Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROD CARBON FIBER 11.0mmX 600mm

Facility

$1,278.00

Service Code	HCPCS C1713
Hospital Charge Code	270639009
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$309.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.28
Rate for Payer: Qualcare PPO/HMO/WC	$191.70

ROD CARBON FIBER 11.0mmX 600mm

Facility

$1,278.00

Service Code	HCPCS C1713
Hospital Charge Code	270639009
Hospital Revenue Code	278
Min. Negotiated Rate	$191.70
Max. Negotiated Rate	$639.00
Rate for Payer: Aetna Commercial	$383.40
Rate for Payer: Aetna Medicare Advantage	$383.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$255.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.89
Rate for Payer: Cigna Commercial	$639.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$309.28
Rate for Payer: Qualcare PPO/HMO/WC	$191.70

ROD CARBON FIBER 11.0mmX 650mm

Facility

$1,316.35

Service Code	HCPCS C1713
Hospital Charge Code	270639010
Hospital Revenue Code	278
Min. Negotiated Rate	$197.45
Max. Negotiated Rate	$318.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$197.45

ROD CARBON FIBER 11.0mmX 650mm

Facility

$1,316.35

Service Code	HCPCS C1713
Hospital Charge Code	270639010
Hospital Revenue Code	278
Min. Negotiated Rate	$197.45
Max. Negotiated Rate	$658.17
Rate for Payer: Aetna Commercial	$394.90
Rate for Payer: Aetna Medicare Advantage	$394.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.67
Rate for Payer: Cigna Commercial	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.56
Rate for Payer: Qualcare PPO/HMO/WC	$197.45

ROD CARBON FIBER 11.0x125mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270638107
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$516.02
Rate for Payer: Aetna Commercial	$309.62
Rate for Payer: Aetna Medicare Advantage	$309.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.17
Rate for Payer: Cigna Commercial	$516.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x125mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270638107
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x150mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270639005
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$516.02
Rate for Payer: Aetna Commercial	$309.62
Rate for Payer: Aetna Medicare Advantage	$309.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.17
Rate for Payer: Cigna Commercial	$516.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x150mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270639005
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x200mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270638106
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$516.02
Rate for Payer: Aetna Commercial	$309.62
Rate for Payer: Aetna Medicare Advantage	$309.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.17
Rate for Payer: Cigna Commercial	$516.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x200mm

Facility

$1,032.05

Service Code	HCPCS C1713
Hospital Charge Code	270638106
Hospital Revenue Code	278
Min. Negotiated Rate	$154.81
Max. Negotiated Rate	$249.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.76
Rate for Payer: Qualcare PPO/HMO/WC	$154.81

ROD CARBON FIBER 11.0x300mm

Facility

$1,109.30

Service Code	HCPCS C1713
Hospital Charge Code	270632993
Hospital Revenue Code	278
Min. Negotiated Rate	$166.40
Max. Negotiated Rate	$268.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.45
Rate for Payer: Qualcare PPO/HMO/WC	$166.40

ROD CARBON FIBER 11.0x300mm

Facility

$1,109.30

Service Code	HCPCS C1713
Hospital Charge Code	270632993
Hospital Revenue Code	278
Min. Negotiated Rate	$166.40
Max. Negotiated Rate	$554.65
Rate for Payer: Aetna Commercial	$332.79
Rate for Payer: Aetna Medicare Advantage	$332.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$282.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$282.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$221.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$282.87
Rate for Payer: Cigna Commercial	$554.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.45
Rate for Payer: Qualcare PPO/HMO/WC	$166.40

ROD CARBON FIBER 11x350MM

Facility

$1,142.60

Service Code	HCPCS C1713
Hospital Charge Code	270635607
Hospital Revenue Code	278
Min. Negotiated Rate	$171.39
Max. Negotiated Rate	$276.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.51
Rate for Payer: Qualcare PPO/HMO/WC	$171.39

ROD CARBON FIBER 11x350MM

Facility

$1,142.60

Service Code	HCPCS C1713
Hospital Charge Code	270635607
Hospital Revenue Code	278
Min. Negotiated Rate	$171.39
Max. Negotiated Rate	$571.30
Rate for Payer: Aetna Commercial	$342.78
Rate for Payer: Aetna Medicare Advantage	$342.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.36
Rate for Payer: Cigna Commercial	$571.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.51
Rate for Payer: Qualcare PPO/HMO/WC	$171.39

ROD CARBON FIBER 11x400MM

Facility

$1,217.45

Service Code	HCPCS C1713
Hospital Charge Code	270634841
Hospital Revenue Code	278
Min. Negotiated Rate	$182.62
Max. Negotiated Rate	$608.73
Rate for Payer: Aetna Commercial	$365.24
Rate for Payer: Aetna Medicare Advantage	$365.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.45
Rate for Payer: Cigna Commercial	$608.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.62
Rate for Payer: Qualcare PPO/HMO/WC	$182.62

ROD CARBON FIBER 11x400MM

Facility

$1,217.45

Service Code	HCPCS C1713
Hospital Charge Code	270634841
Hospital Revenue Code	278
Min. Negotiated Rate	$182.62
Max. Negotiated Rate	$294.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.62
Rate for Payer: Qualcare PPO/HMO/WC	$182.62

ROD CARBON FIBER 11x450MM

Facility

$1,253.95

Service Code	HCPCS C1713
Hospital Charge Code	270639006
Hospital Revenue Code	278
Min. Negotiated Rate	$188.09
Max. Negotiated Rate	$626.98
Rate for Payer: Aetna Commercial	$376.19
Rate for Payer: Aetna Medicare Advantage	$376.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.76
Rate for Payer: Cigna Commercial	$626.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.46
Rate for Payer: Qualcare PPO/HMO/WC	$188.09

ROD CARBON FIBER 11x450MM

Facility

$1,253.95

Service Code	HCPCS C1713
Hospital Charge Code	270639006
Hospital Revenue Code	278
Min. Negotiated Rate	$188.09
Max. Negotiated Rate	$303.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.46
Rate for Payer: Qualcare PPO/HMO/WC	$188.09

ROD CARBON FIBER 11X500 39489

Facility

$1,270.00

Hospital Charge Code	270639007
Hospital Revenue Code	278
Min. Negotiated Rate	$190.50
Max. Negotiated Rate	$307.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.34
Rate for Payer: Qualcare PPO/HMO/WC	$190.50

ROD CARBON FIBER 11X500 39489

Facility

$1,270.00

Hospital Charge Code	270639007
Hospital Revenue Code	278
Min. Negotiated Rate	$190.50
Max. Negotiated Rate	$635.00
Rate for Payer: Aetna Commercial	$381.00
Rate for Payer: Aetna Medicare Advantage	$381.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.85
Rate for Payer: Cigna Commercial	$635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.34
Rate for Payer: Qualcare PPO/HMO/WC	$190.50

ROD CARBON FIBER 8.0mm X 160mm

Facility

$704.50

Service Code	HCPCS C1713
Hospital Charge Code	270644917
Hospital Revenue Code	278
Min. Negotiated Rate	$105.67
Max. Negotiated Rate	$352.25
Rate for Payer: Aetna Commercial	$211.35
Rate for Payer: Aetna Medicare Advantage	$211.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.65
Rate for Payer: Cigna Commercial	$352.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.49
Rate for Payer: Qualcare PPO/HMO/WC	$105.67

ROD CARBON FIBER 8.0mm X 160mm

Facility

$704.50

Service Code	HCPCS C1713
Hospital Charge Code	270644917
Hospital Revenue Code	278
Min. Negotiated Rate	$105.67
Max. Negotiated Rate	$170.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.49
Rate for Payer: Qualcare PPO/HMO/WC	$105.67

ROD CARBON FIBER 8.0mm X 220mm

Facility

$698.35

Service Code	HCPCS C1713
Hospital Charge Code	270619758
Hospital Revenue Code	278
Min. Negotiated Rate	$104.75
Max. Negotiated Rate	$349.18
Rate for Payer: Aetna Commercial	$209.50
Rate for Payer: Aetna Medicare Advantage	$209.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.08
Rate for Payer: Cigna Commercial	$349.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.75

ROD CARBON FIBER 8.0mm X 220mm

Facility

$698.35

Service Code	HCPCS C1713
Hospital Charge Code	270619758
Hospital Revenue Code	278
Min. Negotiated Rate	$104.75
Max. Negotiated Rate	$169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.75

ROD CARBON FIBER 8.0mm X 280mm

Facility

$704.50

Service Code	HCPCS C1713
Hospital Charge Code	270644918
Hospital Revenue Code	278
Min. Negotiated Rate	$105.67
Max. Negotiated Rate	$170.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.49
Rate for Payer: Qualcare PPO/HMO/WC	$105.67

Know your out-of-pocket cost for care.

All Charges