Heights University Hospital

All Charges

Charge

Type

Setting

Price

OSTEOT COTTON WEDGE 20X15X4MM

Facility

$19,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697161
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$5,850.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

OSTEOT COTTON WEDGE 20X15X4MM

Facility

$19,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270697161
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

OSTEOTOME 7MM

Facility

$2,500.00

Hospital Charge Code	270700493
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

OSTEOTOME 7MM

Facility

$2,500.00

Hospital Charge Code	270700493
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

OSTEOTOME BMT 6MM LONG 423890

Facility

$1,556.85

Hospital Charge Code	270615801
Hospital Revenue Code	272
Min. Negotiated Rate	$233.53
Max. Negotiated Rate	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$233.53

OSTEOTOME BMT 6MM LONG 423890

Facility

$1,556.85

Hospital Charge Code	270615801
Hospital Revenue Code	272
Min. Negotiated Rate	$202.39
Max. Negotiated Rate	$778.42
Rate for Payer: Aetna Commercial	$467.06
Rate for Payer: Aetna Medicare Advantage	$467.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.00
Rate for Payer: Cigna Commercial	$778.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.39
Rate for Payer: Oxford Commercial	$778.42
Rate for Payer: Qualcare PPO/HMO/WC	$233.53
Rate for Payer: UnitedHealthcare Commercial	$778.42

OSTEOTOME CEM 3.0-11.5 STR LN

Facility

$930.05

Hospital Charge Code	270670669
Hospital Revenue Code	272
Min. Negotiated Rate	$120.91
Max. Negotiated Rate	$465.02
Rate for Payer: Aetna Commercial	$279.01
Rate for Payer: Aetna Medicare Advantage	$279.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.16
Rate for Payer: Cigna Commercial	$465.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.91
Rate for Payer: Oxford Commercial	$465.02
Rate for Payer: Qualcare PPO/HMO/WC	$139.51
Rate for Payer: UnitedHealthcare Commercial	$465.02

OSTEOTOME CEM 3.0-11.5 STR LN

Facility

$930.05

Hospital Charge Code	270670669
Hospital Revenue Code	272
Min. Negotiated Rate	$139.51
Max. Negotiated Rate	$139.51
Rate for Payer: Qualcare PPO/HMO/WC	$139.51

OSTEOTOME CEM STAG 3 STR LINE

Facility

$930.05

Hospital Charge Code	270670673
Hospital Revenue Code	272
Min. Negotiated Rate	$139.51
Max. Negotiated Rate	$139.51
Rate for Payer: Qualcare PPO/HMO/WC	$139.51

OSTEOTOME CEM STAG 3 STR LINE

Facility

$930.05

Hospital Charge Code	270670673
Hospital Revenue Code	272
Min. Negotiated Rate	$120.91
Max. Negotiated Rate	$465.02
Rate for Payer: Aetna Commercial	$279.01
Rate for Payer: Aetna Medicare Advantage	$279.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.16
Rate for Payer: Cigna Commercial	$465.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.91
Rate for Payer: Oxford Commercial	$465.02
Rate for Payer: Qualcare PPO/HMO/WC	$139.51
Rate for Payer: UnitedHealthcare Commercial	$465.02

OSTEOTOME DRIVER S9 MINI

Facility

$1,300.00

Hospital Charge Code	270696819
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

OSTEOTOME DRIVER S9 MINI

Facility

$1,300.00

Hospital Charge Code	270696819
Hospital Revenue Code	272
Min. Negotiated Rate	$169.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$650.00

OSTEOTOME FLAT FLEX NARROW

Facility

$3,500.00

Hospital Charge Code	270668745
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

OSTEOTOME FLAT FLEX NARROW

Facility

$3,500.00

Hospital Charge Code	270668745
Hospital Revenue Code	272
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$1,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$1,750.00

OSTEOTOME FLAT FLEX NARRW LONG

Facility

$3,500.00

Hospital Charge Code	270677340
Hospital Revenue Code	272
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$1,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Commercial	$1,750.00

OSTEOTOME FLAT FLEX NARRW LONG

Facility

$3,500.00

Hospital Charge Code	270677340
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

OSTEOTOME FLAT FLEX RND NARROW

Facility

$4,600.00

Hospital Charge Code	270678729
Hospital Revenue Code	272
Min. Negotiated Rate	$690.00
Max. Negotiated Rate	$690.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00

OSTEOTOME FLAT FLEX RND NARROW

Facility

$4,600.00

Hospital Charge Code	270678729
Hospital Revenue Code	272
Min. Negotiated Rate	$598.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$1,380.00
Rate for Payer: Aetna Medicare Advantage	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,173.00
Rate for Payer: Cigna Commercial	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.00
Rate for Payer: Oxford Commercial	$2,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.00
Rate for Payer: UnitedHealthcare Commercial	$2,300.00

OSTEOTOME HOOKED 7MM

Facility

$2,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270699907
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

OSTEOTOME HOOKED 7MM

Facility

$2,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270699907
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

OSTEOTOME MIDLINE 3.0

Facility

$1,606.45

Hospital Charge Code	270670674
Hospital Revenue Code	272
Min. Negotiated Rate	$208.84
Max. Negotiated Rate	$803.23
Rate for Payer: Aetna Commercial	$481.94
Rate for Payer: Aetna Medicare Advantage	$481.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$409.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$409.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$409.64
Rate for Payer: Cigna Commercial	$803.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.84
Rate for Payer: Oxford Commercial	$803.23
Rate for Payer: Qualcare PPO/HMO/WC	$240.97
Rate for Payer: UnitedHealthcare Commercial	$803.23

OSTEOTOME MIDLINE 3.0

Facility

$1,606.45

Hospital Charge Code	270670674
Hospital Revenue Code	272
Min. Negotiated Rate	$240.97
Max. Negotiated Rate	$240.97
Rate for Payer: Qualcare PPO/HMO/WC	$240.97

OSTEOTOME THIN BLADE 20MM

Facility

$1,062.00

Service Code	HCPCS A4649
Hospital Charge Code	270697342
Hospital Revenue Code	272
Min. Negotiated Rate	$159.30
Max. Negotiated Rate	$159.30
Rate for Payer: Qualcare PPO/HMO/WC	$159.30

OSTEOTOME THIN BLADE 20MM

Facility

$1,062.00

Service Code	HCPCS A4649
Hospital Charge Code	270697342
Hospital Revenue Code	272
Min. Negotiated Rate	$138.06
Max. Negotiated Rate	$531.00
Rate for Payer: Aetna Commercial	$318.60
Rate for Payer: Aetna Medicare Advantage	$318.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.81
Rate for Payer: Cigna Commercial	$531.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.06
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.30
Rate for Payer: UnitedHealthcare Commercial	$531.00

OSTEOTOMY,CALCANEUS RT

Facility

$57,834.50

Service Code	HCPCS 28300
Hospital Charge Code	16000331
Hospital Revenue Code	360
Min. Negotiated Rate	$8,675.17
Max. Negotiated Rate	$8,675.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17

Know your out-of-pocket cost for care.

All Charges