Heights University Hospital

All Charges

Charge

Type

Setting

Price

POSITIONER SPIDER LIMB KIT

Facility

$466.80

Hospital Charge Code	270678171
Hospital Revenue Code	272
Min. Negotiated Rate	$70.02
Max. Negotiated Rate	$70.02
Rate for Payer: Qualcare PPO/HMO/WC	$70.02

POSITIONER WELL LEG HOLDER

Facility

$63.00

Hospital Charge Code	270665635
Hospital Revenue Code	270
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$31.50

POSITIONER WELL LEG HOLDER

Facility

$63.00

Hospital Charge Code	270665635
Hospital Revenue Code	270
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

POSITIONING ROD 2MM SINGLE USE

Facility

$764.80

Hospital Charge Code	270674963
Hospital Revenue Code	272
Min. Negotiated Rate	$114.72
Max. Negotiated Rate	$114.72
Rate for Payer: Qualcare PPO/HMO/WC	$114.72

POSITIONING ROD 2MM SINGLE USE

Facility

$764.80

Hospital Charge Code	270674963
Hospital Revenue Code	272
Min. Negotiated Rate	$99.42
Max. Negotiated Rate	$382.40
Rate for Payer: Aetna Commercial	$229.44
Rate for Payer: Aetna Medicare Advantage	$229.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.02
Rate for Payer: Cigna Commercial	$382.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.42
Rate for Payer: Oxford Commercial	$382.40
Rate for Payer: Qualcare PPO/HMO/WC	$114.72
Rate for Payer: UnitedHealthcare Commercial	$382.40

POSITIVE SUSCEPTIBILITY P

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008748
Hospital Revenue Code	309
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$9.94
Rate for Payer: Qualcare PPO/HMO/WC	$9.94

POSITIVE SUSCEPTIBILITY P

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008748
Hospital Revenue Code	309
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.24
Rate for Payer: Aetna Medicare Advantage	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.41
Rate for Payer: Cigna Commercial	$7.48
Rate for Payer: Cigna Medicare Advantage	$3.74
Rate for Payer: Clover Medicare Advantage	$7.11
Rate for Payer: EmblemHealth Commercial	$22.44
Rate for Payer: Humana Medicare Advantage	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.94
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.93
Rate for Payer: Wellcare Medicare Advantage	$7.48

POST 1 SRFC RESINBASED CMPST

Facility

$9,790.05

Service Code	HCPCS D2391
Hospital Charge Code	1600000775
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.51
Max. Negotiated Rate	$1,468.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

POST 1 SRFC RESINBASED CMPST

Facility

$9,790.05

Service Code	HCPCS D2391
Hospital Charge Code	1600000775
Hospital Revenue Code	360
Min. Negotiated Rate	$1,272.71
Max. Negotiated Rate	$2,937.01
Rate for Payer: Aetna Commercial	$2,937.01
Rate for Payer: Aetna Medicare Advantage	$2,937.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,496.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,496.46
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	$2,496.46
Rate for Payer: Cigna Commercial	$1,539.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

POST 2 SRFC RESINBASED CMPST

Facility

$9,790.05

Service Code	HCPCS D2392
Hospital Charge Code	1600000776
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.51
Max. Negotiated Rate	$1,468.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

POST 2 SRFC RESINBASED CMPST

Facility

$9,790.05

Service Code	HCPCS D2392
Hospital Charge Code	1600000776
Hospital Revenue Code	360
Min. Negotiated Rate	$1,272.71
Max. Negotiated Rate	$2,937.01
Rate for Payer: Aetna Commercial	$2,937.01
Rate for Payer: Aetna Medicare Advantage	$2,937.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,496.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,496.46
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	$2,496.46
Rate for Payer: Cigna Commercial	$1,539.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

POST 30-DEG ANGLED 4922-2-140

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270648628
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

POST 30-DEG ANGLED 4922-2-140

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270648628
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

POST 3.2MM

Facility

$1,105.00

Hospital Charge Code	270671569
Hospital Revenue Code	278
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$267.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.41
Rate for Payer: Qualcare PPO/HMO/WC	$165.75

POST 3.2MM

Facility

$1,105.00

Hospital Charge Code	270671569
Hospital Revenue Code	278
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$552.50
Rate for Payer: Aetna Commercial	$331.50
Rate for Payer: Aetna Medicare Advantage	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$281.77
Rate for Payer: Cigna Commercial	$552.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.41
Rate for Payer: Qualcare PPO/HMO/WC	$165.75

POST 4 HOLE TOWER

Facility

$605.00

Hospital Charge Code	270684451
Hospital Revenue Code	272
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$90.75

POST 4 HOLE TOWER

Facility

$605.00

Hospital Charge Code	270684451
Hospital Revenue Code	272
Min. Negotiated Rate	$78.65
Max. Negotiated Rate	$302.50
Rate for Payer: Aetna Commercial	$181.50
Rate for Payer: Aetna Medicare Advantage	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.28
Rate for Payer: Cigna Commercial	$302.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Oxford Commercial	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$90.75
Rate for Payer: UnitedHealthcare Commercial	$302.50

POST 5.9 X28 LAPIDUS

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270686978
Hospital Revenue Code	278
Min. Negotiated Rate	$2,616.00
Max. Negotiated Rate	$8,720.00
Rate for Payer: Aetna Commercial	$5,232.00
Rate for Payer: Aetna Medicare Advantage	$5,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,447.20
Rate for Payer: Cigna Commercial	$8,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00

POST 5.9 X28 LAPIDUS

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270686978
Hospital Revenue Code	278
Min. Negotiated Rate	$2,616.00
Max. Negotiated Rate	$4,220.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00

POST 90-DEGREE ANGLED

Facility

$1,125.00

Hospital Charge Code	270650719
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.25
Rate for Payer: Oxford Commercial	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$562.50

POST 90-DEGREE ANGLED

Facility

$1,125.00

Hospital Charge Code	270650719
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

POST ANGLED 30-DEG 4940-2-140

Facility

$545.00

Hospital Charge Code	270647955
Hospital Revenue Code	272
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.85
Rate for Payer: Oxford Commercial	$272.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$272.50

POST ANGLED 30-DEG 4940-2-140

Facility

$545.00

Hospital Charge Code	270647955
Hospital Revenue Code	272
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

POST ANGLED 30 DEGREES HII MRI

Facility

$578.15

Hospital Charge Code	270648003
Hospital Revenue Code	278
Min. Negotiated Rate	$86.72
Max. Negotiated Rate	$289.07
Rate for Payer: Aetna Commercial	$173.44
Rate for Payer: Aetna Medicare Advantage	$173.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.43
Rate for Payer: Cigna Commercial	$289.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.91
Rate for Payer: Qualcare PPO/HMO/WC	$86.72

POST ANGLED 30 DEGREES HII MRI

Facility

$578.15

Hospital Charge Code	270648003
Hospital Revenue Code	278
Min. Negotiated Rate	$86.72
Max. Negotiated Rate	$139.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.91
Rate for Payer: Qualcare PPO/HMO/WC	$86.72

Know your out-of-pocket cost for care.

All Charges