Heights University Hospital

All Charges

Charge

Type

Setting

Price

18 GAUGE NEEDLE W WIRE

Facility

$375.00

Hospital Charge Code	270693289
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

18 GAUGE NEEDLE W WIRE

Facility

$375.00

Hospital Charge Code	270693289
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

18-HYDROXYCORTICOSTERONE,BLD

Facility

$585.17

Service Code	HCPCS 83519
Hospital Charge Code	3001615
Hospital Revenue Code	301
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$87.78
Rate for Payer: Qualcare PPO/HMO/WC	$87.78

18-HYDROXYCORTICOSTERONE,BLD

Facility

$585.17

Service Code	HCPCS 83519
Hospital Charge Code	3001615
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

1.8 KNOTLESS FIBERTAK IMPLANT

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705808
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

1.8 KNOTLESS FIBERTAK IMPLANT

Facility

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705808
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

18MM 1-LVL EMERGE PLATE

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706198
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

18MM 1-LVL EMERGE PLATE

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706198
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

1.8MM DRILL BIT W/DEPTH MARK/1

Facility

$652.45

Hospital Charge Code	270661256
Hospital Revenue Code	272
Min. Negotiated Rate	$97.87
Max. Negotiated Rate	$97.87
Rate for Payer: Qualcare PPO/HMO/WC	$97.87

1.8MM DRILL BIT W/DEPTH MARK/1

Facility

$652.45

Hospital Charge Code	270661256
Hospital Revenue Code	272
Min. Negotiated Rate	$84.82
Max. Negotiated Rate	$326.23
Rate for Payer: Aetna Commercial	$195.74
Rate for Payer: Aetna Medicare Advantage	$195.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.37
Rate for Payer: Cigna Commercial	$326.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.82
Rate for Payer: Oxford Commercial	$326.23
Rate for Payer: Qualcare PPO/HMO/WC	$97.87
Rate for Payer: UnitedHealthcare Commercial	$326.23

1.8MM O-FIX IMPLANT

Facility

$2,079.00

Service Code	HCPCS C1713
Hospital Charge Code	270679625
Hospital Revenue Code	278
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$1,039.50
Rate for Payer: Aetna Commercial	$623.70
Rate for Payer: Aetna Medicare Advantage	$623.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.14
Rate for Payer: Cigna Commercial	$1,039.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.12
Rate for Payer: Qualcare PPO/HMO/WC	$311.85

1.8MM O-FIX IMPLANT

Facility

$2,079.00

Service Code	HCPCS C1713
Hospital Charge Code	270679625
Hospital Revenue Code	278
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$503.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.12
Rate for Payer: Qualcare PPO/HMO/WC	$311.85

1.8MM Q-FIX DISPOSABLE FLEX DR

Facility

$2,430.00

Hospital Charge Code	2707229011
Hospital Revenue Code	272
Min. Negotiated Rate	$364.50
Max. Negotiated Rate	$364.50
Rate for Payer: Qualcare PPO/HMO/WC	$364.50

1.8MM Q-FIX DISPOSABLE FLEX DR

Facility

$2,430.00

Hospital Charge Code	2707229011
Hospital Revenue Code	272
Min. Negotiated Rate	$315.90
Max. Negotiated Rate	$1,215.00
Rate for Payer: Aetna Commercial	$729.00
Rate for Payer: Aetna Medicare Advantage	$729.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$619.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$619.65
Rate for Payer: Cigna Commercial	$1,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.90
Rate for Payer: Oxford Commercial	$1,215.00
Rate for Payer: Qualcare PPO/HMO/WC	$364.50
Rate for Payer: UnitedHealthcare Commercial	$1,215.00

18MM SCREW

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270679111
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

18MM SCREW

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270679111
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

18MM UNIPLATE

Facility

$5,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680085
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$1,687.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

18MM UNIPLATE

Facility

$5,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680085
Hospital Revenue Code	278
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

1/8 QUICK REL DRL STERILE 2PK

Facility

$480.00

Service Code	HCPCS C1768
Hospital Charge Code	270639355
Hospital Revenue Code	272
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

1/8 QUICK REL DRL STERILE 2PK

Facility

$480.00

Service Code	HCPCS C1768
Hospital Charge Code	270639355
Hospital Revenue Code	272
Min. Negotiated Rate	$62.40
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$144.00
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Commercial	$240.00

18X16X8MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706195
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$5,175.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

18X16X8MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706195
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

18X16X9MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706196
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$4,174.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

18X16X9MM STATIC CERVICAL

Facility

$17,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270706196
Hospital Revenue Code	278
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$8,625.00
Rate for Payer: Aetna Commercial	$5,175.00
Rate for Payer: Aetna Medicare Advantage	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,398.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,398.75
Rate for Payer: Cigna Commercial	$8,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,174.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

18 X 30CM STRAIGHT GRAFT

Facility

$3,015.00

Service Code	HCPCS C1768
Hospital Charge Code	270683832
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$1,507.50
Rate for Payer: Aetna Commercial	$904.50
Rate for Payer: Aetna Medicare Advantage	$904.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$768.83
Rate for Payer: Cigna Commercial	$1,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

Know your out-of-pocket cost for care.

All Charges