Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROD LORDOTR PREBENT 55MM

Facility

$4,580.00

Hospital Charge Code	270657316
Hospital Revenue Code	278
Min. Negotiated Rate	$687.00
Max. Negotiated Rate	$1,108.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$916.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,108.36
Rate for Payer: Qualcare PPO/HMO/WC	$687.00

ROD LOTUS AXIAL CONN 3.5X3.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698265
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 LOTUS AXIAL CONN 3.5X3.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698265
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 LOTUS AXIAL CONN 3.5X5.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698264
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 LOTUS AXIAL CONN 3.5X5.5MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698264
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 LOTUS LORDOSED 3.5X240MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698263
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LOTUS LORDOSED 3.5X240MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270698263
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$216.00
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LOTUS LORDOSED 3.5X40MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270696779
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$216.00
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD LOTUS LORDOSED 3.5X40MM

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	270696779
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

ROD MAS PLIF FIXATION 35MM PRE

Facility

$2,980.00

Hospital Charge Code	270663772
Hospital Revenue Code	278
Min. Negotiated Rate	$447.00
Max. Negotiated Rate	$721.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Qualcare PPO/HMO/WC	$447.00

ROD MAS PLIF FIXATION 35MM PRE

Facility

$2,980.00

Hospital Charge Code	270663772
Hospital Revenue Code	278
Min. Negotiated Rate	$447.00
Max. Negotiated Rate	$1,490.00
Rate for Payer: Aetna Commercial	$894.00
Rate for Payer: Aetna Medicare Advantage	$894.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$759.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$596.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$759.90
Rate for Payer: Cigna Commercial	$1,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$721.16
Rate for Payer: Qualcare PPO/HMO/WC	$447.00

ROD MEDIUM FA10000.2

Facility

$4,290.45

Hospital Charge Code	270632397
Hospital Revenue Code	278
Min. Negotiated Rate	$643.57
Max. Negotiated Rate	$1,038.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$858.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,038.29
Rate for Payer: Qualcare PPO/HMO/WC	$643.57

ROD MEDIUM FA10000.2

Facility

$4,290.45

Hospital Charge Code	270632397
Hospital Revenue Code	278
Min. Negotiated Rate	$643.57
Max. Negotiated Rate	$2,145.22
Rate for Payer: Aetna Commercial	$1,287.13
Rate for Payer: Aetna Medicare Advantage	$1,287.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,094.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,094.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$858.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,094.06
Rate for Payer: Cigna Commercial	$2,145.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,038.29
Rate for Payer: Qualcare PPO/HMO/WC	$643.57

ROD MEDT TUNNELING 859041

Facility

$690.45

Hospital Charge Code	270612540
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$167.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

ROD MEDT TUNNELING 859041

Facility

$690.45

Hospital Charge Code	270612540
Hospital Revenue Code	278
Min. Negotiated Rate	$103.57
Max. Negotiated Rate	$345.23
Rate for Payer: Aetna Commercial	$207.13
Rate for Payer: Aetna Medicare Advantage	$207.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.06
Rate for Payer: Cigna Commercial	$345.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.09
Rate for Payer: Qualcare PPO/HMO/WC	$103.57

ROD MERCURY BULLET LORDO 45MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693008
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

ROD MERCURY BULLET LORDO 45MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693008
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

ROD MIS 60MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705055
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ROD MIS 60MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705055
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

ROD MIS BULLET LORDOS 5.5X35MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270696985
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROD MIS BULLET LORDOS 5.5X35MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270696985
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROD MIS BULLET LORDOS 5.5X70MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695824
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROD MIS BULLET LORDOS 5.5X70MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695824
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROD MIS BULLET LORDOS 5.5X75MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695825
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ROD MIS BULLET LORDOS 5.5X75MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270695825
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

Know your out-of-pocket cost for care.

All Charges