min. Negotiated Rate	$690.30
Max. Negotiated Rate	$1,113.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$920.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.68
Rate for Payer: Qualcare PPO/HMO/WC	$690.30

PLATE FIBULA 11 HOLE 2.7

Facility

$4,602.00

Hospital Charge Code	270664325
Hospital Revenue Code	278
Min. Negotiated Rate	$690.30
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$1,380.60
Rate for Payer: Aetna Medicare Advantage	$1,380.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$920.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,173.51
Rate for Payer: Cigna Commercial	$2,301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,113.68
Rate for Payer: Qualcare PPO/HMO/WC	$690.30

PLATE FIBULA 4 HOLE 88MM

Facility

$3,303.30

Service Code	HCPCS C1713
Hospital Charge Code	270660367
Hospital Revenue Code	278
Min. Negotiated Rate	$495.50
Max. Negotiated Rate	$799.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.40
Rate for Payer: Qualcare PPO/HMO/WC	$495.50

PLATE FIBULA 4 HOLE 88MM

Facility

$3,303.30

Service Code	HCPCS C1713
Hospital Charge Code	270660367
Hospital Revenue Code	278
Min. Negotiated Rate	$495.50
Max. Negotiated Rate	$1,651.65
Rate for Payer: Aetna Commercial	$990.99
Rate for Payer: Aetna Medicare Advantage	$990.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$842.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$842.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$842.34
Rate for Payer: Cigna Commercial	$1,651.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$799.40
Rate for Payer: Qualcare PPO/HMO/WC	$495.50

PLATE FIBULA 4 HOLE RIGHT 2.7/

Facility

$4,118.90

Service Code	HCPCS C1713
Hospital Charge Code	270668000
Hospital Revenue Code	278
Min. Negotiated Rate	$617.84
Max. Negotiated Rate	$996.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.77
Rate for Payer: Qualcare PPO/HMO/WC	$617.84

PLATE FIBULA 4 HOLE RIGHT 2.7/

Facility

$4,118.90

Service Code	HCPCS C1713
Hospital Charge Code	270668000
Hospital Revenue Code	278
Min. Negotiated Rate	$617.84
Max. Negotiated Rate	$2,059.45
Rate for Payer: Aetna Commercial	$1,235.67
Rate for Payer: Aetna Medicare Advantage	$1,235.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$823.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,050.32
Rate for Payer: Cigna Commercial	$2,059.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$996.77
Rate for Payer: Qualcare PPO/HMO/WC	$617.84

PLATE FIBULA 5H LEFT

Facility

$2,679.05

Service Code	HCPCS C1713
Hospital Charge Code	270664044
Hospital Revenue Code	278
Min. Negotiated Rate	$401.86
Max. Negotiated Rate	$1,339.53
Rate for Payer: Aetna Commercial	$803.72
Rate for Payer: Aetna Medicare Advantage	$803.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.16
Rate for Payer: Cigna Commercial	$1,339.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.33
Rate for Payer: Qualcare PPO/HMO/WC	$401.86

PLATE FIBULA 5H LEFT

Facility

$2,679.05

Service Code	HCPCS C1713
Hospital Charge Code	270664044
Hospital Revenue Code	278
Min. Negotiated Rate	$401.86
Max. Negotiated Rate	$648.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.33
Rate for Payer: Qualcare PPO/HMO/WC	$401.86

PLATE FIBULA 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691916
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE FIBULA 5 HOLE

Facility

$3,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691916
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

PLATE FIBULA 7 HOLE

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270668350
Hospital Revenue Code	278
Min. Negotiated Rate	$468.00
Max. Negotiated Rate	$755.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: Qualcare PPO/HMO/WC	$468.00

PLATE FIBULA 7 HOLE

Facility

$3,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270668350
Hospital Revenue Code	278
Min. Negotiated Rate	$468.00
Max. Negotiated Rate	$1,560.00
Rate for Payer: Aetna Commercial	$936.00
Rate for Payer: Aetna Medicare Advantage	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$624.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$795.60
Rate for Payer: Cigna Commercial	$1,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$755.04
Rate for Payer: Qualcare PPO/HMO/WC	$468.00

PLATE FIBULA 7-HOLE 814123007

Facility

$580.40

Hospital Charge Code	270632507
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$290.20
Rate for Payer: Aetna Commercial	$174.12
Rate for Payer: Aetna Medicare Advantage	$174.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.00
Rate for Payer: Cigna Commercial	$290.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

PLATE FIBULA 7-HOLE 814123007

Facility

$580.40

Hospital Charge Code	270632507
Hospital Revenue Code	278
Min. Negotiated Rate	$87.06
Max. Negotiated Rate	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Qualcare PPO/HMO/WC	$87.06

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$31,750.00

Hospital Charge Code	27060713
Hospital Revenue Code	278
Min. Negotiated Rate	$4,762.50
Max. Negotiated Rate	$7,683.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,683.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,762.50

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$31,750.00

Hospital Charge Code	27060713
Hospital Revenue Code	278
Min. Negotiated Rate	$4,762.50
Max. Negotiated Rate	$15,875.00
Rate for Payer: Aetna Commercial	$9,525.00
Rate for Payer: Aetna Medicare Advantage	$9,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,096.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,096.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,096.25
Rate for Payer: Cigna Commercial	$15,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,683.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,762.50

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$4,326.00

Service Code	HCPCS C1713
Hospital Charge Code	270660713
Hospital Revenue Code	278
Min. Negotiated Rate	$648.90
Max. Negotiated Rate	$1,046.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.89
Rate for Payer: Qualcare PPO/HMO/WC	$648.90

PLATE FIBULA 9 HOLE 2.7/3.5

Facility

$4,326.00

Service Code	HCPCS C1713
Hospital Charge Code	270660713
Hospital Revenue Code	278
Min. Negotiated Rate	$648.90
Max. Negotiated Rate	$2,163.00
Rate for Payer: Aetna Commercial	$1,297.80
Rate for Payer: Aetna Medicare Advantage	$1,297.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,103.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,103.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$865.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,103.13
Rate for Payer: Cigna Commercial	$2,163.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,046.89
Rate for Payer: Qualcare PPO/HMO/WC	$648.90

PLATE FIBULA ANKLE FX 9H RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700268
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$3,430.62
Rate for Payer: Aetna Commercial	$2,058.38
Rate for Payer: Aetna Medicare Advantage	$2,058.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,749.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,749.62
Rate for Payer: Cigna Commercial	$3,430.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE FIBULA ANKLE FX 9H RT

Facility

$6,861.25

Service Code	HCPCS C1713
Hospital Charge Code	270700268
Hospital Revenue Code	278
Min. Negotiated Rate	$1,029.19
Max. Negotiated Rate	$1,660.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,372.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,660.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,029.19

PLATE FIBULA DISTAL 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687751
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

PLATE FIBULA DISTAL 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270687751
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

PLATEFIBULALATLKG8H132MMRT

Facility

$4,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270695536
Hospital Revenue Code	278
Min. Negotiated Rate	$653.25
Max. Negotiated Rate	$1,053.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$871.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,053.91
Rate for Payer: Qualcare PPO/HMO/WC	$653.25

Know your out-of-pocket cost for care.

All Charges