Heights University Hospital

All Charges

Charge

Type

Setting

Price

BOLT BMT TRANS 5 70 33-345464

Facility

$944.85

Hospital Charge Code	270618210
Hospital Revenue Code	278
Min. Negotiated Rate	$141.73
Max. Negotiated Rate	$472.43
Rate for Payer: Aetna Commercial	$283.45
Rate for Payer: Aetna Medicare Advantage	$283.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.94
Rate for Payer: Cigna Commercial	$472.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.65
Rate for Payer: Qualcare PPO/HMO/WC	$141.73

BOLT BMT TROCHANTER 13-104756

Facility

$2,527.25

Hospital Charge Code	270611652
Hospital Revenue Code	278
Min. Negotiated Rate	$379.09
Max. Negotiated Rate	$611.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.59
Rate for Payer: Qualcare PPO/HMO/WC	$379.09

BOLT BMT TROCHANTER 13-104756

Facility

$2,527.25

Hospital Charge Code	270611652
Hospital Revenue Code	278
Min. Negotiated Rate	$379.09
Max. Negotiated Rate	$1,263.62
Rate for Payer: Aetna Commercial	$758.17
Rate for Payer: Aetna Medicare Advantage	$758.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$644.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$644.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$644.45
Rate for Payer: Cigna Commercial	$1,263.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.59
Rate for Payer: Qualcare PPO/HMO/WC	$379.09

BOLT CONNECTING

Facility

$53.30

Hospital Charge Code	270681236
Hospital Revenue Code	272
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.00

BOLT CONNECTING

Facility

$53.30

Hospital Charge Code	270681236
Hospital Revenue Code	272
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$26.65
Rate for Payer: Aetna Commercial	$15.99
Rate for Payer: Aetna Medicare Advantage	$15.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.59
Rate for Payer: Cigna Commercial	$26.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.93
Rate for Payer: Oxford Commercial	$26.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.00
Rate for Payer: UnitedHealthcare Commercial	$26.65

BOLT FEM NECK 90MM STERILE

Facility

$1,597.55

Service Code	HCPCS C1713
Hospital Charge Code	270686943
Hospital Revenue Code	278
Min. Negotiated Rate	$239.63
Max. Negotiated Rate	$386.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.63

BOLT FEM NECK 90MM STERILE

Facility

$1,597.55

Service Code	HCPCS C1713
Hospital Charge Code	270686943
Hospital Revenue Code	278
Min. Negotiated Rate	$239.63
Max. Negotiated Rate	$798.77
Rate for Payer: Aetna Commercial	$479.26
Rate for Payer: Aetna Medicare Advantage	$479.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407.38
Rate for Payer: Cigna Commercial	$798.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.61
Rate for Payer: Qualcare PPO/HMO/WC	$239.63

BOLT FEMORAL NECK SYSTEM 95MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697922
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

BOLT FEMORAL NECK SYSTEM 95MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697922
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

BOLT FOOT PLATE

Facility

$1,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270697188
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$495.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

BOLT FOOT PLATE

Facility

$1,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270697188
Hospital Revenue Code	278
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$399.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.30
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

BOLT FOR FEMORAL NECK SYS 75MM

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687503
Hospital Revenue Code	278
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$441.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

BOLT FOR FEMORAL NECK SYS 75MM

Facility

$1,825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687503
Hospital Revenue Code	278
Min. Negotiated Rate	$273.75
Max. Negotiated Rate	$912.50
Rate for Payer: Aetna Commercial	$547.50
Rate for Payer: Aetna Medicare Advantage	$547.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$365.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.38
Rate for Payer: Cigna Commercial	$912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$441.65
Rate for Payer: Qualcare PPO/HMO/WC	$273.75

BOLT FOR FEMORAL NECK SYS 90MM

Facility

$1,551.00

Service Code	HCPCS C1713
Hospital Charge Code	270687815
Hospital Revenue Code	278
Min. Negotiated Rate	$232.65
Max. Negotiated Rate	$375.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.34
Rate for Payer: Qualcare PPO/HMO/WC	$232.65

BOLT FOR FEMORAL NECK SYS 90MM

Facility

$1,551.00

Service Code	HCPCS C1713
Hospital Charge Code	270687815
Hospital Revenue Code	278
Min. Negotiated Rate	$232.65
Max. Negotiated Rate	$775.50
Rate for Payer: Aetna Commercial	$465.30
Rate for Payer: Aetna Medicare Advantage	$465.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.50
Rate for Payer: Cigna Commercial	$775.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.34
Rate for Payer: Qualcare PPO/HMO/WC	$232.65

BOLT FOR FEMORAL NECK SYSTEM 8

Facility

$1,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270687016
Hospital Revenue Code	278
Min. Negotiated Rate	$297.00
Max. Negotiated Rate	$990.00
Rate for Payer: Aetna Commercial	$594.00
Rate for Payer: Aetna Medicare Advantage	$594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$504.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$504.90
Rate for Payer: Cigna Commercial	$990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$479.16
Rate for Payer: Qualcare PPO/HMO/WC	$297.00

BOLT FOR FEMORAL NECK SYSTEM 8

Facility

$1,980.00

Service Code	HCPCS C1713
Hospital Charge Code	270687016
Hospital Revenue Code	278
Min. Negotiated Rate	$297.00
Max. Negotiated Rate	$479.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$396.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$479.16
Rate for Payer: Qualcare PPO/HMO/WC	$297.00

BOLT FOR FEMORAL NK 110MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270699631
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Aetna Commercial	$990.00
Rate for Payer: Aetna Medicare Advantage	$990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$841.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$841.50
Rate for Payer: Cigna Commercial	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

BOLT FOR FEMORAL NK 110MM

Facility

$3,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270699631
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$798.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$798.60
Rate for Payer: Qualcare PPO/HMO/WC	$495.00

BOLT IM NAIL CONNECTING

Facility

$903.85

Service Code	HCPCS C1713
Hospital Charge Code	270700140
Hospital Revenue Code	278
Min. Negotiated Rate	$135.58
Max. Negotiated Rate	$218.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.73
Rate for Payer: Qualcare PPO/HMO/WC	$135.58

BOLT IM NAIL CONNECTING

Facility

$903.85

Service Code	HCPCS C1713
Hospital Charge Code	270700140
Hospital Revenue Code	278
Min. Negotiated Rate	$135.58
Max. Negotiated Rate	$451.93
Rate for Payer: Aetna Commercial	$271.15
Rate for Payer: Aetna Medicare Advantage	$271.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.48
Rate for Payer: Cigna Commercial	$451.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.73
Rate for Payer: Qualcare PPO/HMO/WC	$135.58

BOLT JIG FLEXIBLE 8MM

Facility

$8,610.00

Hospital Charge Code	270702100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,291.50
Max. Negotiated Rate	$2,083.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50

BOLT JIG FLEXIBLE 8MM

Facility

$8,610.00

Hospital Charge Code	270702100
Hospital Revenue Code	278
Min. Negotiated Rate	$1,291.50
Max. Negotiated Rate	$4,305.00
Rate for Payer: Aetna Commercial	$2,583.00
Rate for Payer: Aetna Medicare Advantage	$2,583.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,195.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,722.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,195.55
Rate for Payer: Cigna Commercial	$4,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,083.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,291.50

BOLT LOCKING 41MM

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270677752
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

BOLT LOCKING 41MM

Facility

$1,150.00

Service Code	HCPCS C1776
Hospital Charge Code	270677752
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

Know your out-of-pocket cost for care.

All Charges