Heights University Hospital

All Charges

Charge

Type

Setting

Price

4.0MM CANC SCR FT 40MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270688922
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$74.25
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

4.0MM CANC SCR FT 40MM NS

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270688922
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

4.0MM CARBON FIBER ROD 100MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601808
Hospital Revenue Code	278
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$43.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

4.0MM CARBON FIBER ROD 100MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601808
Hospital Revenue Code	278
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$90.72
Rate for Payer: Aetna Commercial	$54.44
Rate for Payer: Aetna Medicare Advantage	$54.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.27
Rate for Payer: Cigna Commercial	$90.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

4.0MM CARBON FIBER ROD 120MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601813
Hospital Revenue Code	278
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$43.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

4.0MM CARBON FIBER ROD 120MM

Facility

$181.45

Service Code	HCPCS C1713
Hospital Charge Code	270601813
Hospital Revenue Code	278
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$90.72
Rate for Payer: Aetna Commercial	$54.44
Rate for Payer: Aetna Medicare Advantage	$54.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.27
Rate for Payer: Cigna Commercial	$90.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.91
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

4.0MM CARBON FIBER ROD 140MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601809
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$74.95
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 140MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601809
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 160MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601810
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$74.95
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 160MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601810
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 180MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601814
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$74.95
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 180MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601814
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 200MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601811
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$124.92
Rate for Payer: Aetna Commercial	$74.95
Rate for Payer: Aetna Medicare Advantage	$74.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$124.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

4.0MM CARBON FIBER ROD 200MM

Facility

$249.85

Service Code	HCPCS C1713
Hospital Charge Code	270601811
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$60.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.48

40MM LORDOTIC BRIDGE PLATE

Facility

$14,406.00

Service Code	HCPCS C1713
Hospital Charge Code	270704086
Hospital Revenue Code	278
Min. Negotiated Rate	$2,160.90
Max. Negotiated Rate	$7,203.00
Rate for Payer: Aetna Commercial	$4,321.80
Rate for Payer: Aetna Medicare Advantage	$4,321.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,673.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,673.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,881.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,673.53
Rate for Payer: Cigna Commercial	$7,203.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,486.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.90

40MM LORDOTIC BRIDGE PLATE

Facility

$14,406.00

Service Code	HCPCS C1713
Hospital Charge Code	270704086
Hospital Revenue Code	278
Min. Negotiated Rate	$2,160.90
Max. Negotiated Rate	$3,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,881.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,486.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,160.90

4.0 MM NASAL SHAVER BLADE

Facility

$316.00

Hospital Charge Code	270338799
Hospital Revenue Code	272
Min. Negotiated Rate	$41.08
Max. Negotiated Rate	$158.00
Rate for Payer: Aetna Commercial	$94.80
Rate for Payer: Aetna Medicare Advantage	$94.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.58
Rate for Payer: Cigna Commercial	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.08
Rate for Payer: Oxford Commercial	$158.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.40
Rate for Payer: UnitedHealthcare Commercial	$158.00

4.0 MM NASAL SHAVER BLADE

Facility

$316.00

Hospital Charge Code	270338799
Hospital Revenue Code	272
Min. Negotiated Rate	$47.40
Max. Negotiated Rate	$47.40
Rate for Payer: Qualcare PPO/HMO/WC	$47.40

40MM ROD

Facility

$1,690.65

Service Code	HCPCS C1713
Hospital Charge Code	270669384
Hospital Revenue Code	278
Min. Negotiated Rate	$253.60
Max. Negotiated Rate	$409.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.14
Rate for Payer: Qualcare PPO/HMO/WC	$253.60

40MM ROD

Facility

$1,690.65

Service Code	HCPCS C1713
Hospital Charge Code	270669384
Hospital Revenue Code	278
Min. Negotiated Rate	$253.60
Max. Negotiated Rate	$845.33
Rate for Payer: Aetna Commercial	$507.19
Rate for Payer: Aetna Medicare Advantage	$507.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$431.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$338.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$431.12
Rate for Payer: Cigna Commercial	$845.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$409.14
Rate for Payer: Qualcare PPO/HMO/WC	$253.60

40MM ROD #11-3040

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705466
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

40MM ROD #11-3040

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705466
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

40MM RODS

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703565
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$284.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

40MM RODS

Facility

$1,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270703565
Hospital Revenue Code	278
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$352.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.35
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

4.0MM ROUBD FLUTED AGGRESSIVE

Facility

$620.00

Hospital Charge Code	270702862
Hospital Revenue Code	270
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

Know your out-of-pocket cost for care.

All Charges