Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 10.5MM X 120MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684351
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

HFN LAG SCREW 10.5MM X 120MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270684351
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

HFN LAG SCREW 10.5MM X 85MM

Facility

$2,544.00

Service Code	HCPCS C1713
Hospital Charge Code	270681532
Hospital Revenue Code	278
Min. Negotiated Rate	$381.60
Max. Negotiated Rate	$615.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.65
Rate for Payer: Qualcare PPO/HMO/WC	$381.60

HFN LAG SCREW 10.5MM X 85MM

Facility

$2,544.00

Service Code	HCPCS C1713
Hospital Charge Code	270681532
Hospital Revenue Code	278
Min. Negotiated Rate	$381.60
Max. Negotiated Rate	$1,272.00
Rate for Payer: Qualcare PPO/HMO/WC	$381.60
Rate for Payer: Aetna Commercial	$763.20
Rate for Payer: Aetna Medicare Advantage	$763.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$648.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$648.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$648.72
Rate for Payer: Cigna Commercial	$1,272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.65

HFN LAG SCREW 10.5MM X 90 MM

Facility

$5,110.00

Service Code	HCPCS C1713
Hospital Charge Code	270681528
Hospital Revenue Code	278
Min. Negotiated Rate	$766.50
Max. Negotiated Rate	$1,236.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,022.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,236.62
Rate for Payer: Qualcare PPO/HMO/WC	$766.50

HFN LAG SCREW 10.5MM X 90 MM

Facility

$5,110.00

Service Code	HCPCS C1713
Hospital Charge Code	270681528
Hospital Revenue Code	278
Min. Negotiated Rate	$766.50
Max. Negotiated Rate	$2,555.00
Rate for Payer: Aetna Commercial	$1,533.00
Rate for Payer: Aetna Medicare Advantage	$1,533.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,303.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,303.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,303.05
Rate for Payer: Cigna Commercial	$2,555.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,236.62
Rate for Payer: Qualcare PPO/HMO/WC	$766.50

HFN LH 125 DEG 11MM X 340MM

Facility

$12,770.00

Service Code	HCPCS C1713
Hospital Charge Code	270683436
Hospital Revenue Code	278
Min. Negotiated Rate	$1,915.50
Max. Negotiated Rate	$3,090.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,554.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,090.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,915.50

HFN LH 125 DEG 11MM X 340MM

Facility

$12,770.00

Service Code	HCPCS C1713
Hospital Charge Code	270683436
Hospital Revenue Code	278
Min. Negotiated Rate	$1,915.50
Max. Negotiated Rate	$6,385.00
Rate for Payer: Aetna Commercial	$3,831.00
Rate for Payer: Aetna Medicare Advantage	$3,831.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,256.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,256.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,554.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,256.35
Rate for Payer: Cigna Commercial	$6,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,090.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,915.50

HFN LH 125 DEG 11MM X 40MM

Facility

$9,144.00

Service Code	HCPCS C1713
Hospital Charge Code	270680793
Hospital Revenue Code	278
Min. Negotiated Rate	$1,371.60
Max. Negotiated Rate	$2,212.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,828.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,212.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,371.60

HFN LH 125 DEG 11MM X 40MM

Facility

$9,144.00

Service Code	HCPCS C1713
Hospital Charge Code	270680793
Hospital Revenue Code	278
Min. Negotiated Rate	$1,371.60
Max. Negotiated Rate	$4,572.00
Rate for Payer: Aetna Commercial	$2,743.20
Rate for Payer: Aetna Medicare Advantage	$2,743.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,331.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,331.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,828.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,331.72
Rate for Payer: Cigna Commercial	$4,572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,212.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,371.60

HFN RH 125 DEG 11MM X 260MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270690403
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 RH 125 DEG 11MM X 260MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270690403
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

HFN RH 125 DEG 11MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270684350
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

HFN RH 125 DEG 11MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270684350
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 RH 125 DEG 11MM X 95MM

Facility

$14,905.00

Hospital Charge Code	270702734
Hospital Revenue Code	278
Min. Negotiated Rate	$2,235.75
Max. Negotiated Rate	$3,607.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,235.75

HFN RH 125 DEG 11MM X 95MM

Facility

$14,905.00

Hospital Charge Code	270702734
Hospital Revenue Code	278
Min. Negotiated Rate	$2,235.75
Max. Negotiated Rate	$7,452.50
Rate for Payer: Aetna Commercial	$4,471.50
Rate for Payer: Aetna Medicare Advantage	$4,471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,800.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,800.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,800.78
Rate for Payer: Cigna Commercial	$7,452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,235.75

HFN RH 125 DEG 9MM X 260 MM

Facility

$9,432.00

Service Code	HCPCS C1713
Hospital Charge Code	270682505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,414.80
Max. Negotiated Rate	$4,716.00
Rate for Payer: Aetna Commercial	$2,829.60
Rate for Payer: Aetna Medicare Advantage	$2,829.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,405.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,886.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,405.16
Rate for Payer: Cigna Commercial	$4,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,282.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,414.80

HFN RH 125 DEG 9MM X 260 MM

Facility

$9,432.00

Service Code	HCPCS C1713
Hospital Charge Code	270682505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,414.80
Max. Negotiated Rate	$2,282.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,886.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,282.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,414.80

HFN RH 125 DEG 9MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688657
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

HFN RH 125 DEG 9MM X 420MM

Facility

$9,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688657
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

H.F. RESCETION ELECT LOOP 24FR

Facility

$7,777.00

Hospital Charge Code	270655911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,166.55
Max. Negotiated Rate	$1,166.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.55

H.F. RESCETION ELECT LOOP 24FR

Facility

$7,777.00

Hospital Charge Code	270655911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,011.01
Max. Negotiated Rate	$3,888.50
Rate for Payer: Aetna Commercial	$2,333.10
Rate for Payer: Aetna Medicare Advantage	$2,333.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,983.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,983.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,983.13
Rate for Payer: Cigna Commercial	$3,888.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,011.01
Rate for Payer: Oxford Commercial	$3,888.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,166.55
Rate for Payer: UnitedHealthcare Commercial	$3,888.50

H. GALACTOMANNAN ANTIGEN URINE

Facility

$155.14

Service Code	HCPCS 87385
Hospital Charge Code	401187385
Hospital Revenue Code	306
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$23.27
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

H. GALACTOMANNAN ANTIGEN URINE

Facility

$155.14

Service Code	HCPCS 87385
Hospital Charge Code	401187385
Hospital Revenue Code	306
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.93
Rate for Payer: Aetna Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.55
Rate for Payer: Cigna Commercial	$13.25
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.59
Rate for Payer: EmblemHealth Commercial	$39.75
Rate for Payer: Humana Medicare Advantage	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.27
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.04
Rate for Payer: Wellcare Medicare Advantage	$13.25

Know your out-of-pocket cost for care.

All Charges