Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROD CURVED D5.5X100MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270700257
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED D5.5X100MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270700257
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$330.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED D5.5X50MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270700259
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED D5.5X50MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270700259
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$330.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED D5.5X90MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270700258
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED D5.5X90MM

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270700258
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$330.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ROD CURVED D5.5 X L 70MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689550
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

ROD CURVED D5.5 X L 70MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270689550
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

ROD CURVED MIS TI 5.5 X 80MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694882
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ROD CURVED MIS TI 5.5 X 80MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694882
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ROD CURVED NEXXT MIS 5.5X45MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693613
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ROD CURVED NEXXT MIS 5.5X45MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693613
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ROD CURVED NEXXT MIS 5.5X60MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693614
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ROD CURVED NEXXT MIS 5.5X60MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693614
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ROD CURVED NOTCHED 50MM

Facility

$3,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270674914
Hospital Revenue Code	278
Min. Negotiated Rate	$561.00
Max. Negotiated Rate	$1,870.00
Rate for Payer: Aetna Commercial	$1,122.00
Rate for Payer: Aetna Medicare Advantage	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$953.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$953.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$748.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$953.70
Rate for Payer: Cigna Commercial	$1,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$905.08
Rate for Payer: Qualcare PPO/HMO/WC	$561.00

ROD CURVED NOTCHED 50MM

Facility

$3,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270674914
Hospital Revenue Code	278
Min. Negotiated Rate	$561.00
Max. Negotiated Rate	$905.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$748.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$905.08
Rate for Payer: Qualcare PPO/HMO/WC	$561.00

ROD CURVED TI50MM

Facility

$875.00

Hospital Charge Code	270703000
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

ROD CURVED TI50MM

Facility

$875.00

Hospital Charge Code	270703000
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

ROD CURVED TI ALLOY 5.5X40MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693445
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD CURVED TI ALLOY 5.5X40MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693445
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD CURVED TI ALLOY 5.5X45MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693438
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD CURVED TI ALLOY 5.5X45MM

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270693438
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD DPY CONNECT MED FA10000-2

Facility

$4,628.00

Hospital Charge Code	270612439
Hospital Revenue Code	278
Min. Negotiated Rate	$694.20
Max. Negotiated Rate	$2,314.00
Rate for Payer: Aetna Commercial	$1,388.40
Rate for Payer: Aetna Medicare Advantage	$1,388.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,180.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,180.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,180.14
Rate for Payer: Cigna Commercial	$2,314.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.98
Rate for Payer: Qualcare PPO/HMO/WC	$694.20

ROD DPY CONNECT MED FA10000-2

Facility

$4,628.00

Hospital Charge Code	270612439
Hospital Revenue Code	278
Min. Negotiated Rate	$694.20
Max. Negotiated Rate	$1,119.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$925.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.98
Rate for Payer: Qualcare PPO/HMO/WC	$694.20

ROD END CURV 5.5 40 535-5040

Facility

$1,604.75

Hospital Charge Code	270628752
Hospital Revenue Code	278
Min. Negotiated Rate	$240.71
Max. Negotiated Rate	$802.38
Rate for Payer: Aetna Commercial	$481.43
Rate for Payer: Aetna Medicare Advantage	$481.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$409.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$409.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$409.21
Rate for Payer: Cigna Commercial	$802.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.35
Rate for Payer: Qualcare PPO/HMO/WC	$240.71

Know your out-of-pocket cost for care.

All Charges