Heights University Hospital

All Charges

Charge

Type

Setting

Price

WIRE BOLT MEDUIM LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699591
Hospital Revenue Code	272
Min. Negotiated Rate	$85.55
Max. Negotiated Rate	$85.55
Rate for Payer: Qualcare PPO/HMO/WC	$85.55

WIRE BOLT MEDUIM LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699591
Hospital Revenue Code	272
Min. Negotiated Rate	$74.15
Max. Negotiated Rate	$285.18
Rate for Payer: Aetna Commercial	$171.10
Rate for Payer: Aetna Medicare Advantage	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.44
Rate for Payer: Cigna Commercial	$285.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.15
Rate for Payer: Oxford Commercial	$285.18
Rate for Payer: Qualcare PPO/HMO/WC	$85.55
Rate for Payer: UnitedHealthcare Commercial	$285.18

WIRE BOLT OFFSET ADAPTER SHORT

Facility

$1,512.80

Service Code	HCPCS A4649
Hospital Charge Code	270674290
Hospital Revenue Code	272
Min. Negotiated Rate	$226.92
Max. Negotiated Rate	$226.92
Rate for Payer: Qualcare PPO/HMO/WC	$226.92

WIRE BOLT OFFSET ADAPTER SHORT

Facility

$1,512.80

Service Code	HCPCS A4649
Hospital Charge Code	270674290
Hospital Revenue Code	272
Min. Negotiated Rate	$196.66
Max. Negotiated Rate	$756.40
Rate for Payer: Aetna Commercial	$453.84
Rate for Payer: Aetna Medicare Advantage	$453.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.76
Rate for Payer: Cigna Commercial	$756.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.66
Rate for Payer: Oxford Commercial	$756.40
Rate for Payer: Qualcare PPO/HMO/WC	$226.92
Rate for Payer: UnitedHealthcare Commercial	$756.40

WIRE BOLT SHORT LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699590
Hospital Revenue Code	272
Min. Negotiated Rate	$74.15
Max. Negotiated Rate	$285.18
Rate for Payer: Aetna Commercial	$171.10
Rate for Payer: Aetna Medicare Advantage	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.44
Rate for Payer: Cigna Commercial	$285.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.15
Rate for Payer: Oxford Commercial	$285.18
Rate for Payer: Qualcare PPO/HMO/WC	$85.55
Rate for Payer: UnitedHealthcare Commercial	$285.18

WIRE BOLT SHORT LRF 1.5X2.0MM

Facility

$570.35

Service Code	HCPCS A4649
Hospital Charge Code	270699590
Hospital Revenue Code	272
Min. Negotiated Rate	$85.55
Max. Negotiated Rate	$85.55
Rate for Payer: Qualcare PPO/HMO/WC	$85.55

WIRE BONE 2.4MMX100CM

Facility

$349.45

Service Code	HCPCS C1713
Hospital Charge Code	270625006
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$174.72
Rate for Payer: Aetna Commercial	$104.83
Rate for Payer: Aetna Medicare Advantage	$104.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.11
Rate for Payer: Cigna Commercial	$174.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.57
Rate for Payer: Qualcare PPO/HMO/WC	$52.42

WIRE BONE 2.4MMX100CM

Facility

$349.45

Service Code	HCPCS C1713
Hospital Charge Code	270625006
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$84.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.57
Rate for Payer: Qualcare PPO/HMO/WC	$52.42

WIRE CALIBRATED MEASURED 1.1MM

Facility

$206.00

Hospital Charge Code	270703052
Hospital Revenue Code	278
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

WIRE CALIBRATED MEASURED 1.1MM

Facility

$206.00

Hospital Charge Code	270703052
Hospital Revenue Code	278
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$61.80
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

WIRE CALIBRATED MEASURED 1.35T

Facility

$206.00

Hospital Charge Code	270703054
Hospital Revenue Code	278
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$49.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

WIRE CALIBRATED MEASURED 1.35T

Facility

$206.00

Hospital Charge Code	270703054
Hospital Revenue Code	278
Min. Negotiated Rate	$30.90
Max. Negotiated Rate	$103.00
Rate for Payer: Aetna Commercial	$61.80
Rate for Payer: Aetna Medicare Advantage	$61.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.53
Rate for Payer: Cigna Commercial	$103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.90

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$99.25

Hospital Charge Code	270600708C
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$24.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$99.25

Hospital Charge Code	270600708C
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$270.50

Service Code	HCPCS C1769
Hospital Charge Code	270600708
Hospital Revenue Code	278
Min. Negotiated Rate	$40.58
Max. Negotiated Rate	$65.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.46
Rate for Payer: Qualcare PPO/HMO/WC	$40.58

WIRE CD GUIDE .038 150CM 3MMJ

Facility

$270.50

Service Code	HCPCS C1769
Hospital Charge Code	270600708
Hospital Revenue Code	278
Min. Negotiated Rate	$40.58
Max. Negotiated Rate	$135.25
Rate for Payer: Aetna Commercial	$81.15
Rate for Payer: Aetna Medicare Advantage	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.98
Rate for Payer: Cigna Commercial	$135.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.46
Rate for Payer: Qualcare PPO/HMO/WC	$40.58

WIRE CERCLAGE 1.0MM COILS

Facility

$283.50

Hospital Charge Code	270676853
Hospital Revenue Code	272
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$42.52
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

WIRE CERCLAGE 1.0MM COILS

Facility

$283.50

Hospital Charge Code	270676853
Hospital Revenue Code	272
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$141.75
Rate for Payer: Aetna Commercial	$85.05
Rate for Payer: Aetna Medicare Advantage	$85.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.29
Rate for Payer: Cigna Commercial	$141.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.85
Rate for Payer: Oxford Commercial	$141.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.52
Rate for Payer: UnitedHealthcare Commercial	$141.75

WIRE CERCLAGE COILS 1.25MM

Facility

$283.50

Service Code	HCPCS C1713
Hospital Charge Code	270676854
Hospital Revenue Code	278
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$141.75
Rate for Payer: Aetna Commercial	$85.05
Rate for Payer: Aetna Medicare Advantage	$85.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.29
Rate for Payer: Cigna Commercial	$141.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.61
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

WIRE CERCLAGE COILS 1.25MM

Facility

$283.50

Service Code	HCPCS C1713
Hospital Charge Code	270676854
Hospital Revenue Code	278
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$68.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.61
Rate for Payer: Qualcare PPO/HMO/WC	$42.52

WIRE CERCLAGE W/EYE 1.25x280MM

Facility

$346.10

Hospital Charge Code	270653107
Hospital Revenue Code	278
Min. Negotiated Rate	$51.91
Max. Negotiated Rate	$83.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.76
Rate for Payer: Qualcare PPO/HMO/WC	$51.91

WIRE CERCLAGE W/EYE 1.25x280MM

Facility

$346.10

Hospital Charge Code	270653107
Hospital Revenue Code	278
Min. Negotiated Rate	$51.91
Max. Negotiated Rate	$173.05
Rate for Payer: Aetna Commercial	$103.83
Rate for Payer: Aetna Medicare Advantage	$103.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.26
Rate for Payer: Cigna Commercial	$173.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.76
Rate for Payer: Qualcare PPO/HMO/WC	$51.91

WIRE CERCLAGE W EYE 1.25X600MM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270700110
Hospital Revenue Code	278
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$392.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00

WIRE CERCLAGE W EYE 1.25X600MM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270700110
Hospital Revenue Code	278
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$810.00
Rate for Payer: Aetna Commercial	$486.00
Rate for Payer: Aetna Medicare Advantage	$486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.10
Rate for Payer: Cigna Commercial	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00

WIRE CK GUIDE .035 TFLN 635413

Facility

$72.85

Hospital Charge Code	270614881
Hospital Revenue Code	272
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$36.42
Rate for Payer: Aetna Commercial	$21.86
Rate for Payer: Aetna Medicare Advantage	$21.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.58
Rate for Payer: Cigna Commercial	$36.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.47
Rate for Payer: Oxford Commercial	$36.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.93
Rate for Payer: UnitedHealthcare Commercial	$36.42

Know your out-of-pocket cost for care.

All Charges