Heights University Hospital

All Charges

Charge

Type

Setting

Price

BONE SCREW T7 2.7x14MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673832
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

BONE SCREW T7 2.7x14MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673832
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$178.50
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

BONE SCREW T7 2.7x16MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673833
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$297.50
Rate for Payer: Aetna Commercial	$178.50
Rate for Payer: Aetna Medicare Advantage	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.72
Rate for Payer: Cigna Commercial	$297.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

BONE SCREW T7 2.7x16MM

Facility

$595.00

Service Code	HCPCS C1713
Hospital Charge Code	270673833
Hospital Revenue Code	278
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$143.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

BONE SCREW T8 2.7MMXL38

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700422
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$218.16
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

BONE SCREW T8 2.7MMXL38

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700422
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

BONE SDK CORTICAL 10 20 171020

Facility

$6,834.45

Hospital Charge Code	270617950
Hospital Revenue Code	272
Min. Negotiated Rate	$888.48
Max. Negotiated Rate	$3,417.22
Rate for Payer: Aetna Commercial	$2,050.34
Rate for Payer: Aetna Medicare Advantage	$2,050.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,742.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,742.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,742.78
Rate for Payer: Cigna Commercial	$3,417.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.48
Rate for Payer: Oxford Commercial	$3,417.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.17
Rate for Payer: UnitedHealthcare Commercial	$3,417.22

BONE SDK CORTICAL 10 20 171020

Facility

$6,834.45

Hospital Charge Code	270617950
Hospital Revenue Code	272
Min. Negotiated Rate	$1,025.17
Max. Negotiated Rate	$1,025.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.17

BONE SHAVER-MICRO HOOK

Facility

$2,225.00

Hospital Charge Code	270663202
Hospital Revenue Code	272
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

BONE SHAVER-MICRO HOOK

Facility

$2,225.00

Hospital Charge Code	270663202
Hospital Revenue Code	272
Min. Negotiated Rate	$289.25
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$667.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.25
Rate for Payer: Oxford Commercial	$1,112.50
Rate for Payer: Qualcare PPO/HMO/WC	$333.75
Rate for Payer: UnitedHealthcare Commercial	$1,112.50

BONE SOURCE 3CC 6184-0-100

Facility

$735.00

Service Code	HCPCS C1762
Hospital Charge Code	270335734
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$177.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

BONE SOURCE 3CC 6184-0-100

Facility

$735.00

Service Code	HCPCS C1762
Hospital Charge Code	270335734
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$220.50
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.87
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

BONE STIM SPF 60 MICROAMP

Facility

$37,651.65

Hospital Charge Code	270677411
Hospital Revenue Code	278
Min. Negotiated Rate	$5,647.75
Max. Negotiated Rate	$18,825.83
Rate for Payer: Aetna Commercial	$11,295.50
Rate for Payer: Aetna Medicare Advantage	$11,295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,601.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,601.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,530.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,601.17
Rate for Payer: Cigna Commercial	$18,825.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,111.70
Rate for Payer: Qualcare PPO/HMO/WC	$5,647.75

BONE STIM SPF 60 MICROAMP

Facility

$37,651.65

Hospital Charge Code	270677411
Hospital Revenue Code	278
Min. Negotiated Rate	$5,647.75
Max. Negotiated Rate	$9,111.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,530.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,111.70
Rate for Payer: Qualcare PPO/HMO/WC	$5,647.75

BONE STIMULATOR

Facility

$16,000.00

Service Code	HCPCS E0749
Hospital Charge Code	270657137
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

BONE STIMULATOR

Facility

$16,000.00

Service Code	HCPCS E0749
Hospital Charge Code	270657137
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

BONE STIMULATOR IMPLANTABLE

Facility

$44,350.00

Hospital Charge Code	270671560
Hospital Revenue Code	278
Min. Negotiated Rate	$6,652.50
Max. Negotiated Rate	$22,175.00
Rate for Payer: Aetna Commercial	$13,305.00
Rate for Payer: Aetna Medicare Advantage	$13,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,309.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,309.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,309.25
Rate for Payer: Cigna Commercial	$22,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,732.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,652.50

BONE STIMULATOR IMPLANTABLE

Facility

$44,350.00

Hospital Charge Code	270671560
Hospital Revenue Code	278
Min. Negotiated Rate	$6,652.50
Max. Negotiated Rate	$10,732.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,732.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,652.50

BONE SUBSTUTE 10CC

Facility

$20,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270687085
Hospital Revenue Code	278
Min. Negotiated Rate	$3,052.50
Max. Negotiated Rate	$4,924.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,924.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,052.50

BONE SUBSTUTE 10CC

Facility

$20,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270687085
Hospital Revenue Code	278
Min. Negotiated Rate	$3,052.50
Max. Negotiated Rate	$10,175.00
Rate for Payer: Aetna Commercial	$6,105.00
Rate for Payer: Aetna Medicare Advantage	$6,105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,189.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,189.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,189.25
Rate for Payer: Cigna Commercial	$10,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,924.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,052.50

BONE SUBSUTE HATRIC AR13000B10

Facility

$4,216.00

Hospital Charge Code	270636942
Hospital Revenue Code	272
Min. Negotiated Rate	$548.08
Max. Negotiated Rate	$2,108.00
Rate for Payer: Aetna Commercial	$1,264.80
Rate for Payer: Aetna Medicare Advantage	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,075.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,075.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,075.08
Rate for Payer: Cigna Commercial	$2,108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.08
Rate for Payer: Oxford Commercial	$2,108.00
Rate for Payer: Qualcare PPO/HMO/WC	$632.40
Rate for Payer: UnitedHealthcare Commercial	$2,108.00

BONE SUBSUTE HATRIC AR13000B10

Facility

$4,216.00

Hospital Charge Code	270636942
Hospital Revenue Code	272
Min. Negotiated Rate	$632.40
Max. Negotiated Rate	$632.40
Rate for Payer: Qualcare PPO/HMO/WC	$632.40

BONE SURVEY COMPL

Facility

$5,100.00

Service Code	HCPCS 77075
Hospital Charge Code	94061197
Hospital Revenue Code	320
Min. Negotiated Rate	$52.38
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

BONE SURVEY COMPL

Facility

$5,100.00

Service Code	HCPCS 77075
Hospital Charge Code	94061197
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BONESYNC 3CC

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687862
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

Know your out-of-pocket cost for care.

All Charges