Heights University Hospital

All Charges

Charge

Type

Setting

Price

SLEEVE BMT CTR 9MM 113792

Facility

$981.65

Hospital Charge Code	270620287
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$237.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.56
Rate for Payer: Qualcare PPO/HMO/WC	$147.25

SLEEVE DBL DRILL 4.0/2.9MM

Facility

$1,239.10

Hospital Charge Code	270677605
Hospital Revenue Code	272
Min. Negotiated Rate	$161.08
Max. Negotiated Rate	$619.55
Rate for Payer: Aetna Commercial	$371.73
Rate for Payer: Aetna Medicare Advantage	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.97
Rate for Payer: Cigna Commercial	$619.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.08
Rate for Payer: Oxford Commercial	$619.55
Rate for Payer: Qualcare PPO/HMO/WC	$185.87
Rate for Payer: UnitedHealthcare Commercial	$619.55

SLEEVE DBL DRILL 4.0/2.9MM

Facility

$1,239.10

Hospital Charge Code	270677605
Hospital Revenue Code	272
Min. Negotiated Rate	$185.87
Max. Negotiated Rate	$185.87
Rate for Payer: Qualcare PPO/HMO/WC	$185.87

SLEEVE DELTA BIOLOX NEUTRAL

Facility

$525.00

Service Code	HCPCS C1776
Hospital Charge Code	270692220
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

SLEEVE DELTA BIOLOX NEUTRAL

Facility

$525.00

Service Code	HCPCS C1776
Hospital Charge Code	270692220
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

SLEEVE DRILL 27MM

Facility

$800.00

Hospital Charge Code	270661801
Hospital Revenue Code	272
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

SLEEVE DRILL 27MM

Facility

$800.00

Hospital Charge Code	270661801
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SLEEVE DRILL 4.0x2.5mm LONG

Facility

$513.00

Hospital Charge Code	270666876
Hospital Revenue Code	272
Min. Negotiated Rate	$66.69
Max. Negotiated Rate	$256.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$153.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.81
Rate for Payer: Cigna Commercial	$256.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.69
Rate for Payer: Oxford Commercial	$256.50
Rate for Payer: Qualcare PPO/HMO/WC	$76.95
Rate for Payer: UnitedHealthcare Commercial	$256.50

SLEEVE DRILL 4.0x2.5mm LONG

Facility

$513.00

Hospital Charge Code	270666876
Hospital Revenue Code	272
Min. Negotiated Rate	$76.95
Max. Negotiated Rate	$76.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.95

SLEEVE DRILL 4.0x2.5mm SHORT

Facility

$1,506.00

Hospital Charge Code	270666875
Hospital Revenue Code	272
Min. Negotiated Rate	$195.78
Max. Negotiated Rate	$753.00
Rate for Payer: Aetna Commercial	$451.80
Rate for Payer: Aetna Medicare Advantage	$451.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.03
Rate for Payer: Cigna Commercial	$753.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.78
Rate for Payer: Oxford Commercial	$753.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.90
Rate for Payer: UnitedHealthcare Commercial	$753.00

SLEEVE DRILL 4.0x2.5mm SHORT

Facility

$1,506.00

Hospital Charge Code	270666875
Hospital Revenue Code	272
Min. Negotiated Rate	$225.90
Max. Negotiated Rate	$225.90
Rate for Payer: Qualcare PPO/HMO/WC	$225.90

SLEEVE DRILL INSERT PARALL 2.0

Facility

$1,545.00

Hospital Charge Code	270666877
Hospital Revenue Code	272
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$231.75
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

SLEEVE DRILL INSERT PARALL 2.0

Facility

$1,545.00

Hospital Charge Code	270666877
Hospital Revenue Code	272
Min. Negotiated Rate	$200.85
Max. Negotiated Rate	$772.50
Rate for Payer: Aetna Commercial	$463.50
Rate for Payer: Aetna Medicare Advantage	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.98
Rate for Payer: Cigna Commercial	$772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.85
Rate for Payer: Oxford Commercial	$772.50
Rate for Payer: Qualcare PPO/HMO/WC	$231.75
Rate for Payer: UnitedHealthcare Commercial	$772.50

SLEEVE DRILL MEAS 8163-01-005

Facility

$850.00

Hospital Charge Code	270658917
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
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) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

SLEEVE DRILL MEAS 8163-01-005

Facility

$850.00

Hospital Charge Code	270658917
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SLEEVE DRILL MEASURING

Facility

$1,870.00

Hospital Charge Code	270648249
Hospital Revenue Code	272
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$935.00
Rate for Payer: Aetna Commercial	$561.00
Rate for Payer: Aetna Medicare Advantage	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$476.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$476.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$476.85
Rate for Payer: Cigna Commercial	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.10
Rate for Payer: Oxford Commercial	$935.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.50
Rate for Payer: UnitedHealthcare Commercial	$935.00

SLEEVE DRILL MEASURING

Facility

$1,870.00

Hospital Charge Code	270648249
Hospital Revenue Code	272
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Qualcare PPO/HMO/WC	$280.50

SLEEVE FEM ADAPTER 0MM NECK

Facility

$547.05

Service Code	HCPCS C1776
Hospital Charge Code	270697131
Hospital Revenue Code	278
Min. Negotiated Rate	$82.06
Max. Negotiated Rate	$273.52
Rate for Payer: Aetna Commercial	$164.12
Rate for Payer: Aetna Medicare Advantage	$164.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.50
Rate for Payer: Cigna Commercial	$273.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.39
Rate for Payer: Qualcare PPO/HMO/WC	$82.06

SLEEVE FEM ADAPTER 0MM NECK

Facility

$547.05

Service Code	HCPCS C1776
Hospital Charge Code	270697131
Hospital Revenue Code	278
Min. Negotiated Rate	$82.06
Max. Negotiated Rate	$132.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.39
Rate for Payer: Qualcare PPO/HMO/WC	$82.06

SLEEVE FEM HD BIOLOX OPT1 TPR

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694752
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SLEEVE FEM HD BIOLOX OPT1 TPR

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694752
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SLEEVE FEM NCK BIOLOX TYP1 3MM

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695938
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SLEEVE FEM NCK BIOLOX TYP1 3MM

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695938
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SLEEVE FEM NECK ADJ STD V40

Facility

$9,195.00

Service Code	HCPCS C1776
Hospital Charge Code	270693840
Hospital Revenue Code	278
Min. Negotiated Rate	$1,379.25
Max. Negotiated Rate	$4,597.50
Rate for Payer: Aetna Commercial	$2,758.50
Rate for Payer: Aetna Medicare Advantage	$2,758.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,344.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,344.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,344.72
Rate for Payer: Cigna Commercial	$4,597.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,225.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,379.25

SLEEVE FEM NECK ADJ STD V40

Facility

$9,195.00

Service Code	HCPCS C1776
Hospital Charge Code	270693840
Hospital Revenue Code	278
Min. Negotiated Rate	$1,379.25
Max. Negotiated Rate	$2,225.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,839.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,225.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,379.25

Know your out-of-pocket cost for care.

All Charges