Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROD SMALL EXT FIX 4.0mm x 80mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270640372
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

ROD SMALL EXT FIX 4.0mm x 80mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270640372
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$41.72
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

ROD SMALL EXT FIX 4x120mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270620408
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$41.72
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

ROD SMALL EXT FIX 4x120mm

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270620408
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

ROD SMALL EXT FX 4.0x140 39574

Facility

$163.75

Hospital Charge Code	270632284
Hospital Revenue Code	278
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$81.88
Rate for Payer: Aetna Commercial	$49.12
Rate for Payer: Aetna Medicare Advantage	$49.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.76
Rate for Payer: Cigna Commercial	$81.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.63
Rate for Payer: Qualcare PPO/HMO/WC	$24.56

ROD SMALL EXT FX 4.0x140 39574

Facility

$163.75

Hospital Charge Code	270632284
Hospital Revenue Code	278
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$39.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.63
Rate for Payer: Qualcare PPO/HMO/WC	$24.56

ROD SMN GUIDE 3.0 900MM 112059

Facility

$668.00

Hospital Charge Code	270621503
Hospital Revenue Code	278
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$161.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.66
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

ROD SMN GUIDE 3.0 900MM 112059

Facility

$668.00

Hospital Charge Code	270621503
Hospital Revenue Code	278
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$334.00
Rate for Payer: Aetna Commercial	$200.40
Rate for Payer: Aetna Medicare Advantage	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.34
Rate for Payer: Cigna Commercial	$334.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.66
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

ROD SNR GUIDE BALL 3 71118202

Facility

$562.45

Hospital Charge Code	270613589
Hospital Revenue Code	278
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$136.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.11
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

ROD SNR GUIDE BALL 3 71118202

Facility

$562.45

Hospital Charge Code	270613589
Hospital Revenue Code	278
Min. Negotiated Rate	$84.37
Max. Negotiated Rate	$281.23
Rate for Payer: Aetna Commercial	$168.74
Rate for Payer: Aetna Medicare Advantage	$168.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.42
Rate for Payer: Cigna Commercial	$281.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.11
Rate for Payer: Qualcare PPO/HMO/WC	$84.37

ROD SOLERA 5.5CMX35MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695304
Hospital Revenue Code	278
Min. Negotiated Rate	$1,027.50
Max. Negotiated Rate	$3,425.00
Rate for Payer: Aetna Commercial	$2,055.00
Rate for Payer: Aetna Medicare Advantage	$2,055.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,746.75
Rate for Payer: Cigna Commercial	$3,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.50

ROD SOLERA 5.5CMX35MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270695304
Hospital Revenue Code	278
Min. Negotiated Rate	$1,027.50
Max. Negotiated Rate	$1,657.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.50

ROD SPINAL 5.5mm X 80 mm

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680579
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD SPINAL 5.5mm X 80 mm

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270680579
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

ROD SPIN CD HORZ 4.75X30MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270697030
Hospital Revenue Code	278
Min. Negotiated Rate	$1,027.50
Max. Negotiated Rate	$1,657.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.50

ROD SPIN CD HORZ 4.75X30MM

Facility

$6,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270697030
Hospital Revenue Code	278
Min. Negotiated Rate	$1,027.50
Max. Negotiated Rate	$3,425.00
Rate for Payer: Aetna Commercial	$2,055.00
Rate for Payer: Aetna Medicare Advantage	$2,055.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,746.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,746.75
Rate for Payer: Cigna Commercial	$3,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,657.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.50

ROD SPINE STRAIGHT 3.5x120MM

Facility

$1,820.00

Hospital Charge Code	270675610
Hospital Revenue Code	278
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$440.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.44
Rate for Payer: Qualcare PPO/HMO/WC	$273.00

ROD SPINE STRAIGHT 3.5x120MM

Facility

$1,820.00

Hospital Charge Code	270675610
Hospital Revenue Code	278
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$910.00
Rate for Payer: Aetna Commercial	$546.00
Rate for Payer: Aetna Medicare Advantage	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$364.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.10
Rate for Payer: Cigna Commercial	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.44
Rate for Payer: Qualcare PPO/HMO/WC	$273.00

ROD SPINL PRELORD HEX TAP 35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692502
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 SPINL PRELORD HEX TAP 35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692502
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 SPINL PRELORD HEX TAP 40MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692501
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 SPINL PRELORD HEX TAP 40MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692501
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 SPIN TITACURVCREO 5.5X50MM

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270693238
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

ROD SPIN TITACURVCREO 5.5X50MM

Facility

$5,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270693238
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

ROD SPNL 5.5X40MM EXT TB OVERW

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270693167
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

Know your out-of-pocket cost for care.

All Charges