Heights University Hospital

All Charges

Charge

Type

Setting

Price

BONE PASTE OSTEOFIL 1CC 002401

Facility

$996.85

Hospital Charge Code	270614654
Hospital Revenue Code	272
Min. Negotiated Rate	$149.53
Max. Negotiated Rate	$149.53
Rate for Payer: Qualcare PPO/HMO/WC	$149.53

BONE PINS 3.2X140MM

Facility

$1,140.75

Service Code	HCPCS C1713
Hospital Charge Code	270690847
Hospital Revenue Code	278
Min. Negotiated Rate	$171.11
Max. Negotiated Rate	$276.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.06
Rate for Payer: Qualcare PPO/HMO/WC	$171.11

BONE PINS 3.2X140MM

Facility

$1,140.75

Service Code	HCPCS C1713
Hospital Charge Code	270690847
Hospital Revenue Code	278
Min. Negotiated Rate	$171.11
Max. Negotiated Rate	$570.38
Rate for Payer: Aetna Commercial	$342.23
Rate for Payer: Aetna Medicare Advantage	$342.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.89
Rate for Payer: Cigna Commercial	$570.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.06
Rate for Payer: Qualcare PPO/HMO/WC	$171.11

BONE PLUG SUTURE

Facility

$633.75

Hospital Charge Code	270673444
Hospital Revenue Code	272
Min. Negotiated Rate	$95.06
Max. Negotiated Rate	$95.06
Rate for Payer: Qualcare PPO/HMO/WC	$95.06

BONE PLUG SUTURE

Facility

$633.75

Hospital Charge Code	270673444
Hospital Revenue Code	272
Min. Negotiated Rate	$82.39
Max. Negotiated Rate	$316.88
Rate for Payer: Cigna Commercial	$316.88
Rate for Payer: Aetna Commercial	$190.12
Rate for Payer: Aetna Medicare Advantage	$190.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.39
Rate for Payer: Oxford Commercial	$316.88
Rate for Payer: Qualcare PPO/HMO/WC	$95.06
Rate for Payer: UnitedHealthcare Commercial	$316.88

BONE PUTTY 2.5CC

Facility

$10,402.50

Service Code	HCPCS C1713
Hospital Charge Code	270696527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,560.38
Max. Negotiated Rate	$5,201.25
Rate for Payer: Aetna Commercial	$3,120.75
Rate for Payer: Aetna Medicare Advantage	$3,120.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,652.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,652.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,080.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,652.64
Rate for Payer: Cigna Commercial	$5,201.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,517.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.38

BONE PUTTY 2.5CC

Facility

$10,402.50

Service Code	HCPCS C1713
Hospital Charge Code	270696527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,560.38
Max. Negotiated Rate	$2,517.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,080.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,517.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.38

BONE REVISION DOWLS 14

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 14

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680643
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 16

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680644
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 16

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680644
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 18

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680645
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE REVISION DOWLS 18

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270680645
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

BONE SCAN, 3-PHASE

Facility

$12,000.00

Service Code	HCPCS 78315
Hospital Charge Code	4500542
Hospital Revenue Code	341
Min. Negotiated Rate	$232.44
Max. Negotiated Rate	$3,600.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

BONE SCAN, 3-PHASE

Facility

$12,000.00

Service Code	HCPCS 78315
Hospital Charge Code	4500542
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

BONE SCREW 16 THD 6.5x75MM

Facility

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	270675136
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

BONE SCREW 16 THD 6.5x75MM

Facility

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	270675136
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$40.50
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

BONE SCREW 1.7MMx7MM 58-17007E

Facility

$550.00

Hospital Charge Code	270655361
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

BONE SCREW 1.7MMx7MM 58-17007E

Facility

$550.00

Hospital Charge Code	270655361
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

BONE SCREW 1.7X24MM

Facility

$650.00

Hospital Charge Code	270669235
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BONE SCREW 1.7X24MM

Facility

$650.00

Hospital Charge Code	270669235
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

BONE SCREW 2 PACKING

Facility

$702.00

Hospital Charge Code	270690116
Hospital Revenue Code	270
Min. Negotiated Rate	$105.30
Max. Negotiated Rate	$105.30
Rate for Payer: Qualcare PPO/HMO/WC	$105.30

BONE SCREW 2 PACKING

Facility

$702.00

Hospital Charge Code	270690116
Hospital Revenue Code	270
Min. Negotiated Rate	$91.26
Max. Negotiated Rate	$351.00
Rate for Payer: Aetna Commercial	$210.60
Rate for Payer: Aetna Medicare Advantage	$210.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.01
Rate for Payer: Cigna Commercial	$351.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.26
Rate for Payer: Oxford Commercial	$351.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.30
Rate for Payer: UnitedHealthcare Commercial	$351.00

BONE SCREW 32MM THD 6.5x95MM

Facility

$145.50

Hospital Charge Code	270675833
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$35.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: Qualcare PPO/HMO/WC	$21.82

BONE SCREW 32MM THD 6.5x95MM

Facility

$145.50

Hospital Charge Code	270675833
Hospital Revenue Code	278
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$72.75
Rate for Payer: Aetna Commercial	$43.65
Rate for Payer: Aetna Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.10
Rate for Payer: Cigna Commercial	$72.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.21
Rate for Payer: Qualcare PPO/HMO/WC	$21.82

Know your out-of-pocket cost for care.

All Charges