Heights University Hospital

All Charges

Charge

Type

Setting

Price

LOCK SCREW DRIVER

Facility

$2,595.00

Hospital Charge Code	270656530
Hospital Revenue Code	278
Min. Negotiated Rate	$389.25
Max. Negotiated Rate	$1,297.50
Rate for Payer: Aetna Commercial	$778.50
Rate for Payer: Aetna Medicare Advantage	$778.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$661.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$661.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$661.73
Rate for Payer: Cigna Commercial	$1,297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.99
Rate for Payer: Qualcare PPO/HMO/WC	$389.25

LOCK SCREW DRIVER

Facility

$2,595.00

Hospital Charge Code	270656530
Hospital Revenue Code	278
Min. Negotiated Rate	$389.25
Max. Negotiated Rate	$627.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$519.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$627.99
Rate for Payer: Qualcare PPO/HMO/WC	$389.25

LOCK SCREW SQUARE 2.7 MM X 12M

Facility

$650.00

Hospital Charge Code	270663852
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

LOCK SCREW SQUARE 2.7 MM X 12M

Facility

$650.00

Hospital Charge Code	270663852
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

LOCK SCREW SQUARE 2.7MM X 16MM

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270688184
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$126.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

LOCK SCREW SQUARE 2.7MM X 16MM

Facility

$522.50

Service Code	HCPCS C1713
Hospital Charge Code	270688184
Hospital Revenue Code	278
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$261.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$261.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.44
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

LOCK SCREW SQUARE 2.7MM X 18MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270688185
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

LOCK SCREW SQUARE 2.7MM X 18MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270688185
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$294.00
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

LOCK SCREW SQUARE 2.7MM X 24MM

Facility

$650.00

Service Code	HCPCS C1776
Hospital Charge Code	270663849
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

LOCK SCREW SQUARE 2.7MM X 24MM

Facility

$650.00

Service Code	HCPCS C1776
Hospital Charge Code	270663849
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411325
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411327
Hospital Revenue Code	255
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411327
Hospital Revenue Code	255
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

LOCM IODINE VISIPA PER ML

Facility

$8.00

Hospital Charge Code	7411325
Hospital Revenue Code	255
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

LOCOSAMIDE UNIT 50MG/5ML

Facility

$291.12

Service Code	NDC 904746466
Hospital Charge Code	606390602
Hospital Revenue Code	250
Min. Negotiated Rate	$37.85
Max. Negotiated Rate	$145.56
Rate for Payer: Aetna Commercial	$87.34
Rate for Payer: Aetna Medicare Advantage	$87.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.24
Rate for Payer: Cigna Commercial	$145.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.85
Rate for Payer: Oxford Commercial	$145.56
Rate for Payer: Qualcare PPO/HMO/WC	$43.67
Rate for Payer: UnitedHealthcare Commercial	$145.56

LOCOSAMIDE UNIT 50MG/5ML

Facility

$291.12

Service Code	NDC 904746466
Hospital Charge Code	606390602
Hospital Revenue Code	250
Min. Negotiated Rate	$43.67
Max. Negotiated Rate	$43.67
Rate for Payer: Qualcare PPO/HMO/WC	$43.67

LODA UNIT TA 30 4.8 015713

Facility

$263.50

Hospital Charge Code	270600053
Hospital Revenue Code	270
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$39.52
Rate for Payer: Qualcare PPO/HMO/WC	$39.52

LODA UNIT TA 30 4.8 015713

Facility

$263.50

Hospital Charge Code	270600053
Hospital Revenue Code	270
Min. Negotiated Rate	$34.26
Max. Negotiated Rate	$131.75
Rate for Payer: Aetna Commercial	$79.05
Rate for Payer: Aetna Medicare Advantage	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.19
Rate for Payer: Cigna Commercial	$131.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.26
Rate for Payer: Oxford Commercial	$131.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.52
Rate for Payer: UnitedHealthcare Commercial	$131.75

LOGOL'S SOLN/15ML

Facility

$56.00

Hospital Charge Code	60634571
Hospital Revenue Code	250
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

LOGOL'S SOLN/15ML

Facility

$56.00

Hospital Charge Code	60634571
Hospital Revenue Code	250
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$28.00

LO IMPLANT, 8x10x25MM

Facility

$29,335.00

Hospital Charge Code	270665931
Hospital Revenue Code	270
Min. Negotiated Rate	$4,400.25
Max. Negotiated Rate	$4,400.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,400.25

LO IMPLANT, 8x10x25MM

Facility

$29,335.00

Hospital Charge Code	270665931
Hospital Revenue Code	270
Min. Negotiated Rate	$3,813.55
Max. Negotiated Rate	$14,667.50
Rate for Payer: Aetna Commercial	$8,800.50
Rate for Payer: Aetna Medicare Advantage	$8,800.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,480.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,480.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,480.43
Rate for Payer: Cigna Commercial	$14,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,813.55
Rate for Payer: Oxford Commercial	$14,667.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,400.25
Rate for Payer: UnitedHealthcare Commercial	$14,667.50

LO IMPLANT 8X10X30MM

Facility

$28,205.00

Hospital Charge Code	270657294
Hospital Revenue Code	278
Min. Negotiated Rate	$4,230.75
Max. Negotiated Rate	$14,102.50
Rate for Payer: Aetna Commercial	$8,461.50
Rate for Payer: Aetna Medicare Advantage	$8,461.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,641.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,192.27
Rate for Payer: Cigna Commercial	$14,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,825.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,230.75

LO IMPLANT 8X10X30MM

Facility

$28,205.00

Hospital Charge Code	270657294
Hospital Revenue Code	278
Min. Negotiated Rate	$4,230.75
Max. Negotiated Rate	$6,825.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,641.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,825.61
Rate for Payer: Qualcare PPO/HMO/WC	$4,230.75

LO IMPLANT 8X10X30MM

Facility

$29,335.00

Hospital Charge Code	270657291
Hospital Revenue Code	278
Min. Negotiated Rate	$4,400.25
Max. Negotiated Rate	$7,099.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,867.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,099.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,400.25

Know your out-of-pocket cost for care.

All Charges