Heights University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL INSERT ULTRA SZ6 14MM

Facility

$3,000.00

Hospital Charge Code	270672651
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TIBIAL INSERT ULTRA SZ6 16MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672652
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TIBIAL INSERT ULTRA SZ6 16MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672652
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TIBIAL INSERT WEDGE MED 70MM

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681867
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

TIBIAL INSERT WEDGE MED 70MM

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681867
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

TIBIAL INSERT WEDGE SMALL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680959
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

TIBIAL INSERT WEDGE SMALL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680959
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

TIBIAL INSR POST STAB SZ4 11MM

Facility

$3,425.00

Hospital Charge Code	270669601
Hospital Revenue Code	278
Min. Negotiated Rate	$513.75
Max. Negotiated Rate	$828.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.85
Rate for Payer: Qualcare PPO/HMO/WC	$513.75

TIBIAL INSR POST STAB SZ4 11MM

Facility

$3,425.00

Hospital Charge Code	270669601
Hospital Revenue Code	278
Min. Negotiated Rate	$513.75
Max. Negotiated Rate	$1,712.50
Rate for Payer: Aetna Commercial	$1,027.50
Rate for Payer: Aetna Medicare Advantage	$1,027.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.38
Rate for Payer: Cigna Commercial	$1,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.85
Rate for Payer: Qualcare PPO/HMO/WC	$513.75

TIBIAL INSRT POST STAB 1.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270674365
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

TIBIAL INSRT POST STAB 1.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270674365
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

TIBIAL INSRT POST STB 2.5 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684588
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

TIBIAL INSRT POST STB 2.5 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684588
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

TIBIAL INSRT POST STB 2.5 17MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678381
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

TIBIAL INSRT POST STB 2.5 17MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678381
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

TIBIAL INSRT POST STB 2.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677172
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

TIBIAL INSRT POST STB 2.5 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677172
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

TIBIAL INSRT POST STB 3.5 15MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270682567
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

TIBIAL INSRT POST STB 3.5 15MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270682567
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

TIBIAL INSRT POST STB SZ2 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270673570
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

TIBIAL INSRT POST STB SZ2 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270673570
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

TIBIAL INSRT POST STB SZ2 13MM

Facility

$5,596.00

Service Code	HCPCS C1776
Hospital Charge Code	270681294
Hospital Revenue Code	278
Min. Negotiated Rate	$839.40
Max. Negotiated Rate	$2,798.00
Rate for Payer: Aetna Commercial	$1,678.80
Rate for Payer: Aetna Medicare Advantage	$1,678.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,426.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,426.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,119.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,426.98
Rate for Payer: Cigna Commercial	$2,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,354.23
Rate for Payer: Qualcare PPO/HMO/WC	$839.40

TIBIAL INSRT POST STB SZ2 13MM

Facility

$5,596.00

Service Code	HCPCS C1776
Hospital Charge Code	270681294
Hospital Revenue Code	278
Min. Negotiated Rate	$839.40
Max. Negotiated Rate	$1,354.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,119.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,354.23
Rate for Payer: Qualcare PPO/HMO/WC	$839.40

TIBIAL INSRT POST STB SZ2 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675280
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

TIBIAL INSRT POST STB SZ2 13MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675280
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

Know your out-of-pocket cost for care.

All Charges