Heights University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL KNEE BASE FX BEAR SZ 3

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686916
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TIBIAL KNEE BASE FX BEAR SZ 3

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686916
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TIBIAL KNEE BASE FX BEAR SZ 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685556
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TIBIAL KNEE BASE FX BEAR SZ 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270685556
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TIBIAL KNEE LOCKING CLIP I/BII

Facility

$1,396.30

Hospital Charge Code	270669474
Hospital Revenue Code	278
Min. Negotiated Rate	$209.44
Max. Negotiated Rate	$337.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.90
Rate for Payer: Qualcare PPO/HMO/WC	$209.44

TIBIAL KNEE LOCKING CLIP I/BII

Facility

$1,396.30

Hospital Charge Code	270669474
Hospital Revenue Code	278
Min. Negotiated Rate	$209.44
Max. Negotiated Rate	$698.15
Rate for Payer: Aetna Commercial	$418.89
Rate for Payer: Aetna Medicare Advantage	$418.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$356.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$356.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$356.06
Rate for Payer: Cigna Commercial	$698.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.90
Rate for Payer: Qualcare PPO/HMO/WC	$209.44

TIBIAL NAIL 10MM X 30CM

Facility

$9,415.50

Hospital Charge Code	270657802
Hospital Revenue Code	278
Min. Negotiated Rate	$1,412.33
Max. Negotiated Rate	$4,707.75
Rate for Payer: Aetna Commercial	$2,824.65
Rate for Payer: Aetna Medicare Advantage	$2,824.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,400.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,400.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,883.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,400.95
Rate for Payer: Cigna Commercial	$4,707.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,278.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,412.33

TIBIAL NAIL 10MM X 30CM

Facility

$9,415.50

Hospital Charge Code	270657802
Hospital Revenue Code	278
Min. Negotiated Rate	$1,412.33
Max. Negotiated Rate	$2,278.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,883.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,278.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,412.33

TIBIAL NAIL 10X 315

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270656597
Hospital Revenue Code	278
Min. Negotiated Rate	$927.00
Max. Negotiated Rate	$3,090.00
Rate for Payer: Aetna Commercial	$1,854.00
Rate for Payer: Aetna Medicare Advantage	$1,854.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,575.90
Rate for Payer: Cigna Commercial	$3,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: Qualcare PPO/HMO/WC	$927.00

TIBIAL NAIL 10X 315

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270656597
Hospital Revenue Code	278
Min. Negotiated Rate	$927.00
Max. Negotiated Rate	$1,495.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: Qualcare PPO/HMO/WC	$927.00

TIBIAL NAIL 8X330

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270679170
Hospital Revenue Code	278
Min. Negotiated Rate	$927.00
Max. Negotiated Rate	$3,090.00
Rate for Payer: Aetna Commercial	$1,854.00
Rate for Payer: Aetna Medicare Advantage	$1,854.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,575.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,575.90
Rate for Payer: Cigna Commercial	$3,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: Qualcare PPO/HMO/WC	$927.00

TIBIAL NAIL 8X330

Facility

$6,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270679170
Hospital Revenue Code	278
Min. Negotiated Rate	$927.00
Max. Negotiated Rate	$1,495.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,495.56
Rate for Payer: Qualcare PPO/HMO/WC	$927.00

TIBIAL NAIL 9MMX 300MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270683794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$3,335.00
Rate for Payer: Aetna Commercial	$2,001.00
Rate for Payer: Aetna Medicare Advantage	$2,001.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,700.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,700.85
Rate for Payer: Cigna Commercial	$3,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

TIBIAL NAIL 9MMX 300MM

Facility

$6,670.00

Service Code	HCPCS C1713
Hospital Charge Code	270683794
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.50
Max. Negotiated Rate	$1,614.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,614.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,000.50

TIBIAL NAIL 9X320MM

Facility

$14,300.00

Hospital Charge Code	270702712
Hospital Revenue Code	278
Min. Negotiated Rate	$2,145.00
Max. Negotiated Rate	$7,150.00
Rate for Payer: Aetna Commercial	$4,290.00
Rate for Payer: Aetna Medicare Advantage	$4,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,646.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,646.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,646.50
Rate for Payer: Cigna Commercial	$7,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,460.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,145.00

TIBIAL NAIL 9X320MM

Facility

$14,300.00

Hospital Charge Code	270702712
Hospital Revenue Code	278
Min. Negotiated Rate	$2,145.00
Max. Negotiated Rate	$3,460.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,460.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,145.00

TIBIAL NAIL EXPRX BND 10X285MM

Facility

$19,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699731
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

TIBIAL NAIL EXPRX BND 10X285MM

Facility

$19,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699731
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$5,925.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

TIBIAL NAIL STD 9x310MM

Facility

$11,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270673976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,797.00
Max. Negotiated Rate	$5,990.00
Rate for Payer: Aetna Commercial	$3,594.00
Rate for Payer: Aetna Medicare Advantage	$3,594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,054.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,054.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,054.90
Rate for Payer: Cigna Commercial	$5,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,899.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,797.00

TIBIAL NAIL STD 9x310MM

Facility

$11,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270673976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,797.00
Max. Negotiated Rate	$2,899.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,899.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,797.00

TIBIAL NAIL TI CANNU 300 MM

Facility

$6,365.40

Service Code	HCPCS C1713
Hospital Charge Code	270686005
Hospital Revenue Code	278
Min. Negotiated Rate	$954.81
Max. Negotiated Rate	$3,182.70
Rate for Payer: Aetna Commercial	$1,909.62
Rate for Payer: Aetna Medicare Advantage	$1,909.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,623.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,623.18
Rate for Payer: Cigna Commercial	$3,182.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.43
Rate for Payer: Qualcare PPO/HMO/WC	$954.81

TIBIAL NAIL TI CANNU 300 MM

Facility

$6,365.40

Service Code	HCPCS C1713
Hospital Charge Code	270686005
Hospital Revenue Code	278
Min. Negotiated Rate	$954.81
Max. Negotiated Rate	$1,540.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,273.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,540.43
Rate for Payer: Qualcare PPO/HMO/WC	$954.81

TIBIAL NAIL TI STD 10x345MM

Facility

$7,913.45

Service Code	HCPCS C1713
Hospital Charge Code	270651325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.02
Max. Negotiated Rate	$1,915.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.02

TIBIAL NAIL TI STD 10x345MM

Facility

$7,913.45

Service Code	HCPCS C1713
Hospital Charge Code	270651325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.02
Max. Negotiated Rate	$3,956.72
Rate for Payer: Aetna Commercial	$2,374.03
Rate for Payer: Aetna Medicare Advantage	$2,374.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,017.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,017.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,017.93
Rate for Payer: Cigna Commercial	$3,956.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.02

TIBIAL PLATE NEXGEN PRECOAT

Facility

$6,156.25

Hospital Charge Code	270660844
Hospital Revenue Code	278
Min. Negotiated Rate	$923.44
Max. Negotiated Rate	$3,078.12
Rate for Payer: Aetna Commercial	$1,846.88
Rate for Payer: Aetna Medicare Advantage	$1,846.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.84
Rate for Payer: Cigna Commercial	$3,078.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.81
Rate for Payer: Qualcare PPO/HMO/WC	$923.44

Know your out-of-pocket cost for care.

All Charges