Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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

PIN FIXATION TEMP 1.4MM SM

Facility

$370.00

Hospital Charge Code	270662461
Hospital Revenue Code	272
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.10
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$185.00

PIN FIXATION TEMP 1.4MM SM

Facility

$370.00

Hospital Charge Code	270662461
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

PIN FIX PROTECTIVE CAP 6MM

Facility

$329.65

Service Code	HCPCS C1713
Hospital Charge Code	270694576
Hospital Revenue Code	278
Min. Negotiated Rate	$49.45
Max. Negotiated Rate	$79.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.45

PIN FIX PROTECTIVE CAP 6MM

Facility

$329.65

Service Code	HCPCS C1713
Hospital Charge Code	270694576
Hospital Revenue Code	278
Min. Negotiated Rate	$49.45
Max. Negotiated Rate	$164.82
Rate for Payer: Aetna Commercial	$98.89
Rate for Payer: Aetna Medicare Advantage	$98.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.06
Rate for Payer: Cigna Commercial	$164.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.45

PIN FIX SMOOTH MINI 1.1X10MM

Facility

$375.00

Hospital Charge Code	270697021
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIX SMOOTH MINI 1.1X10MM

Facility

$375.00

Hospital Charge Code	270697021
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
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) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

PIN GBA GUIDE 2.4 AR133003-24

Facility

$268.85

Hospital Charge Code	270616690
Hospital Revenue Code	278
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$80.66
Rate for Payer: Aetna Medicare Advantage	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.56
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.06
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

PIN GBA GUIDE 2.4 AR133003-24

Facility

$268.85

Hospital Charge Code	270616690
Hospital Revenue Code	278
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$65.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.06
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

PIN GBA GUIDE 3.0 AR133003-30

Facility

$231.25

Hospital Charge Code	270616689
Hospital Revenue Code	278
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$115.62
Rate for Payer: Aetna Commercial	$69.38
Rate for Payer: Aetna Medicare Advantage	$69.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.97
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

PIN GBA GUIDE 3.0 AR133003-30

Facility

$231.25

Hospital Charge Code	270616689
Hospital Revenue Code	278
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$55.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

PIN GBA GUIDE NIT 1.1 AR-1249

Facility

$184.85

Hospital Charge Code	270614983
Hospital Revenue Code	278
Min. Negotiated Rate	$27.73
Max. Negotiated Rate	$92.42
Rate for Payer: Aetna Commercial	$55.45
Rate for Payer: Aetna Medicare Advantage	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.14
Rate for Payer: Cigna Commercial	$92.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.73
Rate for Payer: Qualcare PPO/HMO/WC	$27.73

PIN GBA GUIDE NIT 1.1 AR-1249

Facility

$184.85

Hospital Charge Code	270614983
Hospital Revenue Code	278
Min. Negotiated Rate	$27.73
Max. Negotiated Rate	$44.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.73
Rate for Payer: Qualcare PPO/HMO/WC	$27.73

PIN GREEN

Facility

$364.75

Hospital Charge Code	270630423
Hospital Revenue Code	279
Min. Negotiated Rate	$47.42
Max. Negotiated Rate	$182.38
Rate for Payer: Aetna Commercial	$109.42
Rate for Payer: Aetna Medicare Advantage	$109.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.01
Rate for Payer: Cigna Commercial	$182.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.42
Rate for Payer: Oxford Commercial	$182.38
Rate for Payer: Qualcare PPO/HMO/WC	$54.71
Rate for Payer: UnitedHealthcare Commercial	$182.38

PIN GREEN

Facility

$364.75

Hospital Charge Code	270630423
Hospital Revenue Code	279
Min. Negotiated Rate	$54.71
Max. Negotiated Rate	$54.71
Rate for Payer: Qualcare PPO/HMO/WC	$54.71

PIN GUIDE CSI SZ 9

Facility

$255.00

Hospital Charge Code	270678242
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$76.50
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

PIN GUIDE CSI SZ 9

Facility

$255.00

Hospital Charge Code	270678242
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

PIN GUIDE DHS 338.00

Facility

$211.25

Hospital Charge Code	270603802
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$51.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

PIN GUIDE DHS 338.00

Facility

$211.25

Hospital Charge Code	270603802
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$63.38
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

PIN GUIDE DISPOSABLE 2MM

Facility

$2,580.00

Service Code	HCPCS C1769
Hospital Charge Code	270696337
Hospital Revenue Code	272
Min. Negotiated Rate	$387.00
Max. Negotiated Rate	$387.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

PIN GUIDE DISPOSABLE 2MM

Facility

$2,580.00

Service Code	HCPCS C1769
Hospital Charge Code	270696337
Hospital Revenue Code	272
Min. Negotiated Rate	$335.40
Max. Negotiated Rate	$1,290.00
Rate for Payer: Aetna Commercial	$774.00
Rate for Payer: Aetna Medicare Advantage	$774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.90
Rate for Payer: Cigna Commercial	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.40
Rate for Payer: Oxford Commercial	$1,290.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00
Rate for Payer: UnitedHealthcare Commercial	$1,290.00

PIN GUIDE FLAREHAWK 27MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692661
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

PIN GUIDE FLAREHAWK 27MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692661
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

PIN GUIDE OPD DVL 100MM G68345

Facility

$24.85

Hospital Charge Code	270606255
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

PIN GUIDE OPD DVL 100MM G68345

Facility

$24.85

Hospital Charge Code	270606255
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

Know your out-of-pocket cost for care.

All Charges