Heights University Hospital

All Charges

Charge

Type

Setting

Price

CEMENT BONE MIMIX 10 GRAM

Facility

$9,125.00

Hospital Charge Code	270662163
Hospital Revenue Code	278
Min. Negotiated Rate	$1,368.75
Max. Negotiated Rate	$4,562.50
Rate for Payer: Aetna Commercial	$2,737.50
Rate for Payer: Aetna Medicare Advantage	$2,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,326.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,326.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,326.88
Rate for Payer: Cigna Commercial	$4,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,208.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,368.75

CEMENT BONE MIXER PACK

Facility

$1,474.00

Hospital Charge Code	270669783O
Hospital Revenue Code	272
Min. Negotiated Rate	$191.62
Max. Negotiated Rate	$737.00
Rate for Payer: Aetna Commercial	$442.20
Rate for Payer: Aetna Medicare Advantage	$442.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.87
Rate for Payer: Cigna Commercial	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.62
Rate for Payer: Oxford Commercial	$737.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.10
Rate for Payer: UnitedHealthcare Commercial	$737.00

CEMENT BONE MIXER PACK

Facility

$1,236.15

Hospital Charge Code	270669783
Hospital Revenue Code	272
Min. Negotiated Rate	$185.42
Max. Negotiated Rate	$185.42
Rate for Payer: Qualcare PPO/HMO/WC	$185.42

CEMENT BONE MIXER PACK

Facility

$1,236.15

Hospital Charge Code	270669783
Hospital Revenue Code	272
Min. Negotiated Rate	$160.70
Max. Negotiated Rate	$618.08
Rate for Payer: Aetna Commercial	$370.85
Rate for Payer: Aetna Medicare Advantage	$370.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.22
Rate for Payer: Cigna Commercial	$618.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.70
Rate for Payer: Oxford Commercial	$618.08
Rate for Payer: Qualcare PPO/HMO/WC	$185.42
Rate for Payer: UnitedHealthcare Commercial	$618.08

CEMENT BONE MIXER PACK

Facility

$1,474.00

Hospital Charge Code	270669783O
Hospital Revenue Code	272
Min. Negotiated Rate	$221.10
Max. Negotiated Rate	$221.10
Rate for Payer: Qualcare PPO/HMO/WC	$221.10

CEMENT BONE MIXING BOWL

Facility

$274.05

Service Code	HCPCS C1713
Hospital Charge Code	270658120
Hospital Revenue Code	278
Min. Negotiated Rate	$41.11
Max. Negotiated Rate	$137.03
Rate for Payer: Aetna Commercial	$82.22
Rate for Payer: Aetna Medicare Advantage	$82.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.88
Rate for Payer: Cigna Commercial	$137.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.32
Rate for Payer: Qualcare PPO/HMO/WC	$41.11

CEMENT BONE MIXING BOWL

Facility

$274.05

Service Code	HCPCS C1713
Hospital Charge Code	270658120
Hospital Revenue Code	278
Min. Negotiated Rate	$41.11
Max. Negotiated Rate	$66.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.32
Rate for Payer: Qualcare PPO/HMO/WC	$41.11

CEMENT BONE PLACOS G 424810

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270635590
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CEMENT BONE PLACOS G 424810

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270635590
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CEMENT BONE RADIOPQUE HVR C01A

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270633797
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CEMENT BONE RADIOPQUE HVR C01A

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270633797
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

CEMENT BONESYNC 5CC PHOSPHATE

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692085
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$2,475.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

CEMENT BONESYNC 5CC PHOSPHATE

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692085
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

CEMENT COBALT 402432

Facility

$545.00

Hospital Charge Code	270638690
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CEMENT COBALT 402432

Facility

$545.00

Hospital Charge Code	270638690
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CEMENT COBALT W/ANTIB 402433

Facility

$1,975.00

Hospital Charge Code	270638571
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CEMENT COBALT W/ANTIB 402433

Facility

$1,975.00

Hospital Charge Code	270638571
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

CEMENT DELIVERY SYSTEM 605-685

Facility

$5,000.00

Hospital Charge Code	270644262
Hospital Revenue Code	272
Min. Negotiated Rate	$650.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Oxford Commercial	$2,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$2,500.00

CEMENT DELIVERY SYSTEM 605-685

Facility

$5,000.00

Hospital Charge Code	270644262
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

CEMENTED HIP STEM SZ.3

Facility

$23,085.00

Hospital Charge Code	270656397
Hospital Revenue Code	278
Min. Negotiated Rate	$3,462.75
Max. Negotiated Rate	$11,542.50
Rate for Payer: Aetna Commercial	$6,925.50
Rate for Payer: Aetna Medicare Advantage	$6,925.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,886.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,886.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,617.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,886.68
Rate for Payer: Cigna Commercial	$11,542.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,586.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,462.75

CEMENTED HIP STEM SZ.3

Facility

$23,085.00

Hospital Charge Code	270656397
Hospital Revenue Code	278
Min. Negotiated Rate	$3,462.75
Max. Negotiated Rate	$5,586.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,617.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,586.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,462.75

CEMENT FEMORAL RESTRICTOR SZ2

Facility

$397.50

Service Code	HCPCS C1713
Hospital Charge Code	270655655
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$96.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ2

Facility

$397.50

Service Code	HCPCS C1713
Hospital Charge Code	270655655
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$119.25
Rate for Payer: Aetna Medicare Advantage	$119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.36
Rate for Payer: Cigna Commercial	$198.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ3

Facility

$397.50

Service Code	HCPCS C1713
Hospital Charge Code	270655657
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$96.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ3

Facility

$397.50

Service Code	HCPCS C1713
Hospital Charge Code	270655657
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$119.25
Rate for Payer: Aetna Medicare Advantage	$119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.36
Rate for Payer: Cigna Commercial	$198.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

Know your out-of-pocket cost for care.

All Charges