Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSRT MDM LINER 22.2/38MM 38D

Facility

$4,465.10

Service Code	HCPCS C1776
Hospital Charge Code	270681299
Hospital Revenue Code	278
Min. Negotiated Rate	$669.76
Max. Negotiated Rate	$1,080.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.55
Rate for Payer: Qualcare PPO/HMO/WC	$669.76

INSRTR THRD SHAFT STR G7

Facility

$2,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270693276
Hospital Revenue Code	278
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$1,300.00
Rate for Payer: Aetna Commercial	$780.00
Rate for Payer: Aetna Medicare Advantage	$780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$663.00
Rate for Payer: Cigna Commercial	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.20
Rate for Payer: Qualcare PPO/HMO/WC	$390.00

INSRTR THRD SHAFT STR G7

Facility

$2,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270693276
Hospital Revenue Code	278
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$629.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$629.20
Rate for Payer: Qualcare PPO/HMO/WC	$390.00

INSRT SPHERE FLEX LEFT 11MM S4

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681130
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

INSRT SPHERE FLEX LEFT 11MM S4

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681130
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

INSRT SPINE FIXATION DVC POSTR

Facility

$23,774.45

Service Code	HCPCS 22840
Hospital Charge Code	16000360
Hospital Revenue Code	360
Min. Negotiated Rate	$724.18
Max. Negotiated Rate	$7,132.34
Rate for Payer: Aetna Commercial	$7,132.34
Rate for Payer: Aetna Medicare Advantage	$7,132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,062.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,062.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,062.48
Rate for Payer: Cigna Commercial	$724.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,090.68
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSRT SPINE FIXATION DVC POSTR

Facility

$23,774.45

Service Code	HCPCS 22840
Hospital Charge Code	16000360
Hospital Revenue Code	360
Min. Negotiated Rate	$3,566.17
Max. Negotiated Rate	$3,566.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17

INSRT SPINE FXTN DVC4-7SEGMNTS

Facility

$25,282.63

Service Code	HCPCS 22846
Hospital Charge Code	16000808
Hospital Revenue Code	360
Min. Negotiated Rate	$729.61
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$7,584.79
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,447.07
Rate for Payer: Cigna Commercial	$729.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,286.74
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

INSRT SPINE FXTN DVC4-7SEGMNTS

Facility

$25,282.63

Service Code	HCPCS 22846
Hospital Charge Code	16000808
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSRT SPN FIXATION DVC7-12SEGS

Facility

$25,282.63

Service Code	HCPCS 22845
Hospital Charge Code	16000375
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSRT SPN FIXATION DVC7-12SEGS

Facility

$25,282.63

Service Code	HCPCS 22845
Hospital Charge Code	16000375
Hospital Revenue Code	360
Min. Negotiated Rate	$701.72
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$7,584.79
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,447.07
Rate for Payer: Cigna Commercial	$701.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,286.74
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

INSRT SPN FXTN DVC 7-12SEGMNTS

Facility

$20,846.25

Service Code	HCPCS 22843
Hospital Charge Code	16000807
Hospital Revenue Code	360
Min. Negotiated Rate	$3,126.94
Max. Negotiated Rate	$3,126.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,126.94

INSRT SPN FXTN DVC 7-12SEGMNTS

Facility

$20,846.25

Service Code	HCPCS 22843
Hospital Charge Code	16000807
Hospital Revenue Code	360
Min. Negotiated Rate	$789.34
Max. Negotiated Rate	$6,253.88
Rate for Payer: Aetna Commercial	$6,253.88
Rate for Payer: Aetna Medicare Advantage	$6,253.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,315.79
Rate for Payer: Cigna Commercial	$789.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,710.01
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,126.94
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSTALLING FAN MOTOR/MOUNTING

Facility

$12,250.00

Hospital Charge Code	270659136
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

INSTALLING FAN MOTOR/MOUNTING

Facility

$12,250.00

Hospital Charge Code	270659136
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$3,675.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

INSTALL STEEL CATWALKS

Facility

$23,500.00

Hospital Charge Code	270647909
Hospital Revenue Code	272
Min. Negotiated Rate	$3,055.00
Max. Negotiated Rate	$11,750.00
Rate for Payer: Aetna Commercial	$7,050.00
Rate for Payer: Aetna Medicare Advantage	$7,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,992.50
Rate for Payer: Cigna Commercial	$11,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,055.00
Rate for Payer: Oxford Commercial	$11,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,525.00
Rate for Payer: UnitedHealthcare Commercial	$11,750.00

INSTALL STEEL CATWALKS

Facility

$23,500.00

Hospital Charge Code	270647909
Hospital Revenue Code	272
Min. Negotiated Rate	$3,525.00
Max. Negotiated Rate	$3,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,525.00

INSTAT 3X4

Facility

$336.00

Hospital Charge Code	6006753
Hospital Revenue Code	250
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$100.80
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$168.00

INSTAT 3X4

Facility

$336.00

Hospital Charge Code	6006753
Hospital Revenue Code	250
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

INS TEMP BALDDER CATH

Facility

$1,167.00

Service Code	HCPCS 51702
Hospital Charge Code	1600000435
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

INS TEMP BALDDER CATH

Facility

$1,167.00

Service Code	HCPCS 51702
Hospital Charge Code	1600000435
Hospital Revenue Code	360
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$350.10
Rate for Payer: Aetna Medicare Advantage	$350.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.58
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.71
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSTIBPSNREVARTSURFVE16MM

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270694285
Hospital Revenue Code	278
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$9,062.50
Rate for Payer: Aetna Commercial	$5,437.50
Rate for Payer: Aetna Medicare Advantage	$5,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,621.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,621.88
Rate for Payer: Cigna Commercial	$9,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

INSTIBPSNREVARTSURFVE16MM

Facility

$18,125.00

Service Code	HCPCS C1776
Hospital Charge Code	270694285
Hospital Revenue Code	278
Min. Negotiated Rate	$2,718.75
Max. Negotiated Rate	$4,386.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,386.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,718.75

INST. KIT,INFERIOR,GLENOID

Facility

$3,265.00

Hospital Charge Code	270687344
Hospital Revenue Code	272
Min. Negotiated Rate	$424.45
Max. Negotiated Rate	$1,632.50
Rate for Payer: Aetna Commercial	$979.50
Rate for Payer: Aetna Medicare Advantage	$979.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$832.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$832.58
Rate for Payer: Cigna Commercial	$1,632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$424.45
Rate for Payer: Oxford Commercial	$1,632.50
Rate for Payer: Qualcare PPO/HMO/WC	$489.75
Rate for Payer: UnitedHealthcare Commercial	$1,632.50

INST. KIT,INFERIOR,GLENOID

Facility

$3,265.00

Hospital Charge Code	270687344
Hospital Revenue Code	272
Min. Negotiated Rate	$489.75
Max. Negotiated Rate	$489.75
Rate for Payer: Qualcare PPO/HMO/WC	$489.75

Know your out-of-pocket cost for care.

All Charges