Heights University Hospital

All Charges

Charge

Type

Setting

Price

24X36X12MM CAGE, 12 DEGREES

Facility

$31,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704954
Hospital Revenue Code	278
Min. Negotiated Rate	$4,725.00
Max. Negotiated Rate	$15,750.00
Rate for Payer: Aetna Commercial	$9,450.00
Rate for Payer: Aetna Medicare Advantage	$9,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,032.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,032.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,032.50
Rate for Payer: Cigna Commercial	$15,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,623.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,725.00

2.5 DRILL

Facility

$750.00

Hospital Charge Code	270657972
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

2.5 DRILL

Facility

$750.00

Hospital Charge Code	270657972
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

2.5 DRILL

Facility

$1,570.00

Hospital Charge Code	270703460
Hospital Revenue Code	279
Min. Negotiated Rate	$204.10
Max. Negotiated Rate	$785.00
Rate for Payer: Aetna Commercial	$471.00
Rate for Payer: Aetna Medicare Advantage	$471.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.35
Rate for Payer: Cigna Commercial	$785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.10
Rate for Payer: Oxford Commercial	$785.00
Rate for Payer: Qualcare PPO/HMO/WC	$235.50
Rate for Payer: UnitedHealthcare Commercial	$785.00

2.5 DRILL

Facility

$1,570.00

Hospital Charge Code	270703460
Hospital Revenue Code	279
Min. Negotiated Rate	$235.50
Max. Negotiated Rate	$235.50
Rate for Payer: Qualcare PPO/HMO/WC	$235.50

2.5 DRILL BIT

Facility

$316.65

Hospital Charge Code	270656288
Hospital Revenue Code	272
Min. Negotiated Rate	$47.50
Max. Negotiated Rate	$47.50
Rate for Payer: Qualcare PPO/HMO/WC	$47.50

2.5 DRILL BIT

Facility

$425.00

Hospital Charge Code	270656429
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

2.5 DRILL BIT

Facility

$316.65

Hospital Charge Code	270656288
Hospital Revenue Code	272
Min. Negotiated Rate	$41.16
Max. Negotiated Rate	$158.32
Rate for Payer: Aetna Commercial	$95.00
Rate for Payer: Aetna Medicare Advantage	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.75
Rate for Payer: Cigna Commercial	$158.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.16
Rate for Payer: Oxford Commercial	$158.32
Rate for Payer: Qualcare PPO/HMO/WC	$47.50
Rate for Payer: UnitedHealthcare Commercial	$158.32

2.5 DRILL BIT

Facility

$425.00

Hospital Charge Code	270656429
Hospital Revenue Code	272
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$212.50

2.5 DRILL BIT LONG

Facility

$730.00

Hospital Charge Code	270656858
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$219.00
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

2.5 DRILL BIT LONG

Facility

$730.00

Hospital Charge Code	270656858
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

2.5 DRILL BIT SHORT

Facility

$271.00

Hospital Charge Code	270656859
Hospital Revenue Code	272
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$135.50
Rate for Payer: Aetna Commercial	$81.30
Rate for Payer: Aetna Medicare Advantage	$81.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.11
Rate for Payer: Cigna Commercial	$135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.23
Rate for Payer: Oxford Commercial	$135.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.65
Rate for Payer: UnitedHealthcare Commercial	$135.50

2.5 DRILL BIT SHORT

Facility

$271.00

Hospital Charge Code	270656859
Hospital Revenue Code	272
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$40.65
Rate for Payer: Qualcare PPO/HMO/WC	$40.65

25 G 5 INCH SPINAL NEEDLE

Facility

$935.00

Hospital Charge Code	270325444
Hospital Revenue Code	272
Min. Negotiated Rate	$121.55
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$280.50
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.55
Rate for Payer: Oxford Commercial	$467.50
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Commercial	$467.50

25 G 5 INCH SPINAL NEEDLE

Facility

$935.00

Hospital Charge Code	270325444
Hospital Revenue Code	272
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$140.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

2.5 GRADUATED DRILL BIT

Facility

$425.00

Hospital Charge Code	270656430
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

2.5 GRADUATED DRILL BIT

Facility

$425.00

Hospital Charge Code	270656430
Hospital Revenue Code	272
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$212.50

25 HOUR URINE FOR KIDNEY STONE

Facility

$119.25

Service Code	HCPCS 84105
Hospital Charge Code	3038533B
Hospital Revenue Code	301
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

25 HOUR URINE FOR KIDNEY STONE

Facility

$119.25

Service Code	HCPCS 84105
Hospital Charge Code	3038533B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

25 HYDROXYVITAMIN D

Facility

$390.00

Service Code	HCPCS 82306
Hospital Charge Code	401082306
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
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	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

25 HYDROXYVITAMIN D

Facility

$390.00

Service Code	HCPCS 82306
Hospital Charge Code	401082306
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

2.5 MM 10 DIGIFUSE

Facility

$10,220.45

Service Code	HCPCS C1713
Hospital Charge Code	270687126
Hospital Revenue Code	278
Min. Negotiated Rate	$1,533.07
Max. Negotiated Rate	$2,473.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,044.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,473.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.07

2.5 MM 10 DIGIFUSE

Facility

$10,220.45

Service Code	HCPCS C1713
Hospital Charge Code	270687126
Hospital Revenue Code	278
Min. Negotiated Rate	$1,533.07
Max. Negotiated Rate	$5,110.23
Rate for Payer: Aetna Commercial	$3,066.14
Rate for Payer: Aetna Medicare Advantage	$3,066.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,606.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,606.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,044.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,606.21
Rate for Payer: Cigna Commercial	$5,110.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,473.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.07

2.5MM HEADED SCREW LENGTH 12MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687946
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$344.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

2.5MM HEADED SCREW LENGTH 12MM

Facility

$1,421.80

Service Code	HCPCS C1713
Hospital Charge Code	270687946
Hospital Revenue Code	278
Min. Negotiated Rate	$213.27
Max. Negotiated Rate	$710.90
Rate for Payer: Aetna Commercial	$426.54
Rate for Payer: Aetna Medicare Advantage	$426.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.56
Rate for Payer: Cigna Commercial	$710.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.08
Rate for Payer: Qualcare PPO/HMO/WC	$213.27

Know your out-of-pocket cost for care.

All Charges