Heights University Hospital

All Charges

Charge

Type

Setting

Price

BOLT LOCKING 4.9x32mm ST

Facility

$976.45

Hospital Charge Code	270651639
Hospital Revenue Code	272
Min. Negotiated Rate	$126.94
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$292.94
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.94
Rate for Payer: Oxford Commercial	$488.23
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Commercial	$488.23

BOLT LOCKING 4.9x32mm ST

Facility

$976.45

Hospital Charge Code	270651639
Hospital Revenue Code	272
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$146.47
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x34mm ST

Facility

$976.45

Hospital Charge Code	270651640
Hospital Revenue Code	272
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$146.47
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x34mm ST

Facility

$976.45

Hospital Charge Code	270651640
Hospital Revenue Code	272
Min. Negotiated Rate	$126.94
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$292.94
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.94
Rate for Payer: Oxford Commercial	$488.23
Rate for Payer: Qualcare PPO/HMO/WC	$146.47
Rate for Payer: UnitedHealthcare Commercial	$488.23

BOLT LOCKING 4.9x36mm ST

Facility

$976.45

Hospital Charge Code	270651641
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x36mm ST

Facility

$976.45

Hospital Charge Code	270651641
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$292.94
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x60mm ST

Facility

$976.45

Hospital Charge Code	270651643
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$292.94
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT LOCKING 4.9x60mm ST

Facility

$976.45

Hospital Charge Code	270651643
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

BOLT PEDICLE 6.15x35 177016235

Facility

$2,703.25

Hospital Charge Code	270632109
Hospital Revenue Code	278
Min. Negotiated Rate	$405.49
Max. Negotiated Rate	$1,351.62
Rate for Payer: Aetna Commercial	$810.98
Rate for Payer: Aetna Medicare Advantage	$810.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.33
Rate for Payer: Cigna Commercial	$1,351.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: Qualcare PPO/HMO/WC	$405.49

BOLT PEDICLE 6.15x35 177016235

Facility

$2,703.25

Hospital Charge Code	270632109
Hospital Revenue Code	278
Min. Negotiated Rate	$405.49
Max. Negotiated Rate	$654.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: Qualcare PPO/HMO/WC	$405.49

BOLT PEDICLE 6.25x40 177016240

Facility

$2,703.25

Hospital Charge Code	270632110
Hospital Revenue Code	278
Min. Negotiated Rate	$405.49
Max. Negotiated Rate	$1,351.62
Rate for Payer: Aetna Commercial	$810.98
Rate for Payer: Aetna Medicare Advantage	$810.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.33
Rate for Payer: Cigna Commercial	$1,351.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: Qualcare PPO/HMO/WC	$405.49

BOLT PEDICLE 6.25x40 177016240

Facility

$2,703.25

Hospital Charge Code	270632110
Hospital Revenue Code	278
Min. Negotiated Rate	$405.49
Max. Negotiated Rate	$654.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.19
Rate for Payer: Qualcare PPO/HMO/WC	$405.49

BOLT PIN HOLDER LG 15 100165

Facility

$248.00

Hospital Charge Code	270632651
Hospital Revenue Code	278
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.02
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

BOLT PIN HOLDER LG 15 100165

Facility

$248.00

Hospital Charge Code	270632651
Hospital Revenue Code	278
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.40
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.02
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

BOLT SALVATION 5. X 120MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

BOLT SALVATION 5. X 120MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

BOLT SALVATION 6.5x100MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674307
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 SALVATION 6.5x100MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674307
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 SALVATION 6.5x130MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674306
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 SALVATION 6.5x130MM

Facility

$8,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270674306
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 SALVATION TOE JT 5X125MM

Facility

$9,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270698682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,384.50
Max. Negotiated Rate	$2,233.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,846.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,384.50

BOLT SALVATION TOE JT 5X125MM

Facility

$9,230.00

Service Code	HCPCS C1713
Hospital Charge Code	270698682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,384.50
Max. Negotiated Rate	$4,615.00
Rate for Payer: Aetna Commercial	$2,769.00
Rate for Payer: Aetna Medicare Advantage	$2,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,353.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,353.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,846.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,353.65
Rate for Payer: Cigna Commercial	$4,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,384.50

BOLT SALVATION WIRE

Facility

$835.00

Hospital Charge Code	270684459
Hospital Revenue Code	272
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$125.25
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

BOLT SALVATION WIRE

Facility

$835.00

Hospital Charge Code	270684459
Hospital Revenue Code	272
Min. Negotiated Rate	$108.55
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$250.50
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.55
Rate for Payer: Oxford Commercial	$417.50
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Commercial	$417.50

BOLT SCHANZ POST EXT FIX

Facility

$1,111.95

Hospital Charge Code	270693746
Hospital Revenue Code	272
Min. Negotiated Rate	$166.79
Max. Negotiated Rate	$166.79
Rate for Payer: Qualcare PPO/HMO/WC	$166.79

Know your out-of-pocket cost for care.

All Charges