Heights University Hospital

All Charges

Charge

Type

Setting

Price

WEDGE ILIAC CREST 12X6

Facility

$3,532.50

Service Code	HCPCS C1776
Hospital Charge Code	270686434
Hospital Revenue Code	278
Min. Negotiated Rate	$529.88
Max. Negotiated Rate	$1,766.25
Rate for Payer: Aetna Commercial	$1,059.75
Rate for Payer: Aetna Medicare Advantage	$1,059.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$900.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$900.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$706.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$900.79
Rate for Payer: Cigna Commercial	$1,766.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.87
Rate for Payer: Qualcare PPO/HMO/WC	$529.88

WEDGE ILIAC CREST 12X6

Facility

$3,532.50

Service Code	HCPCS C1776
Hospital Charge Code	270686434
Hospital Revenue Code	278
Min. Negotiated Rate	$529.88
Max. Negotiated Rate	$854.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$706.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$854.87
Rate for Payer: Qualcare PPO/HMO/WC	$529.88

WEDGE OSFERION 7MMX30 MMX12 MM

Facility

$2,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270691442
Hospital Revenue Code	278
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$1,212.50
Rate for Payer: Aetna Commercial	$727.50
Rate for Payer: Aetna Medicare Advantage	$727.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.38
Rate for Payer: Cigna Commercial	$1,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.85
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

WEDGE OSFERION 7MMX30 MMX12 MM

Facility

$2,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270691442
Hospital Revenue Code	278
Min. Negotiated Rate	$363.75
Max. Negotiated Rate	$586.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$586.85
Rate for Payer: Qualcare PPO/HMO/WC	$363.75

WEDGE OSFERION OSTEOTOMY 10MM

Facility

$2,475.00

Service Code	HCPCS C1776
Hospital Charge Code	270675921
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

WEDGE OSFERION OSTEOTOMY 10MM

Facility

$2,475.00

Service Code	HCPCS C1776
Hospital Charge Code	270675921
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

WEDGE OSTEHON OSTEOTOMY

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270683945
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

WEDGE OSTEHON OSTEOTOMY

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270683945
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

WEDGE PILLOW LRG DISPOSABLE

Facility

$160.00

Hospital Charge Code	270666211
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

WEDGE PILLOW LRG DISPOSABLE

Facility

$160.00

Hospital Charge Code	270666211
Hospital Revenue Code	270
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

WEDGE PLATE 3MM LEFT

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687965
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

WEDGE PLATE 3MM LEFT

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687965
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

WEDGE PLATE 5MM SPACER STER

Facility

$4,005.00

Hospital Charge Code	270676153
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$2,002.50
Rate for Payer: Aetna Commercial	$1,201.50
Rate for Payer: Aetna Medicare Advantage	$1,201.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.27
Rate for Payer: Cigna Commercial	$2,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

WEDGE PLATE 5MM SPACER STER

Facility

$4,005.00

Hospital Charge Code	270676153
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$969.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

WEDGE RESECT OF LUNG INITIAL

Facility

$36,520.38

Service Code	HCPCS 32505
Hospital Charge Code	160000366
Hospital Revenue Code	360
Min. Negotiated Rate	$976.51
Max. Negotiated Rate	$10,956.11
Rate for Payer: Aetna Commercial	$10,956.11
Rate for Payer: Aetna Medicare Advantage	$10,956.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,312.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,312.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,312.70
Rate for Payer: Cigna Commercial	$976.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,747.65
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,478.06
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

WEDGE RESECT OF LUNG INITIAL

Facility

$36,520.38

Service Code	HCPCS 32505
Hospital Charge Code	160000366
Hospital Revenue Code	360
Min. Negotiated Rate	$5,478.06
Max. Negotiated Rate	$5,478.06
Rate for Payer: Qualcare PPO/HMO/WC	$5,478.06

WEDGE SCREW UNIVERSAL 9x20MM

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270675670
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$286.50
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

WEDGE SCREW UNIVERSAL 9x20MM

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270675670
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

WEDGE SCREW UNIVERSAL 9x25MM

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270675671
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$231.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

WEDGE SCREW UNIVERSAL 9x25MM

Facility

$955.00

Service Code	HCPCS C1713
Hospital Charge Code	270675671
Hospital Revenue Code	278
Min. Negotiated Rate	$143.25
Max. Negotiated Rate	$477.50
Rate for Payer: Aetna Commercial	$286.50
Rate for Payer: Aetna Medicare Advantage	$286.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$191.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.53
Rate for Payer: Cigna Commercial	$477.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.11
Rate for Payer: Qualcare PPO/HMO/WC	$143.25

WEDGET EVANS TI /PEEK 18X8MM

Facility

$13,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270686481
Hospital Revenue Code	278
Min. Negotiated Rate	$2,002.50
Max. Negotiated Rate	$6,675.00
Rate for Payer: Aetna Commercial	$4,005.00
Rate for Payer: Aetna Medicare Advantage	$4,005.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,404.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,404.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,404.25
Rate for Payer: Cigna Commercial	$6,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,230.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.50

WEDGET EVANS TI /PEEK 18X8MM

Facility

$13,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270686481
Hospital Revenue Code	278
Min. Negotiated Rate	$2,002.50
Max. Negotiated Rate	$3,230.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,230.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.50

WEDGE TIBIAL THIRD 22-DEGREE

Facility

$2,549.65

Hospital Charge Code	270626695
Hospital Revenue Code	278
Min. Negotiated Rate	$382.45
Max. Negotiated Rate	$1,274.83
Rate for Payer: Aetna Commercial	$764.89
Rate for Payer: Aetna Medicare Advantage	$764.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$650.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$650.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$650.16
Rate for Payer: Cigna Commercial	$1,274.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.02
Rate for Payer: Qualcare PPO/HMO/WC	$382.45

WEDGE TIBIAL THIRD 22-DEGREE

Facility

$2,549.65

Hospital Charge Code	270626695
Hospital Revenue Code	278
Min. Negotiated Rate	$382.45
Max. Negotiated Rate	$617.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.02
Rate for Payer: Qualcare PPO/HMO/WC	$382.45

WEDGE TRIAL SUBTULAR 10MM

Facility

$18,625.00

Service Code	HCPCS C1776
Hospital Charge Code	270698254
Hospital Revenue Code	278
Min. Negotiated Rate	$2,793.75
Max. Negotiated Rate	$4,507.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,507.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,793.75

Know your out-of-pocket cost for care.

All Charges