Heights University Hospital

All Charges

Charge

Type

Setting

Price

KWIRE W STOP F/T10 2X150MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270700727
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

KWIRE W STOP F/T10 2X150MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270700727
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

K-WIRE W/THD TROCAR PT 280MM

Facility

$72.89

Hospital Charge Code	270604428
Hospital Revenue Code	272
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

K-WIRE W/THD TROCAR PT 280MM

Facility

$72.89

Hospital Charge Code	270604428
Hospital Revenue Code	272
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$36.45
Rate for Payer: Aetna Commercial	$21.87
Rate for Payer: Aetna Medicare Advantage	$21.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.59
Rate for Payer: Cigna Commercial	$36.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.48
Rate for Payer: Oxford Commercial	$36.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$36.45

K-WIRE W/THRD TIP 1.25x100MM

Facility

$195.29

Service Code	HCPCS C1769
Hospital Charge Code	270622480
Hospital Revenue Code	278
Min. Negotiated Rate	$29.29
Max. Negotiated Rate	$97.64
Rate for Payer: Aetna Commercial	$58.59
Rate for Payer: Aetna Medicare Advantage	$58.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.80
Rate for Payer: Cigna Commercial	$97.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.26
Rate for Payer: Qualcare PPO/HMO/WC	$29.29

K-WIRE W/THRD TIP 1.25x100MM

Facility

$195.29

Service Code	HCPCS C1769
Hospital Charge Code	270622480
Hospital Revenue Code	278
Min. Negotiated Rate	$29.29
Max. Negotiated Rate	$47.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.26
Rate for Payer: Qualcare PPO/HMO/WC	$29.29

K-WIRE W/TROCAR TIP 0.6x70MM

Facility

$327.55

Service Code	HCPCS C1713
Hospital Charge Code	270604408
Hospital Revenue Code	278
Min. Negotiated Rate	$49.13
Max. Negotiated Rate	$163.78
Rate for Payer: Aetna Commercial	$98.27
Rate for Payer: Aetna Medicare Advantage	$98.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.53
Rate for Payer: Cigna Commercial	$163.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.13

K-WIRE W/TROCAR TIP 0.6x70MM

Facility

$327.55

Service Code	HCPCS C1713
Hospital Charge Code	270604408
Hospital Revenue Code	278
Min. Negotiated Rate	$49.13
Max. Negotiated Rate	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.27
Rate for Payer: Qualcare PPO/HMO/WC	$49.13

K-WIRE W/TROCAR TIP 0.8x70MM

Facility

$32.76

Service Code	HCPCS C1713
Hospital Charge Code	270604411
Hospital Revenue Code	278
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$16.38
Rate for Payer: Aetna Commercial	$9.83
Rate for Payer: Aetna Medicare Advantage	$9.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.35
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

K-WIRE W/TROCAR TIP 0.8x70MM

Facility

$32.76

Service Code	HCPCS C1713
Hospital Charge Code	270604411
Hospital Revenue Code	278
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$7.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.91

K-WIRE W/TROCAR TIP 1.6x150MM

Facility

$38.83

Hospital Charge Code	270601824
Hospital Revenue Code	272
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$19.41
Rate for Payer: Aetna Commercial	$11.65
Rate for Payer: Aetna Medicare Advantage	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.90
Rate for Payer: Cigna Commercial	$19.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$19.41
Rate for Payer: Qualcare PPO/HMO/WC	$5.82
Rate for Payer: UnitedHealthcare Commercial	$19.41

K-WIRE W/TROCAR TIP 1.6x150MM

Facility

$38.83

Hospital Charge Code	270601824
Hospital Revenue Code	272
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$5.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

K-WIRE W/TROCAR TIP 2.0x150MM

Facility

$38.83

Service Code	HCPCS C1713
Hospital Charge Code	270603558
Hospital Revenue Code	278
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

K-WIRE W/TROCAR TIP 2.0x150MM

Facility

$38.83

Service Code	HCPCS C1713
Hospital Charge Code	270603558
Hospital Revenue Code	278
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$19.41
Rate for Payer: Aetna Commercial	$11.65
Rate for Payer: Aetna Medicare Advantage	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.90
Rate for Payer: Cigna Commercial	$19.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.82

K-WIRE W/TROCAR TIP 2.5x285MM

Facility

$483.80

Hospital Charge Code	270637807
Hospital Revenue Code	272
Min. Negotiated Rate	$72.57
Max. Negotiated Rate	$72.57
Rate for Payer: Qualcare PPO/HMO/WC	$72.57

K-WIRE W/TROCAR TIP 2.5x285MM

Facility

$483.80

Hospital Charge Code	270637807
Hospital Revenue Code	272
Min. Negotiated Rate	$62.89
Max. Negotiated Rate	$241.90
Rate for Payer: Aetna Commercial	$145.14
Rate for Payer: Aetna Medicare Advantage	$145.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.37
Rate for Payer: Cigna Commercial	$241.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.89
Rate for Payer: Oxford Commercial	$241.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.57
Rate for Payer: UnitedHealthcare Commercial	$241.90

KYPHON BONE BIOPSY DEVICE

Facility

$750.00

Hospital Charge Code	270339544
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

KYPHON BONE BIOPSY DEVICE

Facility

$750.00

Hospital Charge Code	270339544
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

KYPHON INFLATION SYRINGE

Facility

$900.00

Hospital Charge Code	270339547
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

KYPHON INFLATION SYRINGE

Facility

$900.00

Hospital Charge Code	270339547
Hospital Revenue Code	272
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$450.00

KYPHON XPEDE BONE CEMENT

Facility

$828.50

Service Code	HCPCS C1765
Hospital Charge Code	270704148
Hospital Revenue Code	278
Min. Negotiated Rate	$124.28
Max. Negotiated Rate	$414.25
Rate for Payer: Aetna Commercial	$248.55
Rate for Payer: Aetna Medicare Advantage	$248.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.27
Rate for Payer: Cigna Commercial	$414.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.28

KYPHON XPEDE BONE CEMENT

Facility

$828.50

Service Code	HCPCS C1765
Hospital Charge Code	270704148
Hospital Revenue Code	278
Min. Negotiated Rate	$124.28
Max. Negotiated Rate	$200.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.28

KYPHOPLASTY BALLOONCATH10G15MM

Facility

$4,000.00

Hospital Charge Code	270699974
Hospital Revenue Code	272
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

KYPHOPLASTY BALLOONCATH10G15MM

Facility

$4,000.00

Hospital Charge Code	270699974
Hospital Revenue Code	272
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$2,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$2,000.00

KYPHOPLASTY KIT G21

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695718
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

Know your out-of-pocket cost for care.

All Charges