Heights University Hospital

All Charges

Charge

Type

Setting

Price

PIN DISTRACTOR CERVICAL 12MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270697852
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

PIN DISTRACTOR CERVICAL 12MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270697852
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

PINDOLOL 5 MG TAB

Facility

$9.65

Hospital Charge Code	60628865
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

PINDOLOL 5 MG TAB

Facility

$9.65

Hospital Charge Code	60628865
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

PIN DPY HALF 5 160MM FF1016020

Facility

$614.45

Hospital Charge Code	270612447
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$307.23
Rate for Payer: Aetna Commercial	$184.34
Rate for Payer: Aetna Medicare Advantage	$184.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.68
Rate for Payer: Cigna Commercial	$307.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

PIN DPY HALF 5 160MM FF1016020

Facility

$614.45

Hospital Charge Code	270612447
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$148.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

PIN DPY HALF 5 165MM FF1016525

Facility

$614.45

Hospital Charge Code	270612489
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$148.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

PIN DPY HALF 5 165MM FF1016525

Facility

$614.45

Hospital Charge Code	270612489
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$307.23
Rate for Payer: Aetna Commercial	$184.34
Rate for Payer: Aetna Medicare Advantage	$184.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.68
Rate for Payer: Cigna Commercial	$307.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

PIN DPY HALF 5 175MM FF1017535

Facility

$529.65

Hospital Charge Code	270612633
Hospital Revenue Code	278
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$264.82
Rate for Payer: Aetna Commercial	$158.90
Rate for Payer: Aetna Medicare Advantage	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.06
Rate for Payer: Cigna Commercial	$264.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: Qualcare PPO/HMO/WC	$79.45

PIN DPY HALF 5 175MM FF1017535

Facility

$529.65

Hospital Charge Code	270612633
Hospital Revenue Code	278
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$128.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: Qualcare PPO/HMO/WC	$79.45

PIN DRIVER DIAMOND 8GX15CM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692233
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

PIN DRIVER DIAMOND 8GX15CM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692233
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
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) NJ Health	$150.00
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	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

PIN DRL ,ACL T-ROPE CLSD. 4MM

Facility

$625.00

Hospital Charge Code	270681330
Hospital Revenue Code	272
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.25
Rate for Payer: Oxford Commercial	$312.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$312.50

PIN DRL ,ACL T-ROPE CLSD. 4MM

Facility

$625.00

Hospital Charge Code	270681330
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PIN FINGER DISLOCATION

Facility

$10,580.92

Service Code	HCPCS 26776
Hospital Charge Code	16000858
Hospital Revenue Code	360
Min. Negotiated Rate	$1,587.14
Max. Negotiated Rate	$1,587.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14

PIN FINGER DISLOCATION

Facility

$10,580.92

Service Code	HCPCS 26776
Hospital Charge Code	16000858
Hospital Revenue Code	360
Min. Negotiated Rate	$1,375.52
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,174.28
Rate for Payer: Aetna Medicare Advantage	$3,174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,698.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,698.13
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	$2,698.13
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,375.52
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PIN FIX

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	270665075
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$111.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PIN FIX

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	270665075
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$138.00
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PIN FIXATION ANKLE 4X150X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695539
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

PIN FIXATION ANKLE 4X150X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695539
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

PIN FIXATION CERV BLUNT

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692985
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIXATION CERV BLUNT

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692985
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIXATION SHARP

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692984
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIXATION SHARP

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692984
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIXATION SPRING LOADED

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696272
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

Know your out-of-pocket cost for care.

All Charges