Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TIBIA 3.5MM 8H RT

Facility

$5,098.50

Service Code	HCPCS C1713
Hospital Charge Code	270651849
Hospital Revenue Code	278
Min. Negotiated Rate	$764.77
Max. Negotiated Rate	$2,549.25
Rate for Payer: Aetna Commercial	$1,529.55
Rate for Payer: Aetna Medicare Advantage	$1,529.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.12
Rate for Payer: Cigna Commercial	$2,549.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: Qualcare PPO/HMO/WC	$764.77

PLATE TIBIA 3.5MM 8H RT

Facility

$5,098.50

Service Code	HCPCS C1713
Hospital Charge Code	270651849
Hospital Revenue Code	278
Min. Negotiated Rate	$764.77
Max. Negotiated Rate	$1,233.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: Qualcare PPO/HMO/WC	$764.77

PLATE TIBIA 4.5MM 4H LT

Facility

$6,037.85

Service Code	HCPCS C1713
Hospital Charge Code	270637030
Hospital Revenue Code	278
Min. Negotiated Rate	$905.68
Max. Negotiated Rate	$1,461.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.16
Rate for Payer: Qualcare PPO/HMO/WC	$905.68

PLATE TIBIA 4.5MM 4H LT

Facility

$6,037.85

Service Code	HCPCS C1713
Hospital Charge Code	270637030
Hospital Revenue Code	278
Min. Negotiated Rate	$905.68
Max. Negotiated Rate	$3,018.93
Rate for Payer: Aetna Commercial	$1,811.36
Rate for Payer: Aetna Medicare Advantage	$1,811.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,539.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,539.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,207.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,539.65
Rate for Payer: Cigna Commercial	$3,018.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,461.16
Rate for Payer: Qualcare PPO/HMO/WC	$905.68

PLATE TIBIA 4.5MM 8H LT ST

Facility

$5,280.80

Service Code	HCPCS C1713
Hospital Charge Code	270646083
Hospital Revenue Code	278
Min. Negotiated Rate	$792.12
Max. Negotiated Rate	$2,640.40
Rate for Payer: Aetna Commercial	$1,584.24
Rate for Payer: Aetna Medicare Advantage	$1,584.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,346.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,346.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,346.60
Rate for Payer: Cigna Commercial	$2,640.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.95
Rate for Payer: Qualcare PPO/HMO/WC	$792.12

PLATE TIBIA 4.5MM 8H LT ST

Facility

$5,280.80

Service Code	HCPCS C1713
Hospital Charge Code	270646083
Hospital Revenue Code	278
Min. Negotiated Rate	$792.12
Max. Negotiated Rate	$1,277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,056.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,277.95
Rate for Payer: Qualcare PPO/HMO/WC	$792.12

PLATE TIBIA 4.5MM 8H RT

Facility

$6,183.10

Service Code	HCPCS C1713
Hospital Charge Code	270628206
Hospital Revenue Code	278
Min. Negotiated Rate	$927.47
Max. Negotiated Rate	$1,496.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,496.31
Rate for Payer: Qualcare PPO/HMO/WC	$927.47

PLATE TIBIA 4.5MM 8H RT

Facility

$6,183.10

Service Code	HCPCS C1713
Hospital Charge Code	270628206
Hospital Revenue Code	278
Min. Negotiated Rate	$927.47
Max. Negotiated Rate	$3,091.55
Rate for Payer: Aetna Commercial	$1,854.93
Rate for Payer: Aetna Medicare Advantage	$1,854.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,576.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,576.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,576.69
Rate for Payer: Cigna Commercial	$3,091.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,496.31
Rate for Payer: Qualcare PPO/HMO/WC	$927.47

PLATE TIBIA 4.5x226MM 12H RT

Facility

$6,322.15

Hospital Charge Code	270661909
Hospital Revenue Code	278
Min. Negotiated Rate	$948.32
Max. Negotiated Rate	$1,529.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,264.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.96
Rate for Payer: Qualcare PPO/HMO/WC	$948.32

PLATE TIBIA 4.5x226MM 12H RT

Facility

$6,322.15

Hospital Charge Code	270661909
Hospital Revenue Code	278
Min. Negotiated Rate	$948.32
Max. Negotiated Rate	$3,161.07
Rate for Payer: Aetna Commercial	$1,896.64
Rate for Payer: Aetna Medicare Advantage	$1,896.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,612.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,612.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,264.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,612.15
Rate for Payer: Cigna Commercial	$3,161.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,529.96
Rate for Payer: Qualcare PPO/HMO/WC	$948.32

PLATE TIBIA 4.5x262MM 14H LT

Facility

$6,390.10

Hospital Charge Code	270661914
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$1,546.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x262MM 14H LT

Facility

$6,390.10

Hospital Charge Code	270661914
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$3,195.05
Rate for Payer: Aetna Commercial	$1,917.03
Rate for Payer: Aetna Medicare Advantage	$1,917.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,629.48
Rate for Payer: Cigna Commercial	$3,195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x262MM 14H RT

Facility

$6,390.10

Hospital Charge Code	270661911
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$1,546.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x262MM 14H RT

Facility

$6,390.10

Hospital Charge Code	270661911
Hospital Revenue Code	278
Min. Negotiated Rate	$958.51
Max. Negotiated Rate	$3,195.05
Rate for Payer: Aetna Commercial	$1,917.03
Rate for Payer: Aetna Medicare Advantage	$1,917.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,629.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,278.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,629.48
Rate for Payer: Cigna Commercial	$3,195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,546.40
Rate for Payer: Qualcare PPO/HMO/WC	$958.51

PLATE TIBIA 4.5x82MM 4H LT ST

Facility

$6,244.90

Hospital Charge Code	270665855
Hospital Revenue Code	278
Min. Negotiated Rate	$936.74
Max. Negotiated Rate	$3,122.45
Rate for Payer: Aetna Commercial	$1,873.47
Rate for Payer: Aetna Medicare Advantage	$1,873.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,592.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,592.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,248.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,592.45
Rate for Payer: Cigna Commercial	$3,122.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.27
Rate for Payer: Qualcare PPO/HMO/WC	$936.74

PLATE TIBIA 4.5x82MM 4H LT ST

Facility

$6,244.90

Hospital Charge Code	270665855
Hospital Revenue Code	278
Min. Negotiated Rate	$936.74
Max. Negotiated Rate	$1,511.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,248.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,511.27
Rate for Payer: Qualcare PPO/HMO/WC	$936.74

PLATE TIBIA 4 HOLE 3.5MM RIGHT

Facility

$6,440.00

Hospital Charge Code	270637379
Hospital Revenue Code	278
Min. Negotiated Rate	$966.00
Max. Negotiated Rate	$1,558.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,558.48
Rate for Payer: Qualcare PPO/HMO/WC	$966.00

PLATE TIBIA 4 HOLE 3.5MM RIGHT

Facility

$6,440.00

Hospital Charge Code	270637379
Hospital Revenue Code	278
Min. Negotiated Rate	$966.00
Max. Negotiated Rate	$3,220.00
Rate for Payer: Aetna Commercial	$1,932.00
Rate for Payer: Aetna Medicare Advantage	$1,932.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,642.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,642.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,642.20
Rate for Payer: Cigna Commercial	$3,220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,558.48
Rate for Payer: Qualcare PPO/HMO/WC	$966.00

PLATE TIBIA 6HOLE 123MM LEFT

Facility

$9,671.00

Service Code	HCPCS C1713
Hospital Charge Code	270675653
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.65
Max. Negotiated Rate	$2,340.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.65

PLATE TIBIA 6HOLE 123MM LEFT

Facility

$9,671.00

Service Code	HCPCS C1713
Hospital Charge Code	270675653
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.65
Max. Negotiated Rate	$4,835.50
Rate for Payer: Aetna Commercial	$2,901.30
Rate for Payer: Aetna Medicare Advantage	$2,901.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,466.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,466.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,934.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,466.11
Rate for Payer: Cigna Commercial	$4,835.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,340.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,450.65

PLATE TIBIA 8-H 3.5 RT 239908

Facility

$6,066.15

Hospital Charge Code	270634849
Hospital Revenue Code	278
Min. Negotiated Rate	$909.92
Max. Negotiated Rate	$1,468.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,213.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,468.01
Rate for Payer: Qualcare PPO/HMO/WC	$909.92

PLATE TIBIA 8-H 3.5 RT 239908

Facility

$6,066.15

Hospital Charge Code	270634849
Hospital Revenue Code	278
Min. Negotiated Rate	$909.92
Max. Negotiated Rate	$3,033.07
Rate for Payer: Aetna Commercial	$1,819.85
Rate for Payer: Aetna Medicare Advantage	$1,819.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,546.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,546.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,213.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,546.87
Rate for Payer: Cigna Commercial	$3,033.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,468.01
Rate for Payer: Qualcare PPO/HMO/WC	$909.92

PLATE TIBIA 8HOL 3.5 LT 239909

Facility

$5,624.70

Hospital Charge Code	270633831
Hospital Revenue Code	278
Min. Negotiated Rate	$843.71
Max. Negotiated Rate	$2,812.35
Rate for Payer: Aetna Commercial	$1,687.41
Rate for Payer: Aetna Medicare Advantage	$1,687.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,124.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.30
Rate for Payer: Cigna Commercial	$2,812.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.18
Rate for Payer: Qualcare PPO/HMO/WC	$843.71

PLATE TIBIA 8HOL 3.5 LT 239909

Facility

$5,624.70

Hospital Charge Code	270633831
Hospital Revenue Code	278
Min. Negotiated Rate	$843.71
Max. Negotiated Rate	$1,361.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,124.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.18
Rate for Payer: Qualcare PPO/HMO/WC	$843.71

PLATE TIBIAL 3.5LCP 10HOLES

Facility

$6,448.85

Service Code	HCPCS C1713
Hospital Charge Code	270645819
Hospital Revenue Code	278
Min. Negotiated Rate	$967.33
Max. Negotiated Rate	$3,224.43
Rate for Payer: Aetna Commercial	$1,934.65
Rate for Payer: Aetna Medicare Advantage	$1,934.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.46
Rate for Payer: Cigna Commercial	$3,224.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.62
Rate for Payer: Qualcare PPO/HMO/WC	$967.33

Know your out-of-pocket cost for care.

All Charges