Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE LCP TIBIA 3.5MM 13HOLE L

Facility

$6,529.15

Service Code	HCPCS C1713
Hospital Charge Code	270644882
Hospital Revenue Code	278
Min. Negotiated Rate	$979.37
Max. Negotiated Rate	$3,264.57
Rate for Payer: Aetna Commercial	$1,958.74
Rate for Payer: Aetna Medicare Advantage	$1,958.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,664.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,664.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,664.93
Rate for Payer: Cigna Commercial	$3,264.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.05
Rate for Payer: Qualcare PPO/HMO/WC	$979.37

PLATE LCP TIBIA 3.5MM 13HOLE L

Facility

$6,529.15

Service Code	HCPCS C1713
Hospital Charge Code	270644882
Hospital Revenue Code	278
Min. Negotiated Rate	$979.37
Max. Negotiated Rate	$1,580.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,305.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,580.05
Rate for Payer: Qualcare PPO/HMO/WC	$979.37

PLATE LCP TIBIA 3.5MM 4H LT ST

Facility

$6,090.40

Service Code	HCPCS C1713
Hospital Charge Code	270643261
Hospital Revenue Code	278
Min. Negotiated Rate	$913.56
Max. Negotiated Rate	$3,045.20
Rate for Payer: Aetna Commercial	$1,827.12
Rate for Payer: Aetna Medicare Advantage	$1,827.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,553.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,553.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,553.05
Rate for Payer: Cigna Commercial	$3,045.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.88
Rate for Payer: Qualcare PPO/HMO/WC	$913.56

PLATE LCP TIBIA 3.5MM 4H LT ST

Facility

$6,090.40

Service Code	HCPCS C1713
Hospital Charge Code	270643261
Hospital Revenue Code	278
Min. Negotiated Rate	$913.56
Max. Negotiated Rate	$1,473.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,218.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.88
Rate for Payer: Qualcare PPO/HMO/WC	$913.56

PLATE LCP TIBIA 3.5MM 4H RT ST

Facility

$6,238.70

Service Code	HCPCS C1713
Hospital Charge Code	270646927
Hospital Revenue Code	278
Min. Negotiated Rate	$935.80
Max. Negotiated Rate	$1,509.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,247.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,509.77
Rate for Payer: Qualcare PPO/HMO/WC	$935.80

PLATE LCP TIBIA 3.5MM 4H RT ST

Facility

$6,238.70

Service Code	HCPCS C1713
Hospital Charge Code	270646927
Hospital Revenue Code	278
Min. Negotiated Rate	$935.80
Max. Negotiated Rate	$3,119.35
Rate for Payer: Aetna Commercial	$1,871.61
Rate for Payer: Aetna Medicare Advantage	$1,871.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,590.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,590.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,247.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,590.87
Rate for Payer: Cigna Commercial	$3,119.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,509.77
Rate for Payer: Qualcare PPO/HMO/WC	$935.80

PLATE LCP TIBIA 3.5MM 6H LFT

Facility

$5,951.35

Service Code	HCPCS C1713
Hospital Charge Code	270643933
Hospital Revenue Code	278
Min. Negotiated Rate	$892.70
Max. Negotiated Rate	$1,440.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,190.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.23
Rate for Payer: Qualcare PPO/HMO/WC	$892.70

PLATE LCP TIBIA 3.5MM 6H LFT

Facility

$5,951.35

Service Code	HCPCS C1713
Hospital Charge Code	270643933
Hospital Revenue Code	278
Min. Negotiated Rate	$892.70
Max. Negotiated Rate	$2,975.68
Rate for Payer: Aetna Commercial	$1,785.40
Rate for Payer: Aetna Medicare Advantage	$1,785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,517.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,190.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,517.59
Rate for Payer: Cigna Commercial	$2,975.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.23
Rate for Payer: Qualcare PPO/HMO/WC	$892.70

PLATE LCP TIBIA 3.5MM 8H RT ST

Facility

$6,214.00

Service Code	HCPCS C1713
Hospital Charge Code	270646922
Hospital Revenue Code	278
Min. Negotiated Rate	$932.10
Max. Negotiated Rate	$1,503.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,503.79
Rate for Payer: Qualcare PPO/HMO/WC	$932.10

PLATE LCP TIBIA 3.5MM 8H RT ST

Facility

$6,214.00

Service Code	HCPCS C1713
Hospital Charge Code	270646922
Hospital Revenue Code	278
Min. Negotiated Rate	$932.10
Max. Negotiated Rate	$3,107.00
Rate for Payer: Aetna Commercial	$1,864.20
Rate for Payer: Aetna Medicare Advantage	$1,864.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,584.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,584.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,584.57
Rate for Payer: Cigna Commercial	$3,107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,503.79
Rate for Payer: Qualcare PPO/HMO/WC	$932.10

PLATE LCP TIBIA 3.5x116 5HOLE

Facility

$6,081.10

Service Code	HCPCS C1713
Hospital Charge Code	270642939
Hospital Revenue Code	278
Min. Negotiated Rate	$912.16
Max. Negotiated Rate	$1,471.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.63
Rate for Payer: Qualcare PPO/HMO/WC	$912.16

PLATE LCP TIBIA 3.5x116 5HOLE

Facility

$6,081.10

Service Code	HCPCS C1713
Hospital Charge Code	270642939
Hospital Revenue Code	278
Min. Negotiated Rate	$912.16
Max. Negotiated Rate	$3,040.55
Rate for Payer: Aetna Commercial	$1,824.33
Rate for Payer: Aetna Medicare Advantage	$1,824.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,550.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,550.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,550.68
Rate for Payer: Cigna Commercial	$3,040.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.63
Rate for Payer: Qualcare PPO/HMO/WC	$912.16

PLATE LCP TIBIA 4H/L 93MM STER

Facility

$6,039.00

Hospital Charge Code	270675550
Hospital Revenue Code	278
Min. Negotiated Rate	$905.85
Max. Negotiated Rate	$1,461.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.44
Rate for Payer: Qualcare PPO/HMO/WC	$905.85

PLATE LCP TIBIA 4H/L 93MM STER

Facility

$6,039.00

Hospital Charge Code	270675550
Hospital Revenue Code	278
Min. Negotiated Rate	$905.85
Max. Negotiated Rate	$3,019.50
Rate for Payer: Aetna Commercial	$1,811.70
Rate for Payer: Aetna Medicare Advantage	$1,811.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,539.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,539.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,539.94
Rate for Payer: Cigna Commercial	$3,019.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.44
Rate for Payer: Qualcare PPO/HMO/WC	$905.85

PLATE LCP TIBIAL 3.5MM 6H119MM

Facility

$8,300.20

Service Code	HCPCS C1713
Hospital Charge Code	270695644
Hospital Revenue Code	278
Min. Negotiated Rate	$1,245.03
Max. Negotiated Rate	$4,150.10
Rate for Payer: Aetna Commercial	$2,490.06
Rate for Payer: Aetna Medicare Advantage	$2,490.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,116.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,116.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,660.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,116.55
Rate for Payer: Cigna Commercial	$4,150.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.03

PLATE LCP TIBIAL 3.5MM 6H119MM

Facility

$8,300.20

Service Code	HCPCS C1713
Hospital Charge Code	270695644
Hospital Revenue Code	278
Min. Negotiated Rate	$1,245.03
Max. Negotiated Rate	$2,008.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,660.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,008.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,245.03

PLATE LCP TITA 3.5x190m 14HOLE

Facility

$5,475.00

Hospital Charge Code	270667948
Hospital Revenue Code	272
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$821.25
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

PLATE LCP TITA 3.5x190m 14HOLE

Facility

$5,475.00

Hospital Charge Code	270667948
Hospital Revenue Code	272
Min. Negotiated Rate	$711.75
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) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.75
Rate for Payer: Oxford Commercial	$2,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Commercial	$2,737.50

PLATE LCP VOLAR 2.4MM 9H/5H

Facility

$3,667.85

Service Code	HCPCS C1713
Hospital Charge Code	270641160
Hospital Revenue Code	278
Min. Negotiated Rate	$550.18
Max. Negotiated Rate	$1,833.92
Rate for Payer: Aetna Commercial	$1,100.36
Rate for Payer: Aetna Medicare Advantage	$1,100.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$935.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$935.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$935.30
Rate for Payer: Cigna Commercial	$1,833.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.62
Rate for Payer: Qualcare PPO/HMO/WC	$550.18

PLATE LCP VOLAR 2.4MM 9H/5H

Facility

$3,667.85

Service Code	HCPCS C1713
Hospital Charge Code	270641160
Hospital Revenue Code	278
Min. Negotiated Rate	$550.18
Max. Negotiated Rate	$887.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$887.62
Rate for Payer: Qualcare PPO/HMO/WC	$550.18

PLATE LCP X-ART 6H 3.5MM LT

Facility

$5,939.00

Service Code	HCPCS C1713
Hospital Charge Code	270643583
Hospital Revenue Code	278
Min. Negotiated Rate	$890.85
Max. Negotiated Rate	$2,969.50
Rate for Payer: Aetna Commercial	$1,781.70
Rate for Payer: Aetna Medicare Advantage	$1,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,514.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,514.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,187.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,514.44
Rate for Payer: Cigna Commercial	$2,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.24
Rate for Payer: Qualcare PPO/HMO/WC	$890.85

PLATE LCP X-ART 6H 3.5MM LT

Facility

$5,939.00

Service Code	HCPCS C1713
Hospital Charge Code	270643583
Hospital Revenue Code	278
Min. Negotiated Rate	$890.85
Max. Negotiated Rate	$1,437.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,187.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,437.24
Rate for Payer: Qualcare PPO/HMO/WC	$890.85

PLATE LCP X-ART 6H 3.5MM RT ST

Facility

$6,146.00

Service Code	HCPCS C1713
Hospital Charge Code	270678905
Hospital Revenue Code	278
Min. Negotiated Rate	$921.90
Max. Negotiated Rate	$1,487.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,229.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,487.33
Rate for Payer: Qualcare PPO/HMO/WC	$921.90

PLATE LCP X-ART 6H 3.5MM RT ST

Facility

$6,146.00

Service Code	HCPCS C1713
Hospital Charge Code	270678905
Hospital Revenue Code	278
Min. Negotiated Rate	$921.90
Max. Negotiated Rate	$3,073.00
Rate for Payer: Aetna Commercial	$1,843.80
Rate for Payer: Aetna Medicare Advantage	$1,843.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,229.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,567.23
Rate for Payer: Cigna Commercial	$3,073.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,487.33
Rate for Payer: Qualcare PPO/HMO/WC	$921.90

PLATE LCP X-ART 8H 3.5MM LT ST

Facility

$6,510.65

Service Code	HCPCS C1713
Hospital Charge Code	270675067
Hospital Revenue Code	278
Min. Negotiated Rate	$976.60
Max. Negotiated Rate	$3,255.32
Rate for Payer: Aetna Commercial	$1,953.19
Rate for Payer: Aetna Medicare Advantage	$1,953.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,660.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,660.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,302.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,660.22
Rate for Payer: Cigna Commercial	$3,255.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,575.58
Rate for Payer: Qualcare PPO/HMO/WC	$976.60

Know your out-of-pocket cost for care.

All Charges