Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEXAVITAMIN/TAB

Facility

$4.00

Service Code	NDC 49348010110
Hospital Charge Code	60633092
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HEXAVITAMIN/TAB

Facility

$4.00

Service Code	NDC 49348010110
Hospital Charge Code	60633092
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

HEXTENE 6% (500ML)

Facility

$43.00

Hospital Charge Code	60635274
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

HEXTENE 6% (500ML)

Facility

$43.00

Hospital Charge Code	60635274
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

HEX WRENCH PRECISION

Facility

$375.00

Hospital Charge Code	270679696
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

HEX WRENCH PRECISION

Facility

$375.00

Hospital Charge Code	270679696
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

HFH LH 125 DEG 9MMX320MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270689270
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

HFH LH 125 DEG 9MMX320MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270689270
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$2,947.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

HFN 125 DEG 9MM X 180MM

Facility

$6,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270681531
Hospital Revenue Code	278
Min. Negotiated Rate	$997.20
Max. Negotiated Rate	$3,324.00
Rate for Payer: Aetna Commercial	$1,994.40
Rate for Payer: Aetna Medicare Advantage	$1,994.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,695.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,695.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,695.24
Rate for Payer: Cigna Commercial	$3,324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.82
Rate for Payer: Qualcare PPO/HMO/WC	$997.20

HFN 125 DEG 9MM X 180MM

Facility

$6,648.00

Service Code	HCPCS C1713
Hospital Charge Code	270681531
Hospital Revenue Code	278
Min. Negotiated Rate	$997.20
Max. Negotiated Rate	$1,608.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.82
Rate for Payer: Qualcare PPO/HMO/WC	$997.20

HFN 130 DEG 13MM X 180MM

Facility

$6,362.40

Service Code	HCPCS C1713
Hospital Charge Code	270679319
Hospital Revenue Code	278
Min. Negotiated Rate	$954.36
Max. Negotiated Rate	$3,181.20
Rate for Payer: Aetna Commercial	$1,908.72
Rate for Payer: Aetna Medicare Advantage	$1,908.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,622.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,622.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,272.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,622.41
Rate for Payer: Cigna Commercial	$3,181.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,539.70
Rate for Payer: Qualcare PPO/HMO/WC	$954.36

HFN 130 DEG 13MM X 180MM

Facility

$6,362.40

Service Code	HCPCS C1713
Hospital Charge Code	270679319
Hospital Revenue Code	278
Min. Negotiated Rate	$954.36
Max. Negotiated Rate	$1,539.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,272.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,539.70
Rate for Payer: Qualcare PPO/HMO/WC	$954.36

HFN 130 DEG 9MM X 180MM

Facility

$6,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687401
Hospital Revenue Code	278
Min. Negotiated Rate	$1,038.75
Max. Negotiated Rate	$1,675.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,675.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,038.75

HFN 130 DEG 9MM X 180MM

Facility

$6,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270687401
Hospital Revenue Code	278
Min. Negotiated Rate	$1,038.75
Max. Negotiated Rate	$3,462.50
Rate for Payer: Aetna Commercial	$2,077.50
Rate for Payer: Aetna Medicare Advantage	$2,077.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,765.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,765.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,765.88
Rate for Payer: Cigna Commercial	$3,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,675.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,038.75

HFN A/R SCREW 65MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270681533
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$516.00
Rate for Payer: Aetna Commercial	$309.60
Rate for Payer: Aetna Medicare Advantage	$309.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.16
Rate for Payer: Cigna Commercial	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

HFN A/R SCREW 65MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270681533
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$249.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

HFN A/R SCREW 75MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270680792
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$249.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

HFN A/R SCREW 75MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	270680792
Hospital Revenue Code	278
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$516.00
Rate for Payer: Aetna Commercial	$309.60
Rate for Payer: Aetna Medicare Advantage	$309.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.16
Rate for Payer: Cigna Commercial	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

HFN AR SCREW 80MM

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270679371
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

HFN AR SCREW 80MM

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270679371
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

HFN A/R SCREW 85MM

Facility

$1,047.00

Service Code	HCPCS C1713
Hospital Charge Code	270681529
Hospital Revenue Code	278
Min. Negotiated Rate	$157.05
Max. Negotiated Rate	$253.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.37
Rate for Payer: Qualcare PPO/HMO/WC	$157.05

HFN A/R SCREW 85MM

Facility

$1,047.00

Service Code	HCPCS C1713
Hospital Charge Code	270681529
Hospital Revenue Code	278
Min. Negotiated Rate	$157.05
Max. Negotiated Rate	$523.50
Rate for Payer: Aetna Commercial	$314.10
Rate for Payer: Aetna Medicare Advantage	$314.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.99
Rate for Payer: Cigna Commercial	$523.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.37
Rate for Payer: Qualcare PPO/HMO/WC	$157.05

HFN LAG SCREW 10.5MMX100MM

Facility

$2,517.60

Service Code	HCPCS C1713
Hospital Charge Code	270678400
Hospital Revenue Code	278
Min. Negotiated Rate	$377.64
Max. Negotiated Rate	$1,258.80
Rate for Payer: Aetna Commercial	$755.28
Rate for Payer: Aetna Medicare Advantage	$755.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$641.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$641.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$641.99
Rate for Payer: Cigna Commercial	$1,258.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$609.26
Rate for Payer: Qualcare PPO/HMO/WC	$377.64

HFN LAG SCREW 10.5MMX100MM

Facility

$2,517.60

Service Code	HCPCS C1713
Hospital Charge Code	270678400
Hospital Revenue Code	278
Min. Negotiated Rate	$377.64
Max. Negotiated Rate	$609.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$609.26
Rate for Payer: Qualcare PPO/HMO/WC	$377.64

HFN LAG SCREW 10.5MMX105MM

Facility

$2,517.60

Service Code	HCPCS C1713
Hospital Charge Code	270679318
Hospital Revenue Code	278
Min. Negotiated Rate	$377.64
Max. Negotiated Rate	$609.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$609.26
Rate for Payer: Qualcare PPO/HMO/WC	$377.64

Know your out-of-pocket cost for care.

All Charges