Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATE TIBIAL STEM 71MM 141513

Facility

$13,265.00

Hospital Charge Code	270647562
Hospital Revenue Code	278
Min. Negotiated Rate	$1,989.75
Max. Negotiated Rate	$3,210.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,653.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,210.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,989.75

PLATE TIBIAL STEM 71MM 141513

Facility

$13,265.00

Hospital Charge Code	270647562
Hospital Revenue Code	278
Min. Negotiated Rate	$1,989.75
Max. Negotiated Rate	$6,632.50
Rate for Payer: Aetna Commercial	$3,979.50
Rate for Payer: Aetna Medicare Advantage	$3,979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,382.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,382.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,653.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,382.57
Rate for Payer: Cigna Commercial	$6,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,210.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,989.75

PLATE TIBIAL STEMMED 67mm

Facility

$15,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270638752
Hospital Revenue Code	278
Min. Negotiated Rate	$2,314.50
Max. Negotiated Rate	$3,734.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,086.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,734.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,314.50

PLATE TIBIAL STEMMED 67mm

Facility

$15,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270638752
Hospital Revenue Code	278
Min. Negotiated Rate	$2,314.50
Max. Negotiated Rate	$7,715.00
Rate for Payer: Aetna Medicare Advantage	$4,629.00
Rate for Payer: Aetna Commercial	$4,629.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,934.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,934.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,086.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,934.65
Rate for Payer: Cigna Commercial	$7,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,734.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,314.50

PLATE TIBIAL STEMMED 83mm

Facility

$15,430.00

Hospital Charge Code	270669904
Hospital Revenue Code	278
Min. Negotiated Rate	$2,314.50
Max. Negotiated Rate	$7,715.00
Rate for Payer: Aetna Commercial	$4,629.00
Rate for Payer: Aetna Medicare Advantage	$4,629.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,934.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,934.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,086.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,934.65
Rate for Payer: Cigna Commercial	$7,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,734.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,314.50

PLATE TIBIAL STEMMED 83mm

Facility

$15,430.00

Hospital Charge Code	270669904
Hospital Revenue Code	278
Min. Negotiated Rate	$2,314.50
Max. Negotiated Rate	$3,734.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,086.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,734.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,314.50

PLATE TIBIAL SZ 8 NEXGEN PRE-

Facility

$6,405.90

Hospital Charge Code	270632060
Hospital Revenue Code	278
Min. Negotiated Rate	$960.88
Max. Negotiated Rate	$3,202.95
Rate for Payer: Aetna Commercial	$1,921.77
Rate for Payer: Aetna Medicare Advantage	$1,921.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,281.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,633.50
Rate for Payer: Cigna Commercial	$3,202.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,550.23
Rate for Payer: Qualcare PPO/HMO/WC	$960.88

PLATE TIBIAL SZ 8 NEXGEN PRE-

Facility

$6,405.90

Hospital Charge Code	270632060
Hospital Revenue Code	278
Min. Negotiated Rate	$960.88
Max. Negotiated Rate	$1,550.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,281.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,550.23
Rate for Payer: Qualcare PPO/HMO/WC	$960.88

PLATE TIBIA MED DIST SS LEFT4

Facility

$8,858.00

Service Code	HCPCS C1713
Hospital Charge Code	270704607
Hospital Revenue Code	278
Min. Negotiated Rate	$1,328.70
Max. Negotiated Rate	$4,429.00
Rate for Payer: Aetna Commercial	$2,657.40
Rate for Payer: Aetna Medicare Advantage	$2,657.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,258.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,258.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,771.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,258.79
Rate for Payer: Cigna Commercial	$4,429.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,143.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,328.70

PLATE TIBIA MED DIST SS LEFT4

Facility

$8,858.00

Service Code	HCPCS C1713
Hospital Charge Code	270704607
Hospital Revenue Code	278
Min. Negotiated Rate	$1,328.70
Max. Negotiated Rate	$2,143.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,771.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,143.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,328.70

PLATE TIBIA MED DIST SS LT 6H

Facility

$9,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270699402
Hospital Revenue Code	278
Min. Negotiated Rate	$1,413.75
Max. Negotiated Rate	$4,712.50
Rate for Payer: Aetna Commercial	$2,827.50
Rate for Payer: Aetna Medicare Advantage	$2,827.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,403.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,403.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,403.38
Rate for Payer: Cigna Commercial	$4,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,280.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.75

PLATE TIBIA MED DIST SS LT 6H

Facility

$9,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270699402
Hospital Revenue Code	278
Min. Negotiated Rate	$1,413.75
Max. Negotiated Rate	$2,280.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,280.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.75

PLATE TIBIA PROX 3.5x119 6H RT

Facility

$6,489.50

Service Code	HCPCS C1713
Hospital Charge Code	270681562
Hospital Revenue Code	278
Min. Negotiated Rate	$973.42
Max. Negotiated Rate	$3,244.75
Rate for Payer: Aetna Commercial	$1,946.85
Rate for Payer: Aetna Medicare Advantage	$1,946.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,654.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,654.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,297.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,654.82
Rate for Payer: Cigna Commercial	$3,244.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,570.46
Rate for Payer: Qualcare PPO/HMO/WC	$973.42

PLATE TIBIA PROX 3.5x119 6H RT

Facility

$6,489.50

Service Code	HCPCS C1713
Hospital Charge Code	270681562
Hospital Revenue Code	278
Min. Negotiated Rate	$973.42
Max. Negotiated Rate	$1,570.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,297.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,570.46
Rate for Payer: Qualcare PPO/HMO/WC	$973.42

PLATE TIBIA PROX VA-LCP 3.5MM

Facility

$6,912.85

Service Code	HCPCS C1713
Hospital Charge Code	270681178
Hospital Revenue Code	278
Min. Negotiated Rate	$1,036.93
Max. Negotiated Rate	$1,672.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,382.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,672.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,036.93

PLATE TIBIA PROX VA-LCP 3.5MM

Facility

$6,912.85

Service Code	HCPCS C1713
Hospital Charge Code	270681178
Hospital Revenue Code	278
Min. Negotiated Rate	$1,036.93
Max. Negotiated Rate	$3,456.43
Rate for Payer: Aetna Commercial	$2,073.86
Rate for Payer: Aetna Medicare Advantage	$2,073.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,762.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,762.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,382.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,762.78
Rate for Payer: Cigna Commercial	$3,456.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,672.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,036.93

PLATE TIBIA VA LCP 3.5 X147 MM

Facility

$93.35

Service Code	HCPCS C1713
Hospital Charge Code	270691497
Hospital Revenue Code	278
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$22.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.59
Rate for Payer: Qualcare PPO/HMO/WC	$14.00

PLATE TIBIA VA LCP 3.5 X147 MM

Facility

$93.35

Service Code	HCPCS C1713
Hospital Charge Code	270691497
Hospital Revenue Code	278
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$46.67
Rate for Payer: Aetna Commercial	$28.00
Rate for Payer: Aetna Medicare Advantage	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.80
Rate for Payer: Cigna Commercial	$46.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.59
Rate for Payer: Qualcare PPO/HMO/WC	$14.00

PLATE TIB PROX 3.5x145MM 8H LT

Facility

$6,565.90

Service Code	HCPCS C1713
Hospital Charge Code	270680906
Hospital Revenue Code	278
Min. Negotiated Rate	$984.88
Max. Negotiated Rate	$1,588.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,313.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,588.95
Rate for Payer: Qualcare PPO/HMO/WC	$984.88

PLATE TIB PROX 3.5x145MM 8H LT

Facility

$6,565.90

Service Code	HCPCS C1713
Hospital Charge Code	270680906
Hospital Revenue Code	278
Min. Negotiated Rate	$984.88
Max. Negotiated Rate	$3,282.95
Rate for Payer: Aetna Commercial	$1,969.77
Rate for Payer: Aetna Medicare Advantage	$1,969.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,674.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,674.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,313.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,674.30
Rate for Payer: Cigna Commercial	$3,282.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,588.95
Rate for Payer: Qualcare PPO/HMO/WC	$984.88

PLATE TIB PROX MED TI 5H 84MM

Facility

$11,140.30

Service Code	HCPCS C1713
Hospital Charge Code	270699450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,671.05
Max. Negotiated Rate	$2,695.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,228.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,695.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,671.05

PLATE TIB PROX MED TI 5H 84MM

Facility

$11,140.30

Service Code	HCPCS C1713
Hospital Charge Code	270699450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,671.05
Max. Negotiated Rate	$5,570.15
Rate for Payer: Aetna Commercial	$3,342.09
Rate for Payer: Aetna Medicare Advantage	$3,342.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,840.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,840.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,228.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,840.78
Rate for Payer: Cigna Commercial	$5,570.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,695.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,671.05

PLATE TIB PRX SM 3.5x177 10H R

Facility

$8,007.70

Service Code	HCPCS C1713
Hospital Charge Code	270681563
Hospital Revenue Code	278
Min. Negotiated Rate	$1,201.15
Max. Negotiated Rate	$4,003.85
Rate for Payer: Aetna Commercial	$2,402.31
Rate for Payer: Aetna Medicare Advantage	$2,402.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,041.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,041.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,601.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,041.96
Rate for Payer: Cigna Commercial	$4,003.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,937.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,201.15

PLATE TIB PRX SM 3.5x177 10H R

Facility

$8,007.70

Service Code	HCPCS C1713
Hospital Charge Code	270681563
Hospital Revenue Code	278
Min. Negotiated Rate	$1,201.15
Max. Negotiated Rate	$1,937.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,601.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,937.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,201.15

PLATE TIB SLP 9.0 AR13200ST090

Facility

$5,183.25

Hospital Charge Code	270636941
Hospital Revenue Code	278
Min. Negotiated Rate	$777.49
Max. Negotiated Rate	$2,591.62
Rate for Payer: Aetna Commercial	$1,554.97
Rate for Payer: Aetna Medicare Advantage	$1,554.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,321.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,321.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,036.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,321.73
Rate for Payer: Cigna Commercial	$2,591.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.35
Rate for Payer: Qualcare PPO/HMO/WC	$777.49

Know your out-of-pocket cost for care.

All Charges