Heights University Hospital

All Charges

Charge

Type

Setting

Price

10.2MM CANN DRILL BIT LENGTH 2

Facility

$3,300.00

Hospital Charge Code	270686947
Hospital Revenue Code	272
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

10.5MM X 80MM LAG SCREW

Facility

$4,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270704115
Hospital Revenue Code	278
Min. Negotiated Rate	$647.62
Max. Negotiated Rate	$2,158.75
Rate for Payer: Aetna Commercial	$1,295.25
Rate for Payer: Aetna Medicare Advantage	$1,295.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,100.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,100.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$863.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,100.96
Rate for Payer: Cigna Commercial	$2,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.84
Rate for Payer: Qualcare PPO/HMO/WC	$647.62

10.5MM X 80MM LAG SCREW

Facility

$4,317.50

Service Code	HCPCS C1713
Hospital Charge Code	270704115
Hospital Revenue Code	278
Min. Negotiated Rate	$647.62
Max. Negotiated Rate	$1,044.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$863.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.84
Rate for Payer: Qualcare PPO/HMO/WC	$647.62

10CC BONESYNC BIOACTIVE MATRIX

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706282
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

10CC BONESYNC BIOACTIVE MATRIX

Facility

$8,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706282
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

10CC DBM FIBER

Facility

$10,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705939
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

10CC DBM FIBER

Facility

$10,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705939
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

10CC PROTEIOS GROWTH FACTOR

Facility

$14,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270703846
Hospital Revenue Code	278
Min. Negotiated Rate	$2,208.75
Max. Negotiated Rate	$3,563.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,208.75

10CC PROTEIOS GROWTH FACTOR

Facility

$14,725.00

Service Code	HCPCS C1889
Hospital Charge Code	270703846
Hospital Revenue Code	278
Min. Negotiated Rate	$2,208.75
Max. Negotiated Rate	$7,362.50
Rate for Payer: Aetna Commercial	$4,417.50
Rate for Payer: Aetna Medicare Advantage	$4,417.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,754.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,754.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,754.88
Rate for Payer: Cigna Commercial	$7,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,563.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,208.75

10CM RAIL

Facility

$3,100.00

Hospital Charge Code	270656608
Hospital Revenue Code	278
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$930.00
Rate for Payer: Aetna Medicare Advantage	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.50
Rate for Payer: Cigna Commercial	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.20
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

10CM RAIL

Facility

$3,100.00

Hospital Charge Code	270656608
Hospital Revenue Code	278
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$750.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.20
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

10 CM X15 CM OVA

Facility

$3,665.00

Service Code	HCPCS C1781
Hospital Charge Code	270684332
Hospital Revenue Code	278
Min. Negotiated Rate	$549.75
Max. Negotiated Rate	$1,832.50
Rate for Payer: Aetna Commercial	$1,099.50
Rate for Payer: Aetna Medicare Advantage	$1,099.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$934.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$934.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$934.58
Rate for Payer: Cigna Commercial	$1,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: Qualcare PPO/HMO/WC	$549.75

10 CM X15 CM OVA

Facility

$3,665.00

Service Code	HCPCS C1781
Hospital Charge Code	270684332
Hospital Revenue Code	278
Min. Negotiated Rate	$549.75
Max. Negotiated Rate	$886.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: Qualcare PPO/HMO/WC	$549.75

10 CM X 15 CM OVAL

Facility

$3,665.00

Service Code	HCPCS C1781
Hospital Charge Code	270684330
Hospital Revenue Code	278
Min. Negotiated Rate	$549.75
Max. Negotiated Rate	$886.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: Qualcare PPO/HMO/WC	$549.75

10 CM X 15 CM OVAL

Facility

$3,665.00

Service Code	HCPCS C1781
Hospital Charge Code	270684330
Hospital Revenue Code	278
Min. Negotiated Rate	$549.75
Max. Negotiated Rate	$1,832.50
Rate for Payer: Aetna Commercial	$1,099.50
Rate for Payer: Aetna Medicare Advantage	$1,099.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$934.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$934.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$733.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$934.58
Rate for Payer: Cigna Commercial	$1,832.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$886.93
Rate for Payer: Qualcare PPO/HMO/WC	$549.75

10% CO2/BAL N2 E CYLINDER

Facility

$402.15

Hospital Charge Code	270658114
Hospital Revenue Code	278
Min. Negotiated Rate	$60.32
Max. Negotiated Rate	$201.07
Rate for Payer: Aetna Commercial	$120.64
Rate for Payer: Aetna Medicare Advantage	$120.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.55
Rate for Payer: Cigna Commercial	$201.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.32
Rate for Payer: Qualcare PPO/HMO/WC	$60.32

10% CO2/BAL N2 E CYLINDER

Facility

$402.15

Hospital Charge Code	270658114
Hospital Revenue Code	278
Min. Negotiated Rate	$60.32
Max. Negotiated Rate	$97.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.32
Rate for Payer: Qualcare PPO/HMO/WC	$60.32

`10 DEG GLENOID BASEPLATE

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

`10 DEG GLENOID BASEPLATE

Facility

$12,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

1.0 DRILL

Facility

$900.00

Hospital Charge Code	270657996
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

1.0 DRILL

Facility

$900.00

Hospital Charge Code	270657996
Hospital Revenue Code	272
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$450.00

10 HOLE LEFT DISTAL MEDIAL PLA

Facility

$10,745.00

Hospital Charge Code	270665462
Hospital Revenue Code	278
Min. Negotiated Rate	$1,611.75
Max. Negotiated Rate	$5,372.50
Rate for Payer: Aetna Commercial	$3,223.50
Rate for Payer: Aetna Medicare Advantage	$3,223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,739.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,739.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,739.97
Rate for Payer: Cigna Commercial	$5,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,600.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,611.75

10 HOLE LEFT DISTAL MEDIAL PLA

Facility

$10,745.00

Hospital Charge Code	270665462
Hospital Revenue Code	278
Min. Negotiated Rate	$1,611.75
Max. Negotiated Rate	$2,600.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,149.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,600.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,611.75

10 HOLE MID SHORT PLATE

Facility

$3,307.00

Hospital Charge Code	270657828
Hospital Revenue Code	278
Min. Negotiated Rate	$496.05
Max. Negotiated Rate	$1,653.50
Rate for Payer: Aetna Commercial	$992.10
Rate for Payer: Aetna Medicare Advantage	$992.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$843.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$843.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$661.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$843.28
Rate for Payer: Cigna Commercial	$1,653.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.29
Rate for Payer: Qualcare PPO/HMO/WC	$496.05

10 HOLE MID SHORT PLATE

Facility

$3,307.00

Hospital Charge Code	270657828
Hospital Revenue Code	278
Min. Negotiated Rate	$496.05
Max. Negotiated Rate	$800.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$661.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$800.29
Rate for Payer: Qualcare PPO/HMO/WC	$496.05

Know your out-of-pocket cost for care.

All Charges