Heights University Hospital

All Charges

Charge

Type

Setting

Price

LOCKING COVER INT FUS DEV 7MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694458
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

LOCKING COVER INT FUS DEV 8MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694459
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

LOCKING COVER INT FUS DEV 8MM

Facility

$500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694459
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

LOCKING DEVICE BIOPSY CAP OLYM

Facility

$46.13

Hospital Charge Code	270674005
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna Commercial	$13.84
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$23.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$23.07

LOCKING DEVICE BIOPSY CAP OLYM

Facility

$46.13

Hospital Charge Code	270674005
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

LOCKING GUIDE

Facility

$4,975.00

Hospital Charge Code	270688313
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

LOCKING GUIDE

Facility

$4,975.00

Hospital Charge Code	270688313
Hospital Revenue Code	272
Min. Negotiated Rate	$646.75
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.75
Rate for Payer: Oxford Commercial	$2,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$2,487.50

LOCKING HINGE 42 HOLE

Facility

$1,021.65

Service Code	HCPCS C1713
Hospital Charge Code	270683956
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$247.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

LOCKING HINGE 42 HOLE

Facility

$1,021.65

Service Code	HCPCS C1713
Hospital Charge Code	270683956
Hospital Revenue Code	278
Min. Negotiated Rate	$153.25
Max. Negotiated Rate	$510.82
Rate for Payer: Aetna Commercial	$306.50
Rate for Payer: Aetna Medicare Advantage	$306.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.52
Rate for Payer: Cigna Commercial	$510.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.24
Rate for Payer: Qualcare PPO/HMO/WC	$153.25

LOCKING INSERT

Facility

$250.00

Hospital Charge Code	270640117
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOCKING INSERT

Facility

$250.00

Hospital Charge Code	270640117
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOCKING NAIL R1.5, TI, RIGHT 1

Facility

$17,580.00

Hospital Charge Code	270664830
Hospital Revenue Code	278
Min. Negotiated Rate	$2,637.00
Max. Negotiated Rate	$4,254.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,254.36
Rate for Payer: Qualcare PPO/HMO/WC	$2,637.00

LOCKING NAIL R1.5, TI, RIGHT 1

Facility

$17,580.00

Hospital Charge Code	270664830
Hospital Revenue Code	278
Min. Negotiated Rate	$2,637.00
Max. Negotiated Rate	$8,790.00
Rate for Payer: Aetna Commercial	$5,274.00
Rate for Payer: Aetna Medicare Advantage	$5,274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,482.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,482.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,482.90
Rate for Payer: Cigna Commercial	$8,790.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,254.36
Rate for Payer: Qualcare PPO/HMO/WC	$2,637.00

LOCKING NUT OCT SYST

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270694399
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

LOCKING NUT OCT SYST

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270694399
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$226.20
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

LOCKING PIN

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270638569
Hospital Revenue Code	278
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$287.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50

LOCKING PIN

Facility

$1,190.00

Service Code	HCPCS C1713
Hospital Charge Code	270638569
Hospital Revenue Code	278
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$595.00
Rate for Payer: Aetna Commercial	$357.00
Rate for Payer: Aetna Medicare Advantage	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$238.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$303.45
Rate for Payer: Cigna Commercial	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.98
Rate for Payer: Qualcare PPO/HMO/WC	$178.50

LOCKING PLATE 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686455
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LOCKING PLATE 6 HOLE

Facility

$3,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270686455
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

LOCKING SCREW 2.4X24MM

Facility

$1,146.60

Service Code	HCPCS C1713
Hospital Charge Code	270704718
Hospital Revenue Code	278
Min. Negotiated Rate	$171.99
Max. Negotiated Rate	$277.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.48
Rate for Payer: Qualcare PPO/HMO/WC	$171.99

LOCKING SCREW 2.4X24MM

Facility

$1,146.60

Service Code	HCPCS C1713
Hospital Charge Code	270704718
Hospital Revenue Code	278
Min. Negotiated Rate	$171.99
Max. Negotiated Rate	$573.30
Rate for Payer: Aetna Commercial	$343.98
Rate for Payer: Aetna Medicare Advantage	$343.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.38
Rate for Payer: Cigna Commercial	$573.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.48
Rate for Payer: Qualcare PPO/HMO/WC	$171.99

LOCKING SCREW 2.5 X 20 MM

Facility

$893.75

Service Code	HCPCS C1713
Hospital Charge Code	270701811
Hospital Revenue Code	278
Min. Negotiated Rate	$134.06
Max. Negotiated Rate	$446.88
Rate for Payer: Aetna Commercial	$268.12
Rate for Payer: Aetna Medicare Advantage	$268.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.91
Rate for Payer: Cigna Commercial	$446.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.29
Rate for Payer: Qualcare PPO/HMO/WC	$134.06

LOCKING SCREW 2.5 X 20 MM

Facility

$893.75

Service Code	HCPCS C1713
Hospital Charge Code	270701811
Hospital Revenue Code	278
Min. Negotiated Rate	$134.06
Max. Negotiated Rate	$216.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.29
Rate for Payer: Qualcare PPO/HMO/WC	$134.06

LOCKING SCREW 2.7 X 12

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270684673
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

LOCKING SCREW 2.7 X 12

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270684673
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

Know your out-of-pocket cost for care.

All Charges