Heights University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY DBM 1CC MAX FUSE

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270692260
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

PUTTY DBM 2.5cc AC 023000025

Facility

$2,283.75

Hospital Charge Code	270638715
Hospital Revenue Code	278
Min. Negotiated Rate	$342.56
Max. Negotiated Rate	$1,141.88
Rate for Payer: Aetna Commercial	$685.12
Rate for Payer: Aetna Medicare Advantage	$685.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.36
Rate for Payer: Cigna Commercial	$1,141.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.67
Rate for Payer: Qualcare PPO/HMO/WC	$342.56

PUTTY DBM 2.5cc AC 023000025

Facility

$2,283.75

Hospital Charge Code	270638715
Hospital Revenue Code	278
Min. Negotiated Rate	$342.56
Max. Negotiated Rate	$552.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.67
Rate for Payer: Qualcare PPO/HMO/WC	$342.56

PUTTY DBM 2CC

Facility

$1,120.00

Hospital Charge Code	270671244
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

PUTTY DBM 2CC

Facility

$1,120.00

Hospital Charge Code	270671244
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$336.00
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

PUTTY DBM 5.0CC OSTEOSEL PLUS

Facility

$4,875.00

Hospital Charge Code	270701859
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

PUTTY DBM 5.0CC OSTEOSEL PLUS

Facility

$4,875.00

Hospital Charge Code	270701859
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

PUTTY DBM 5 CC

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692207
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,275.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

PUTTY DBM 5 CC

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692207
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

PUTTY DBM .5CC

Facility

$400.00

Hospital Charge Code	270671242
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

PUTTY DBM .5CC

Facility

$400.00

Hospital Charge Code	270671242
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

PUTTY DBM 5CC

Facility

$2,610.00

Hospital Charge Code	270671245
Hospital Revenue Code	278
Min. Negotiated Rate	$391.50
Max. Negotiated Rate	$631.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$522.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.62
Rate for Payer: Qualcare PPO/HMO/WC	$391.50

PUTTY DBM 5CC

Facility

$2,610.00

Hospital Charge Code	270671245
Hospital Revenue Code	278
Min. Negotiated Rate	$391.50
Max. Negotiated Rate	$1,305.00
Rate for Payer: Aetna Commercial	$783.00
Rate for Payer: Aetna Medicare Advantage	$783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$665.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$665.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$665.55
Rate for Payer: Cigna Commercial	$1,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$631.62
Rate for Payer: Qualcare PPO/HMO/WC	$391.50

PUTTY DBM ALLOSYNC 5 CC

Facility

$5,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270690875
Hospital Revenue Code	278
Min. Negotiated Rate	$857.25
Max. Negotiated Rate	$1,383.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,143.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,383.03
Rate for Payer: Qualcare PPO/HMO/WC	$857.25

PUTTY DBM ALLOSYNC 5 CC

Facility

$5,715.00

Service Code	HCPCS C1713
Hospital Charge Code	270690875
Hospital Revenue Code	278
Min. Negotiated Rate	$857.25
Max. Negotiated Rate	$2,857.50
Rate for Payer: Aetna Commercial	$1,714.50
Rate for Payer: Aetna Medicare Advantage	$1,714.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,457.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,457.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,457.33
Rate for Payer: Cigna Commercial	$2,857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,383.03
Rate for Payer: Qualcare PPO/HMO/WC	$857.25

PUTTY DBM APEX .05CC

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270676652
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

PUTTY DBM APEX .05CC

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270676652
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

PUTTY DBM PRIME HD 1 CC

Facility

$516.00

Service Code	HCPCS C1713
Hospital Charge Code	270698874
Hospital Revenue Code	278
Min. Negotiated Rate	$77.40
Max. Negotiated Rate	$124.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.87
Rate for Payer: Qualcare PPO/HMO/WC	$77.40

PUTTY DBM PRIME HD 1 CC

Facility

$516.00

Service Code	HCPCS C1713
Hospital Charge Code	270698874
Hospital Revenue Code	278
Min. Negotiated Rate	$77.40
Max. Negotiated Rate	$258.00
Rate for Payer: Aetna Commercial	$154.80
Rate for Payer: Aetna Medicare Advantage	$154.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.58
Rate for Payer: Cigna Commercial	$258.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.87
Rate for Payer: Qualcare PPO/HMO/WC	$77.40

PUTTY DBM STAGRAFT 5CC

Facility

$3,845.00

Service Code	HCPCS C9359
Hospital Charge Code	270648288
Hospital Revenue Code	278
Min. Negotiated Rate	$576.75
Max. Negotiated Rate	$1,922.50
Rate for Payer: Aetna Commercial	$1,153.50
Rate for Payer: Aetna Medicare Advantage	$1,153.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.48
Rate for Payer: Cigna Commercial	$1,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.49
Rate for Payer: Qualcare PPO/HMO/WC	$576.75

PUTTY DBM STAGRAFT 5CC

Facility

$3,845.00

Service Code	HCPCS C9359
Hospital Charge Code	270648288
Hospital Revenue Code	278
Min. Negotiated Rate	$576.75
Max. Negotiated Rate	$930.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$769.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.49
Rate for Payer: Qualcare PPO/HMO/WC	$576.75

PUTTY DBM W/CHIPS 10CC

Facility

$5,165.00

Hospital Charge Code	270671251
Hospital Revenue Code	278
Min. Negotiated Rate	$774.75
Max. Negotiated Rate	$1,249.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,033.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,249.93
Rate for Payer: Qualcare PPO/HMO/WC	$774.75

PUTTY DBM W/CHIPS 10CC

Facility

$5,165.00

Hospital Charge Code	270671251
Hospital Revenue Code	278
Min. Negotiated Rate	$774.75
Max. Negotiated Rate	$2,582.50
Rate for Payer: Aetna Commercial	$1,549.50
Rate for Payer: Aetna Medicare Advantage	$1,549.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,317.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,317.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,033.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,317.08
Rate for Payer: Cigna Commercial	$2,582.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,249.93
Rate for Payer: Qualcare PPO/HMO/WC	$774.75

PUTTY DBM W/CHIPS 1CC

Facility

$860.00

Hospital Charge Code	270671248
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$258.00
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

PUTTY DBM W/CHIPS 1CC

Facility

$860.00

Hospital Charge Code	270671248
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

Know your out-of-pocket cost for care.

All Charges