Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE START TIBIAL 2.5/ 3.5 MM

Facility

$16,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270687281
Hospital Revenue Code	278
Min. Negotiated Rate	$2,490.00
Max. Negotiated Rate	$8,300.00
Rate for Payer: Aetna Commercial	$4,980.00
Rate for Payer: Aetna Medicare Advantage	$4,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,233.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,233.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,233.00
Rate for Payer: Cigna Commercial	$8,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,017.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,490.00

PLATE START TIBIAL 2.5/ 3.5 MM

Facility

$16,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270687281
Hospital Revenue Code	278
Min. Negotiated Rate	$2,490.00
Max. Negotiated Rate	$4,017.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,017.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,490.00

PLATE STR 1.6MM 10 HOLE

Facility

$4,094.25

Hospital Charge Code	270703048
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$990.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

PLATE STR 1.6MM 10 HOLE

Facility

$4,094.25

Hospital Charge Code	270703048
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$2,047.12
Rate for Payer: Aetna Commercial	$1,228.28
Rate for Payer: Aetna Medicare Advantage	$1,228.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.03
Rate for Payer: Cigna Commercial	$2,047.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

PLATE STR 1.6 MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689947
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE STR 1.6 MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689947
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE STR 2.0 MM 6 HOLE REIN

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689950
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE STR 2.0 MM 6 HOLE REIN

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270689950
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

PLATE STR 2.0x17MM 3HOLE

Facility

$241.90

Service Code	HCPCS C1713
Hospital Charge Code	270651723
Hospital Revenue Code	278
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$120.95
Rate for Payer: Aetna Commercial	$72.57
Rate for Payer: Aetna Medicare Advantage	$72.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.68
Rate for Payer: Cigna Commercial	$120.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.54
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

PLATE STR 2.0x17MM 3HOLE

Facility

$241.90

Service Code	HCPCS C1713
Hospital Charge Code	270651723
Hospital Revenue Code	278
Min. Negotiated Rate	$36.28
Max. Negotiated Rate	$58.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.54
Rate for Payer: Qualcare PPO/HMO/WC	$36.28

PLATE STR 2.0x23MM 4HOLE

Facility

$258.00

Service Code	HCPCS C1713
Hospital Charge Code	270604328
Hospital Revenue Code	278
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$62.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

PLATE STR 2.0x23MM 4HOLE

Facility

$258.00

Service Code	HCPCS C1713
Hospital Charge Code	270604328
Hospital Revenue Code	278
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$77.40
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

PLATE STR 2.0x29MM 5HOLE

Facility

$276.55

Service Code	HCPCS C1713
Hospital Charge Code	270651724
Hospital Revenue Code	278
Min. Negotiated Rate	$41.48
Max. Negotiated Rate	$66.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.93
Rate for Payer: Qualcare PPO/HMO/WC	$41.48

PLATE STR 2.0x29MM 5HOLE

Facility

$276.55

Service Code	HCPCS C1713
Hospital Charge Code	270651724
Hospital Revenue Code	278
Min. Negotiated Rate	$41.48
Max. Negotiated Rate	$138.28
Rate for Payer: Aetna Commercial	$82.97
Rate for Payer: Aetna Medicare Advantage	$82.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.52
Rate for Payer: Cigna Commercial	$138.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.93
Rate for Payer: Qualcare PPO/HMO/WC	$41.48

PLATE STR 6 HOLE 2.0MM STERILE

Facility

$2,542.95

Service Code	HCPCS C1713
Hospital Charge Code	270686759
Hospital Revenue Code	278
Min. Negotiated Rate	$381.44
Max. Negotiated Rate	$615.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.39
Rate for Payer: Qualcare PPO/HMO/WC	$381.44

PLATE STR 6 HOLE 2.0MM STERILE

Facility

$2,542.95

Service Code	HCPCS C1713
Hospital Charge Code	270686759
Hospital Revenue Code	278
Min. Negotiated Rate	$381.44
Max. Negotiated Rate	$1,271.47
Rate for Payer: Aetna Commercial	$762.88
Rate for Payer: Aetna Medicare Advantage	$762.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$648.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$648.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$648.45
Rate for Payer: Cigna Commercial	$1,271.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.39
Rate for Payer: Qualcare PPO/HMO/WC	$381.44

PLATE STRAIGHT 1.5MM 12HOLE

Facility

$1,053.70

Service Code	HCPCS C1713
Hospital Charge Code	270654814
Hospital Revenue Code	278
Min. Negotiated Rate	$158.06
Max. Negotiated Rate	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.06

PLATE STRAIGHT 1.5MM 12HOLE

Facility

$1,053.70

Service Code	HCPCS C1713
Hospital Charge Code	270654814
Hospital Revenue Code	278
Min. Negotiated Rate	$158.06
Max. Negotiated Rate	$526.85
Rate for Payer: Aetna Commercial	$316.11
Rate for Payer: Aetna Medicare Advantage	$316.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.69
Rate for Payer: Cigna Commercial	$526.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.06

PLATE STRAIGHT 1.5MM 6HOLE

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270654812
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

PLATE STRAIGHT 1.5MM 6HOLE

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270654812
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

PLATE STRAIGHT 2.0MM 12HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654825
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

PLATE STRAIGHT 2.0MM 12HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654825
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$329.08
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

PLATE STRAIGHT 2.0MM 6HOLE

Facility

$945.30

Service Code	HCPCS C1713
Hospital Charge Code	270654824
Hospital Revenue Code	278
Min. Negotiated Rate	$141.79
Max. Negotiated Rate	$472.65
Rate for Payer: Aetna Commercial	$283.59
Rate for Payer: Aetna Medicare Advantage	$283.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.05
Rate for Payer: Cigna Commercial	$472.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.76
Rate for Payer: Qualcare PPO/HMO/WC	$141.79

PLATE STRAIGHT 2.0MM 6HOLE

Facility

$945.30

Service Code	HCPCS C1713
Hospital Charge Code	270654824
Hospital Revenue Code	278
Min. Negotiated Rate	$141.79
Max. Negotiated Rate	$228.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.76
Rate for Payer: Qualcare PPO/HMO/WC	$141.79

PLATE STRAIGHT 2.4MM 6 HOLE

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270694872
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

Know your out-of-pocket cost for care.

All Charges