Heights University Hospital

All Charges

Charge

Type

Setting

Price

LAG SCREW SOLID FIXED 85mm

Facility

$2,725.00

Hospital Charge Code	270644154
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$659.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

LAG SCREW SOLID FIXED 85mm

Facility

$2,725.00

Hospital Charge Code	270644154
Hospital Revenue Code	278
Min. Negotiated Rate	$408.75
Max. Negotiated Rate	$1,362.50
Rate for Payer: Aetna Commercial	$817.50
Rate for Payer: Aetna Medicare Advantage	$817.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.88
Rate for Payer: Cigna Commercial	$1,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$659.45
Rate for Payer: Qualcare PPO/HMO/WC	$408.75

LAG SCREW SOLID SLIDING 115 MM

Facility

$2,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270681679
Hospital Revenue Code	278
Min. Negotiated Rate	$334.50
Max. Negotiated Rate	$1,115.00
Rate for Payer: Aetna Commercial	$669.00
Rate for Payer: Aetna Medicare Advantage	$669.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$568.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$568.65
Rate for Payer: Cigna Commercial	$1,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.66
Rate for Payer: Qualcare PPO/HMO/WC	$334.50

LAG SCREW SOLID SLIDING 115 MM

Facility

$2,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270681679
Hospital Revenue Code	278
Min. Negotiated Rate	$334.50
Max. Negotiated Rate	$539.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.66
Rate for Payer: Qualcare PPO/HMO/WC	$334.50

LAG SCREW SOLID SLIDING 75MM

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270685415
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

LAG SCREW SOLID SLIDING 75MM

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270685415
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$697.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

LAG SCREW TI 10.5MMX95MM

Facility

$3,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270656522
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$1,842.50
Rate for Payer: Aetna Commercial	$1,105.50
Rate for Payer: Aetna Medicare Advantage	$1,105.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.67
Rate for Payer: Cigna Commercial	$1,842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

LAG SCREW TI 10.5MMX95MM

Facility

$3,685.00

Service Code	HCPCS C1713
Hospital Charge Code	270656522
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$891.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

LAG SCREW TI 10.5x80MM

Facility

$3,077.10

Hospital Charge Code	270663318
Hospital Revenue Code	278
Min. Negotiated Rate	$461.56
Max. Negotiated Rate	$1,538.55
Rate for Payer: Aetna Commercial	$923.13
Rate for Payer: Aetna Medicare Advantage	$923.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.66
Rate for Payer: Cigna Commercial	$1,538.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: Qualcare PPO/HMO/WC	$461.56

LAG SCREW TI 10.5x80MM

Facility

$3,077.10

Hospital Charge Code	270663318
Hospital Revenue Code	278
Min. Negotiated Rate	$461.56
Max. Negotiated Rate	$744.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.66
Rate for Payer: Qualcare PPO/HMO/WC	$461.56

LAMELLAR BLADE

Facility

$190.00

Hospital Charge Code	270332568
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$95.00

LAMELLAR BLADE

Facility

$190.00

Hospital Charge Code	270332568
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

LAM FACETC/FRMT ARTHRD LUM 1

Facility

$1,133.60

Service Code	HCPCS 63052
Hospital Charge Code	16001022
Hospital Revenue Code	360
Min. Negotiated Rate	$170.04
Max. Negotiated Rate	$170.04
Rate for Payer: Qualcare PPO/HMO/WC	$170.04

LAM FACETC/FRMT ARTHRD LUM 1

Facility

$1,133.60

Service Code	HCPCS 63052
Hospital Charge Code	16001022
Hospital Revenue Code	360
Min. Negotiated Rate	$147.37
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$340.08
Rate for Payer: Aetna Medicare Advantage	$340.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.07
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	$289.07
Rate for Payer: Cigna Commercial	$249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.37
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$170.04
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

LAM FACTC/FRMT ARTHRD LUM EA

Facility

$848.24

Service Code	HCPCS 63053
Hospital Charge Code	16001023
Hospital Revenue Code	360
Min. Negotiated Rate	$127.24
Max. Negotiated Rate	$127.24
Rate for Payer: Qualcare PPO/HMO/WC	$127.24

LAM FACTC/FRMT ARTHRD LUM EA

Facility

$848.24

Service Code	HCPCS 63053
Hospital Charge Code	16001023
Hospital Revenue Code	360
Min. Negotiated Rate	$110.27
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$254.47
Rate for Payer: Aetna Medicare Advantage	$254.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.30
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	$216.30
Rate for Payer: Cigna Commercial	$221.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.27
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.24
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

LAMICTAL-LAMOTRIGINE SERUM****

Facility

$297.00

Service Code	HCPCS 80299
Hospital Charge Code	3009989
Hospital Revenue Code	301
Min. Negotiated Rate	$44.55
Max. Negotiated Rate	$44.55
Rate for Payer: Qualcare PPO/HMO/WC	$44.55

LAMICTAL-LAMOTRIGINE SERUM****

Facility

$297.00

Service Code	HCPCS 80299
Hospital Charge Code	3009989
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

LAMICTRAL 100MG

Facility

$13.00

Hospital Charge Code	60635086
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

LAMICTRAL 100MG

Facility

$13.00

Hospital Charge Code	60635086
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

LAMICTRAL 150MG

Facility

$40.07

Service Code	NDC 51079086520
Hospital Charge Code	60635087
Hospital Revenue Code	250
Min. Negotiated Rate	$5.21
Max. Negotiated Rate	$20.04
Rate for Payer: Aetna Commercial	$12.02
Rate for Payer: Aetna Medicare Advantage	$12.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.22
Rate for Payer: Cigna Commercial	$20.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.21
Rate for Payer: Oxford Commercial	$20.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.01
Rate for Payer: UnitedHealthcare Commercial	$20.04

LAMICTRAL 150MG

Facility

$40.07

Service Code	NDC 51079086520
Hospital Charge Code	60635087
Hospital Revenue Code	250
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$6.01

LAMICTRAL 200MG

Facility

$43.62

Service Code	NDC 51079086620
Hospital Charge Code	60635088
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$21.81
Rate for Payer: Aetna Commercial	$13.09
Rate for Payer: Aetna Medicare Advantage	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.12
Rate for Payer: Cigna Commercial	$21.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.67
Rate for Payer: Oxford Commercial	$21.81
Rate for Payer: Qualcare PPO/HMO/WC	$6.54
Rate for Payer: UnitedHealthcare Commercial	$21.81

LAMICTRAL 200MG

Facility

$43.62

Service Code	NDC 51079086620
Hospital Charge Code	60635088
Hospital Revenue Code	250
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$6.54
Rate for Payer: Qualcare PPO/HMO/WC	$6.54

LAMICTRAL 25MG

Facility

$15.00

Hospital Charge Code	60635089
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

Know your out-of-pocket cost for care.

All Charges