Heights University Hospital

All Charges

Charge

Type

Setting

Price

K-WIRE .9MM 4

Facility

$60.00

Hospital Charge Code	270675711
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

KWIRE .9MMX152MM STANDARD TIP

Facility

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	270661783
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

KWIRE .9MMX152MM STANDARD TIP

Facility

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	270661783
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

KWIRE ANKLE 1.6MMX22.9CM

Facility

$243.00

Service Code	HCPCS C1713
Hospital Charge Code	270695540
Hospital Revenue Code	278
Min. Negotiated Rate	$36.45
Max. Negotiated Rate	$121.50
Rate for Payer: Aetna Commercial	$72.90
Rate for Payer: Aetna Medicare Advantage	$72.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.97
Rate for Payer: Cigna Commercial	$121.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.81
Rate for Payer: Qualcare PPO/HMO/WC	$36.45

KWIRE ANKLE 1.6MMX22.9CM

Facility

$243.00

Service Code	HCPCS C1713
Hospital Charge Code	270695540
Hospital Revenue Code	278
Min. Negotiated Rate	$36.45
Max. Negotiated Rate	$58.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.81
Rate for Payer: Qualcare PPO/HMO/WC	$36.45

K-WIRE ATTACHMENT F/PEN DRIVE

Facility

$9,924.00

Hospital Charge Code	270674161
Hospital Revenue Code	272
Min. Negotiated Rate	$1,290.12
Max. Negotiated Rate	$4,962.00
Rate for Payer: Aetna Commercial	$2,977.20
Rate for Payer: Aetna Medicare Advantage	$2,977.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,530.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,530.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,530.62
Rate for Payer: Cigna Commercial	$4,962.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,290.12
Rate for Payer: Oxford Commercial	$4,962.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,488.60
Rate for Payer: UnitedHealthcare Commercial	$4,962.00

K-WIRE ATTACHMENT F/PEN DRIVE

Facility

$9,924.00

Hospital Charge Code	270674161
Hospital Revenue Code	272
Min. Negotiated Rate	$1,488.60
Max. Negotiated Rate	$1,488.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,488.60

K-WIRE BEVELED LAT 12IN 1.5MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694854
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

K-WIRE BEVELED LAT 12IN 1.5MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694854
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

K-WIRE BLUNT-ABBOTT SPINE

Facility

$220.00

Hospital Charge Code	270339020
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

K-WIRE BLUNT-ABBOTT SPINE

Facility

$220.00

Hospital Charge Code	270339020
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

K-WIRE BLUNT NITINOL 21X1.4MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698154
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

K-WIRE BLUNT NITINOL 21X1.4MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270698154
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KWIRE BLUNT NITOL 20INCH

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270696836
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

KWIRE BLUNT NITOL 20INCH

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270696836
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

K-WIRE BLUNT TIP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692116
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

K-WIRE BLUNT TIP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692116
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

KWIRE BONE 1.6MM 9IN

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	270687077
Hospital Revenue Code	278
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$93.75
Rate for Payer: Aetna Commercial	$56.25
Rate for Payer: Aetna Medicare Advantage	$56.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.81
Rate for Payer: Cigna Commercial	$93.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

KWIRE BONE 1.6MM 9IN

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	270687077
Hospital Revenue Code	278
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.38
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

K-WIRE CAP (PIN GUARD) .045

Facility

$99.00

Hospital Charge Code	270331588
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

K-WIRE CAP (PIN GUARD) .045

Facility

$99.00

Hospital Charge Code	270331588
Hospital Revenue Code	272
Min. Negotiated Rate	$12.87
Max. Negotiated Rate	$49.50
Rate for Payer: Aetna Commercial	$29.70
Rate for Payer: Aetna Medicare Advantage	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.25
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$49.50
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$49.50

K WIRE COCR 1.1 X 105 MM

Facility

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689420
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

K WIRE COCR 1.1 X 105 MM

Facility

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689420
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

K-WIRE COCR 1.4 X 127MM

Facility

$140.00

Hospital Charge Code	270686588
Hospital Revenue Code	272
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.20
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$70.00

K-WIRE COCR 1.4 X 127MM

Facility

$140.00

Hospital Charge Code	270686588
Hospital Revenue Code	272
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

Know your out-of-pocket cost for care.

All Charges