Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLADE OSCIL LG BONE 5052551***

Facility

$57.00

Hospital Charge Code	1604982
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

BLADE OSCILL MICRO 5.5x12mm

Facility

$72.50

Hospital Charge Code	270638944
Hospital Revenue Code	272
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

BLADE OSCILL MICRO 5.5x12mm

Facility

$72.50

Hospital Charge Code	270638944
Hospital Revenue Code	272
Min. Negotiated Rate	$9.43
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$21.75
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.43
Rate for Payer: Oxford Commercial	$36.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$36.25

BLADE OSCILL MICRO 5.5X12mm

Facility

$69.85

Hospital Charge Code	270638994
Hospital Revenue Code	272
Min. Negotiated Rate	$10.48
Max. Negotiated Rate	$10.48
Rate for Payer: Qualcare PPO/HMO/WC	$10.48

BLADE OSCILL MICRO 5.5X12mm

Facility

$69.85

Hospital Charge Code	270638994
Hospital Revenue Code	272
Min. Negotiated Rate	$9.08
Max. Negotiated Rate	$34.92
Rate for Payer: Aetna Commercial	$20.95
Rate for Payer: Aetna Medicare Advantage	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.81
Rate for Payer: Cigna Commercial	$34.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.08
Rate for Payer: Oxford Commercial	$34.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.48
Rate for Payer: UnitedHealthcare Commercial	$34.92

BLADE OSCILL SAW 19.5X0.9X86MM

Facility

$60.00

Hospital Charge Code	270638997
Hospital Revenue Code	270
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

BLADE OSCILL SAW 19.5X0.9X86MM

Facility

$60.00

Hospital Charge Code	270638997
Hospital Revenue Code	270
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

BLADE OSCILL SAW LG BONE

Facility

$205.00

Hospital Charge Code	270658497
Hospital Revenue Code	272
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$61.50
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$102.50
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$102.50

BLADE OSCILL SAW LG BONE

Facility

$205.00

Hospital Charge Code	270658497
Hospital Revenue Code	272
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

BLADE OSCIL MICRO 10X28.5MM

Facility

$50.00

Hospital Charge Code	270638996
Hospital Revenue Code	270
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

BLADE OSCIL MICRO 10X28.5MM

Facility

$50.00

Hospital Charge Code	270638996
Hospital Revenue Code	270
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

BLADE OSTEOTOME THIN 12MMX3IN

Facility

$560.00

Service Code	HCPCS A4649
Hospital Charge Code	270698026
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

BLADE OSTEOTOME THIN 12MMX3IN

Facility

$560.00

Service Code	HCPCS A4649
Hospital Charge Code	270698026
Hospital Revenue Code	272
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$280.00

BLADE OVAL 4.0 55MM 16-50903

Facility

$254.45

Hospital Charge Code	270601072
Hospital Revenue Code	272
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$76.33
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.08
Rate for Payer: Oxford Commercial	$127.22
Rate for Payer: Qualcare PPO/HMO/WC	$38.17
Rate for Payer: UnitedHealthcare Commercial	$127.22

BLADE OVAL 4.0 55MM 16-50903

Facility

$254.45

Hospital Charge Code	270601072
Hospital Revenue Code	272
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$38.17
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

BLADE OVAL 4.0 X 8.0 MM

Facility

$58.80

Hospital Charge Code	270664986
Hospital Revenue Code	270
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$29.40
Rate for Payer: Aetna Commercial	$17.64
Rate for Payer: Aetna Medicare Advantage	$17.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.99
Rate for Payer: Cigna Commercial	$29.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.64
Rate for Payer: Oxford Commercial	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.82
Rate for Payer: UnitedHealthcare Commercial	$29.40

BLADE OVAL 4.0 X 8.0 MM

Facility

$58.80

Hospital Charge Code	270664986
Hospital Revenue Code	270
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$8.82
Rate for Payer: Qualcare PPO/HMO/WC	$8.82

BLADE OVAL 4.0 X 8 MM

Facility

$63.70

Hospital Charge Code	270664984
Hospital Revenue Code	270
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$31.85
Rate for Payer: Aetna Commercial	$19.11
Rate for Payer: Aetna Medicare Advantage	$19.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.24
Rate for Payer: Cigna Commercial	$31.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.28
Rate for Payer: Oxford Commercial	$31.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.55
Rate for Payer: UnitedHealthcare Commercial	$31.85

BLADE OVAL 4.0 X 8 MM

Facility

$63.70

Hospital Charge Code	270664984
Hospital Revenue Code	270
Min. Negotiated Rate	$9.55
Max. Negotiated Rate	$9.55
Rate for Payer: Qualcare PPO/HMO/WC	$9.55

BLADE PATELLA REAMER W/PILO

Facility

$876.25

Hospital Charge Code	270661319
Hospital Revenue Code	272
Min. Negotiated Rate	$113.91
Max. Negotiated Rate	$438.12
Rate for Payer: Aetna Commercial	$262.88
Rate for Payer: Aetna Medicare Advantage	$262.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.44
Rate for Payer: Cigna Commercial	$438.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.91
Rate for Payer: Oxford Commercial	$438.12
Rate for Payer: Qualcare PPO/HMO/WC	$131.44
Rate for Payer: UnitedHealthcare Commercial	$438.12

BLADE PATELLA REAMER W/PILO

Facility

$876.25

Hospital Charge Code	270661319
Hospital Revenue Code	272
Min. Negotiated Rate	$131.44
Max. Negotiated Rate	$131.44
Rate for Payer: Qualcare PPO/HMO/WC	$131.44

BLADE PRECISION 19.5X0.38X41MM

Facility

$180.20

Service Code	HCPCS A4649
Hospital Charge Code	270691103
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$90.10
Rate for Payer: Aetna Commercial	$54.06
Rate for Payer: Aetna Medicare Advantage	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.95
Rate for Payer: Cigna Commercial	$90.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.43
Rate for Payer: Oxford Commercial	$90.10
Rate for Payer: Qualcare PPO/HMO/WC	$27.03
Rate for Payer: UnitedHealthcare Commercial	$90.10

BLADE PRECISION 19.5X0.38X41MM

Facility

$180.20

Service Code	HCPCS A4649
Hospital Charge Code	270691103
Hospital Revenue Code	272
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$27.03
Rate for Payer: Qualcare PPO/HMO/WC	$27.03

BLADE PRECISION 9X.51X18.5MM

Facility

$180.20

Service Code	HCPCS A4649
Hospital Charge Code	270691100
Hospital Revenue Code	272
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$27.03
Rate for Payer: Qualcare PPO/HMO/WC	$27.03

BLADE PRECISION 9X.51X18.5MM

Facility

$180.20

Service Code	HCPCS A4649
Hospital Charge Code	270691100
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$90.10
Rate for Payer: Aetna Commercial	$54.06
Rate for Payer: Aetna Medicare Advantage	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.95
Rate for Payer: Cigna Commercial	$90.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.43
Rate for Payer: Oxford Commercial	$90.10
Rate for Payer: Qualcare PPO/HMO/WC	$27.03
Rate for Payer: UnitedHealthcare Commercial	$90.10

Know your out-of-pocket cost for care.

All Charges