Heights University Hospital

All Charges

Charge

Type

Setting

Price

TIBIAL PLATE NEXGEN PRECOAT

Facility

$6,156.25

Hospital Charge Code	270660844
Hospital Revenue Code	278
Min. Negotiated Rate	$923.44
Max. Negotiated Rate	$1,489.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.81
Rate for Payer: Qualcare PPO/HMO/WC	$923.44

TIBIAL PLATE STEMMED SZ 1

Facility

$6,156.70

Hospital Charge Code	270657858
Hospital Revenue Code	278
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$3,078.35
Rate for Payer: Aetna Commercial	$1,847.01
Rate for Payer: Aetna Medicare Advantage	$1,847.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,569.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,569.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,569.96
Rate for Payer: Cigna Commercial	$3,078.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.92
Rate for Payer: Qualcare PPO/HMO/WC	$923.50

TIBIAL PLATE STEMMED SZ 1

Facility

$6,156.70

Hospital Charge Code	270657858
Hospital Revenue Code	278
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$1,489.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,231.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,489.92
Rate for Payer: Qualcare PPO/HMO/WC	$923.50

TIBIAL PLATFORM COMPONENT S

Facility

$11,675.00

Hospital Charge Code	270666804
Hospital Revenue Code	278
Min. Negotiated Rate	$1,751.25
Max. Negotiated Rate	$2,825.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,825.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.25

TIBIAL PLATFORM COMPONENT S

Facility

$11,675.00

Hospital Charge Code	270666804
Hospital Revenue Code	278
Min. Negotiated Rate	$1,751.25
Max. Negotiated Rate	$5,837.50
Rate for Payer: Aetna Commercial	$3,502.50
Rate for Payer: Aetna Medicare Advantage	$3,502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,977.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,977.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,977.12
Rate for Payer: Cigna Commercial	$5,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,825.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,751.25

TIBIAL POROUS TITM CONSTRUCT

Facility

$11,060.00

Hospital Charge Code	270668334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,659.00
Max. Negotiated Rate	$2,676.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,676.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.00

TIBIAL POROUS TITM CONSTRUCT

Facility

$11,060.00

Hospital Charge Code	270668334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,659.00
Max. Negotiated Rate	$5,530.00
Rate for Payer: Aetna Commercial	$3,318.00
Rate for Payer: Aetna Medicare Advantage	$3,318.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,820.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,820.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,820.30
Rate for Payer: Cigna Commercial	$5,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,676.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,659.00

TIBIAL POSTERIOR STAB SZ1 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679842
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 POSTERIOR STAB SZ1 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679842
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 POSTERIOR STAB SZ1 13MM

Facility

$4,000.00

Hospital Charge Code	270671564
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 POSTERIOR STAB SZ1 13MM

Facility

$4,000.00

Hospital Charge Code	270671564
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 POSTERIOR STAB SZ1 18MM

Facility

$4,284.65

Hospital Charge Code	270670879
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$2,142.32
Rate for Payer: Aetna Commercial	$1,285.39
Rate for Payer: Aetna Medicare Advantage	$1,285.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.59
Rate for Payer: Cigna Commercial	$2,142.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

TIBIAL POSTERIOR STAB SZ1 18MM

Facility

$4,284.65

Hospital Charge Code	270670879
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$1,036.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

TIBIAL POSTERIOR STAB SZ1 30MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680581
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 POSTERIOR STAB SZ1 30MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270680581
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 POSTERIOR STAB SZ1 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678221
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 POSTERIOR STAB SZ1 9MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270678221
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 POSTERIOR STAB SZ2 15MM

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270671566
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 POSTERIOR STAB SZ2 15MM

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270671566
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 POSTERIOR STAB SZ2 18MM

Facility

$5,360.00

Service Code	HCPCS C1776
Hospital Charge Code	270668732
Hospital Revenue Code	278
Min. Negotiated Rate	$804.00
Max. Negotiated Rate	$1,297.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,072.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,297.12
Rate for Payer: Qualcare PPO/HMO/WC	$804.00

TIBIAL POSTERIOR STAB SZ2 18MM

Facility

$5,360.00

Service Code	HCPCS C1776
Hospital Charge Code	270668732
Hospital Revenue Code	278
Min. Negotiated Rate	$804.00
Max. Negotiated Rate	$2,680.00
Rate for Payer: Aetna Commercial	$1,608.00
Rate for Payer: Aetna Medicare Advantage	$1,608.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,366.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,366.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,366.80
Rate for Payer: Cigna Commercial	$2,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,297.12
Rate for Payer: Qualcare PPO/HMO/WC	$804.00

TIBIAL POSTERIOR STAB. SZ2 22M

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270669871
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$1,036.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

TIBIAL POSTERIOR STAB. SZ2 22M

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270669871
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$2,142.32
Rate for Payer: Aetna Commercial	$1,285.39
Rate for Payer: Aetna Medicare Advantage	$1,285.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.59
Rate for Payer: Cigna Commercial	$2,142.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

TIBIAL POSTERIOR STAB SZ3 13MM

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270670880
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$1,036.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

TIBIAL POSTERIOR STAB SZ3 13MM

Facility

$4,284.65

Service Code	HCPCS C1776
Hospital Charge Code	270670880
Hospital Revenue Code	278
Min. Negotiated Rate	$642.70
Max. Negotiated Rate	$2,142.32
Rate for Payer: Aetna Commercial	$1,285.39
Rate for Payer: Aetna Medicare Advantage	$1,285.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,092.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$856.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,092.59
Rate for Payer: Cigna Commercial	$2,142.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,036.89
Rate for Payer: Qualcare PPO/HMO/WC	$642.70

Know your out-of-pocket cost for care.

All Charges