Heights University Hospital

All Charges

Charge

Type

Setting

Price

SYTHROID/0.088MG

Facility

$3.00

Hospital Charge Code	60634782
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

SZ.4 42 INSERT 28HEAD DUAL MOB

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705864
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SZ.4 42 INSERT 28HEAD DUAL MOB

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705864
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SZ.4 DUAL MOBILITY LINER

Facility

$4,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270705866
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SZ.4 DUAL MOBILITY LINER

Facility

$4,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270705866
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SZ.8 CEMENTLESS HIP SYSTEM

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270705865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

SZ.8 CEMENTLESS HIP SYSTEM

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270705865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$3,450.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

T-15 TAPERED DRIVER

Facility

$2,090.00

Hospital Charge Code	270686087
Hospital Revenue Code	272
Min. Negotiated Rate	$271.70
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.70
Rate for Payer: Oxford Commercial	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$313.50
Rate for Payer: UnitedHealthcare Commercial	$1,045.00

T-15 TAPERED DRIVER

Facility

$2,090.00

Hospital Charge Code	270686087
Hospital Revenue Code	272
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$313.50
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

T1 CANN TFNA

Facility

$7,919.65

Service Code	HCPCS C1713
Hospital Charge Code	270686307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.95
Max. Negotiated Rate	$1,916.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.95

T1 CANN TFNA

Facility

$7,919.65

Service Code	HCPCS C1713
Hospital Charge Code	270686307
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.95
Max. Negotiated Rate	$3,959.82
Rate for Payer: Aetna Commercial	$2,375.89
Rate for Payer: Aetna Medicare Advantage	$2,375.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,583.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,019.51
Rate for Payer: Cigna Commercial	$3,959.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.95

T1 LAG SCREW 10.5X90MM

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270656563
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$1,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

T1 LAG SCREW 10.5X90MM

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270656563
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$2,215.00
Rate for Payer: Aetna Commercial	$1,329.00
Rate for Payer: Aetna Medicare Advantage	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.65
Rate for Payer: Cigna Commercial	$2,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

T2 F/T LOCKING SCREW 4X45MM

Facility

$1,220.00

Hospital Charge Code	270656556
Hospital Revenue Code	278
Min. Negotiated Rate	$183.00
Max. Negotiated Rate	$610.00
Rate for Payer: Aetna Commercial	$366.00
Rate for Payer: Aetna Medicare Advantage	$366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.10
Rate for Payer: Cigna Commercial	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.24
Rate for Payer: Qualcare PPO/HMO/WC	$183.00

T2 F/T LOCKING SCREW 4X45MM

Facility

$1,220.00

Hospital Charge Code	270656556
Hospital Revenue Code	278
Min. Negotiated Rate	$183.00
Max. Negotiated Rate	$295.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.24
Rate for Payer: Qualcare PPO/HMO/WC	$183.00

T30 LOCK SCREW

Facility

$925.00

Service Code	HCPCS C1713
Hospital Charge Code	270695751
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$462.50
Rate for Payer: Aetna Commercial	$277.50
Rate for Payer: Aetna Medicare Advantage	$277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.88
Rate for Payer: Cigna Commercial	$462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

T30 LOCK SCREW

Facility

$925.00

Service Code	HCPCS C1713
Hospital Charge Code	270695751
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$223.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.85
Rate for Payer: Qualcare PPO/HMO/WC	$138.75

T3 FREE

Facility

$261.00

Service Code	HCPCS 84481
Hospital Charge Code	38472801
Hospital Revenue Code	301
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$39.15
Rate for Payer: Qualcare PPO/HMO/WC	$39.15

T3 FREE

Facility

$261.00

Service Code	HCPCS 84481
Hospital Charge Code	38472801
Hospital Revenue Code	301
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.89
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.07
Rate for Payer: Cigna Commercial	$16.94
Rate for Payer: Cigna Medicare Advantage	$8.47
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.96
Rate for Payer: Wellcare Medicare Advantage	$16.94

T3 HEMODIALYS 15X5F 15CM CT ST

Facility

$700.00

Hospital Charge Code	270680502
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$350.00

T3 HEMODIALYS 15X5F 15CM CT ST

Facility

$700.00

Hospital Charge Code	270680502
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

T3 REVERSE

Facility

$160.85

Service Code	HCPCS 84482
Hospital Charge Code	3030400
Hospital Revenue Code	301
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.06
Rate for Payer: Aetna Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$15.76
Rate for Payer: Cigna Medicare Advantage	$7.88
Rate for Payer: Clover Medicare Advantage	$14.97
Rate for Payer: EmblemHealth Commercial	$47.28
Rate for Payer: Humana Medicare Advantage	$16.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.71
Rate for Payer: Wellcare Medicare Advantage	$15.76

T3 REVERSE

Facility

$160.85

Service Code	HCPCS 84482
Hospital Charge Code	3030400
Hospital Revenue Code	301
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$24.13
Rate for Payer: Qualcare PPO/HMO/WC	$24.13

T3,REVERSE,LC/MS/MS

Facility

$390.00

Service Code	HCPCS 84482
Hospital Charge Code	39900145
Hospital Revenue Code	301
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.06
Rate for Payer: Aetna Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.74
Rate for Payer: Cigna Commercial	$15.76
Rate for Payer: Cigna Medicare Advantage	$7.88
Rate for Payer: Clover Medicare Advantage	$14.97
Rate for Payer: EmblemHealth Commercial	$47.28
Rate for Payer: Humana Medicare Advantage	$16.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.71
Rate for Payer: Wellcare Medicare Advantage	$15.76

T3,REVERSE,LC/MS/MS

Facility

$390.00

Service Code	HCPCS 84482
Hospital Charge Code	39900145
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges