Heights University Hospital

All Charges

Charge

Type

Setting

Price

F-SERIES CANN SCREW 2.0X40MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681049
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$465.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

F-SERIES CANN SCREW 2.0X45MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681048
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

F-SERIES CANN SCREW 2.0X45MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681048
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$465.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

F-SERIES CANN SCREW 4.0 X 45MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270679981
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

F-SERIES CANN SCREW 4.0 X 45MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270679981
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

FSH

Facility

$633.00

Service Code	HCPCS 83001
Hospital Charge Code	38472284
Hospital Revenue Code	301
Min. Negotiated Rate	$94.95
Max. Negotiated Rate	$94.95
Rate for Payer: Qualcare PPO/HMO/WC	$94.95

FSH

Facility

$192.85

Service Code	HCPCS 83001
Hospital Charge Code	39900416
Hospital Revenue Code	301
Min. Negotiated Rate	$9.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.20
Rate for Payer: Aetna Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.08
Rate for Payer: Cigna Commercial	$18.58
Rate for Payer: Cigna Medicare Advantage	$9.29
Rate for Payer: Clover Medicare Advantage	$17.65
Rate for Payer: EmblemHealth Commercial	$55.74
Rate for Payer: Humana Medicare Advantage	$19.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.69
Rate for Payer: Wellcare Medicare Advantage	$18.58

FSH

Facility

$192.85

Service Code	HCPCS 83001
Hospital Charge Code	39900416
Hospital Revenue Code	301
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

FSH

Facility

$633.00

Service Code	HCPCS 83001
Hospital Charge Code	38472284
Hospital Revenue Code	301
Min. Negotiated Rate	$9.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.20
Rate for Payer: Aetna Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.08
Rate for Payer: Cigna Commercial	$18.58
Rate for Payer: Cigna Medicare Advantage	$9.29
Rate for Payer: Clover Medicare Advantage	$17.65
Rate for Payer: EmblemHealth Commercial	$55.74
Rate for Payer: Humana Medicare Advantage	$19.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.69
Rate for Payer: Wellcare Medicare Advantage	$18.58

FTA -ABS

Facility

$124.00

Service Code	HCPCS 86780
Hospital Charge Code	38476210
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

FTA -ABS

Facility

$124.00

Service Code	HCPCS 86780
Hospital Charge Code	38476210
Hospital Revenue Code	302
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

FTA-ABS, CSF

Facility

$141.65

Service Code	HCPCS 86780
Hospital Charge Code	3009750
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

FTA-ABS, CSF

Facility

$141.65

Service Code	HCPCS 86780
Hospital Charge Code	3009750
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

FTA-ABS,SERUM

Facility

$667.59

Service Code	HCPCS 86780
Hospital Charge Code	39990049EX
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

FTA-ABS,SERUM

Facility

$667.59

Service Code	HCPCS 86780
Hospital Charge Code	39990049EX
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FTA-ABS,SERUM, I

Facility

$91.00

Service Code	HCPCS 86780
Hospital Charge Code	39990049A
Hospital Revenue Code	306
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

FTA-ABS,SERUM, I

Facility

$91.00

Service Code	HCPCS 86780
Hospital Charge Code	39990049A
Hospital Revenue Code	306
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

F.TULARENSIS AB,DA (SERUM)

Facility

$390.00

Service Code	HCPCS 86000
Hospital Charge Code	397080011
Hospital Revenue Code	305
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.62
Rate for Payer: Aetna Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.57
Rate for Payer: Cigna Commercial	$6.98
Rate for Payer: Cigna Medicare Advantage	$3.49
Rate for Payer: Clover Medicare Advantage	$6.63
Rate for Payer: EmblemHealth Commercial	$20.94
Rate for Payer: Humana Medicare Advantage	$7.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.40
Rate for Payer: Wellcare Medicare Advantage	$6.98

F.TULARENSIS AB,DA (SERUM)

Facility

$390.00

Service Code	HCPCS 86000
Hospital Charge Code	397080011
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FULL CORE BIOPSY 16GX15CM

Facility

$235.00

Hospital Charge Code	270670786
Hospital Revenue Code	272
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

FULL CORE BIOPSY 16GX15CM

Facility

$235.00

Hospital Charge Code	270670786
Hospital Revenue Code	272
Min. Negotiated Rate	$30.55
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$70.50
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.55
Rate for Payer: Oxford Commercial	$117.50
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$117.50

FULL RAD BONECUTTER 4.5MM PLAT

Facility

$400.00

Hospital Charge Code	270692790
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

FULL RAD BONECUTTER 4.5MM PLAT

Facility

$400.00

Hospital Charge Code	270692790
Hospital Revenue Code	272
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$200.00

FULL RING 155MM

Facility

$8,025.00

Hospital Charge Code	270674285
Hospital Revenue Code	272
Min. Negotiated Rate	$1,043.25
Max. Negotiated Rate	$4,012.50
Rate for Payer: Aetna Commercial	$2,407.50
Rate for Payer: Aetna Medicare Advantage	$2,407.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,046.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,046.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,046.38
Rate for Payer: Cigna Commercial	$4,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,043.25
Rate for Payer: Oxford Commercial	$4,012.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,203.75
Rate for Payer: UnitedHealthcare Commercial	$4,012.50

FULL RING 155MM

Facility

$8,025.00

Hospital Charge Code	270674285
Hospital Revenue Code	272
Min. Negotiated Rate	$1,203.75
Max. Negotiated Rate	$1,203.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,203.75

Know your out-of-pocket cost for care.

All Charges