Heights University Hospital

All Charges

Charge

Type

Setting

Price

TIBILA BEARING CONDYL 63/67x16

Facility

$12,930.00

Hospital Charge Code	270676087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,939.50
Max. Negotiated Rate	$6,465.00
Rate for Payer: Aetna Commercial	$3,879.00
Rate for Payer: Aetna Medicare Advantage	$3,879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,297.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,297.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,586.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,297.15
Rate for Payer: Cigna Commercial	$6,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,939.50

TIBILA BEARING CONDYL 63/67x16

Facility

$12,930.00

Hospital Charge Code	270676087
Hospital Revenue Code	278
Min. Negotiated Rate	$1,939.50
Max. Negotiated Rate	$3,129.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,939.50

TIBILA CUTTING BLOCK

Facility

$500.00

Hospital Charge Code	270678757
Hospital Revenue Code	272
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

TIBILA CUTTING BLOCK

Facility

$500.00

Hospital Charge Code	270678757
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

TIB INSERT ANKLE TMPROLONGSZ5

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697191
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$3,450.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

TIB INSERT ANKLE TMPROLONGSZ5

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697191
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

TIB INS POST STAB SZ 2 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697208
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

TIB INS POST STAB SZ 2 11MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697208
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

TIB/PER PTA ADD EA-BI

Facility

$15,877.00

Service Code	HCPCS 3723250
Hospital Charge Code	7411811
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-BI

Facility

$15,877.00

Service Code	HCPCS 3723250
Hospital Charge Code	2690560
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-BI

Facility

$15,877.00

Service Code	HCPCS 3723250
Hospital Charge Code	2690560
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-BI

Facility

$15,877.00

Service Code	HCPCS 3723250
Hospital Charge Code	7411811
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	366837232L
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	321037232L
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	321037232L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	2691450
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	7411942
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	2691450
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	7411942
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-LT

Facility

$15,877.00

Service Code	HCPCS 37232LT
Hospital Charge Code	366837232L
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-RT

Facility

$15,877.00

Service Code	HCPCS 37232RT
Hospital Charge Code	321037232R
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-RT

Facility

$15,877.00

Service Code	HCPCS 37232RT
Hospital Charge Code	411037232R
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,938.50
Rate for Payer: Cigna Commercial	$7,938.50
Rate for Payer: Aetna Commercial	$4,763.10
Rate for Payer: Aetna Medicare Advantage	$4,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,048.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,048.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,064.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-RT

Facility

$15,877.00

Service Code	HCPCS 37232RT
Hospital Charge Code	2691455
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-RT

Facility

$15,877.00

Service Code	HCPCS 37232RT
Hospital Charge Code	366837232R
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

TIB/PER PTA ADD EA-RT

Facility

$15,877.00

Service Code	HCPCS 37232RT
Hospital Charge Code	7411943
Hospital Revenue Code	361
Min. Negotiated Rate	$2,381.55
Max. Negotiated Rate	$2,381.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,381.55

Know your out-of-pocket cost for care.

All Charges