Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCRW 4.0X14 CNCLCK 8161-40-014

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270661577
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$189.75
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCRW 4.0X16 CNCLCK 8161-40-016

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661578
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X16 CNCLCK 8161-40-016

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661578
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X18 CNCLCK 8161-40-018

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661579
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X18 CNCLCK 8161-40-018

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270661579
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X20 CNCLCK 8161-40-020

Facility

$850.00

Hospital Charge Code	270661581
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.0X20 CNCLCK 8161-40-020

Facility

$850.00

Hospital Charge Code	270661581
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW 4.5m MALLEOLAR 50m2334051

Facility

$85.00

Hospital Charge Code	270610356
Hospital Revenue Code	278
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

SCRW 4.5m MALLEOLAR 50m2334051

Facility

$85.00

Hospital Charge Code	270610356
Hospital Revenue Code	278
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

SCRW AFFIXS CORT BONE 5.0X38MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270679372
Hospital Revenue Code	278
Min. Negotiated Rate	$108.34
Max. Negotiated Rate	$174.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$108.34

SCRW AFFIXS CORT BONE 5.0X38MM

Facility

$722.30

Service Code	HCPCS C1713
Hospital Charge Code	270679372
Hospital Revenue Code	278
Min. Negotiated Rate	$108.34
Max. Negotiated Rate	$361.15
Rate for Payer: Aetna Commercial	$216.69
Rate for Payer: Aetna Medicare Advantage	$216.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.19
Rate for Payer: Cigna Commercial	$361.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$108.34

SCRW BNE 1.7MMx11MM 58-17011E

Facility

$550.00

Hospital Charge Code	270655366
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCRW BNE 1.7MMx11MM 58-17011E

Facility

$550.00

Hospital Charge Code	270655366
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCRW BNE1.7MMx9MM LCK53-17009E

Facility

$705.00

Hospital Charge Code	270655373
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$211.50
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCRW BNE1.7MMx9MM LCK53-17009E

Facility

$705.00

Hospital Charge Code	270655373
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCRW BNE LOCK 14Mx2.7M 5227014

Facility

$450.00

Hospital Charge Code	270640884
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 14Mx2.7M 5227014

Facility

$450.00

Hospital Charge Code	270640884
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 14Mx2.7M 5227614

Facility

$525.00

Hospital Charge Code	270640887
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCRW BNE LOCK 14Mx2.7M 5227614

Facility

$525.00

Hospital Charge Code	270640887
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCRW BNE LOCK 16Mx2.7M 5220616

Facility

$450.00

Hospital Charge Code	270640889
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 16Mx2.7M 5220616

Facility

$450.00

Hospital Charge Code	270640889
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 16Mx2.7M 5227616

Facility

$525.00

Hospital Charge Code	270640886
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCRW BNE LOCK 16Mx2.7M 5227616

Facility

$525.00

Hospital Charge Code	270640886
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCRW BNE LOCK 18Mx2.7M 5220618

Facility

$450.00

Hospital Charge Code	270640891
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 18Mx2.7M 5220618

Facility

$450.00

Hospital Charge Code	270640891
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

Know your out-of-pocket cost for care.

All Charges