Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

BONESYNC BIOACTIVE

Facility

$15,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706176
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

BONESYNC BIOACTIVE

Facility

$15,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706176
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$4,650.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

BONE TAMP INFLATABLE 15/3 K09A

Facility

$5,381.65

Hospital Charge Code	270633786
Hospital Revenue Code	272
Min. Negotiated Rate	$807.25
Max. Negotiated Rate	$807.25
Rate for Payer: Qualcare PPO/HMO/WC	$807.25

BONE TAMP INFLATABLE 15/3 K09A

Facility

$5,381.65

Hospital Charge Code	270633786
Hospital Revenue Code	272
Min. Negotiated Rate	$699.61
Max. Negotiated Rate	$2,690.82
Rate for Payer: Aetna Commercial	$1,614.49
Rate for Payer: Aetna Medicare Advantage	$1,614.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,372.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,372.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,372.32
Rate for Payer: Cigna Commercial	$2,690.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.61
Rate for Payer: Oxford Commercial	$2,690.82
Rate for Payer: Qualcare PPO/HMO/WC	$807.25
Rate for Payer: UnitedHealthcare Commercial	$2,690.82

BONE TAMP INFLATABLE 20/3 K08A

Facility

$5,451.10

Hospital Charge Code	270631258
Hospital Revenue Code	272
Min. Negotiated Rate	$708.64
Max. Negotiated Rate	$2,725.55
Rate for Payer: Aetna Commercial	$1,635.33
Rate for Payer: Aetna Medicare Advantage	$1,635.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,390.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,390.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,390.03
Rate for Payer: Cigna Commercial	$2,725.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$708.64
Rate for Payer: Oxford Commercial	$2,725.55
Rate for Payer: Qualcare PPO/HMO/WC	$817.66
Rate for Payer: UnitedHealthcare Commercial	$2,725.55

BONE TAMP INFLATABLE 20/3 K08A

Facility

$5,451.10

Hospital Charge Code	270631258
Hospital Revenue Code	272
Min. Negotiated Rate	$817.66
Max. Negotiated Rate	$817.66
Rate for Payer: Qualcare PPO/HMO/WC	$817.66

BONE TAMP/KYPHON EXPRESS II 15

Facility

$14,962.50

Service Code	HCPCS C1713
Hospital Charge Code	270669630
Hospital Revenue Code	278
Min. Negotiated Rate	$2,244.38
Max. Negotiated Rate	$7,481.25
Rate for Payer: Aetna Commercial	$4,488.75
Rate for Payer: Aetna Medicare Advantage	$4,488.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,815.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,992.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,815.44
Rate for Payer: Cigna Commercial	$7,481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,620.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38

BONE TAMP/KYPHON EXPRESS II 15

Facility

$14,962.50

Service Code	HCPCS C1713
Hospital Charge Code	270669630
Hospital Revenue Code	278
Min. Negotiated Rate	$2,244.38
Max. Negotiated Rate	$3,620.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,620.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,244.38

BONE TAP

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688421
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

BONE TAP

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688421
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

BONE TAP 3.5MM X100MM

Facility

$1,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270704606
Hospital Revenue Code	278
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$515.00
Rate for Payer: Aetna Commercial	$309.00
Rate for Payer: Aetna Medicare Advantage	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.65
Rate for Payer: Cigna Commercial	$515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.26
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

BONE TAP 3.5MM X100MM

Facility

$1,030.00

Service Code	HCPCS C1713
Hospital Charge Code	270704606
Hospital Revenue Code	278
Min. Negotiated Rate	$154.50
Max. Negotiated Rate	$249.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$206.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.26
Rate for Payer: Qualcare PPO/HMO/WC	$154.50

BONE TAP 5.5 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690565
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BONE TAP 5.5 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690565
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

BONE TAP SYMPHONY 4.0

Facility

$2,160.00

Hospital Charge Code	270693361
Hospital Revenue Code	272
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$648.00
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.80
Rate for Payer: Oxford Commercial	$1,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$1,080.00

BONE TAP SYMPHONY 4.0

Facility

$2,160.00

Hospital Charge Code	270693361
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

BONE TAP SYMPHONY 4.5

Facility

$2,160.00

Hospital Charge Code	270693362
Hospital Revenue Code	272
Min. Negotiated Rate	$280.80
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$648.00
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.80
Rate for Payer: Oxford Commercial	$1,080.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00
Rate for Payer: UnitedHealthcare Commercial	$1,080.00

BONE TAP SYMPHONY 4.5

Facility

$2,160.00

Hospital Charge Code	270693362
Hospital Revenue Code	272
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$324.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

BONE VOID FILLER 10CC

Facility

$10,752.50

Hospital Charge Code	270671241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.88
Max. Negotiated Rate	$2,602.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,602.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.88

BONE VOID FILLER 10CC

Facility

$13,433.75

Service Code	HCPCS C1713
Hospital Charge Code	270670728
Hospital Revenue Code	278
Min. Negotiated Rate	$2,015.06
Max. Negotiated Rate	$3,250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06

BONE VOID FILLER 10CC

Facility

$10,752.50

Hospital Charge Code	270671241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.88
Max. Negotiated Rate	$5,376.25
Rate for Payer: Aetna Commercial	$3,225.75
Rate for Payer: Aetna Medicare Advantage	$3,225.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.89
Rate for Payer: Cigna Commercial	$5,376.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,602.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.88

BONE VOID FILLER 10CC

Facility

$13,433.75

Service Code	HCPCS C1713
Hospital Charge Code	270670728
Hospital Revenue Code	278
Min. Negotiated Rate	$2,015.06
Max. Negotiated Rate	$6,716.88
Rate for Payer: Aetna Commercial	$4,030.12
Rate for Payer: Aetna Medicare Advantage	$4,030.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,425.61
Rate for Payer: Cigna Commercial	$6,716.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06

BONE VOID FILLER 10CC 25X100X4

Facility

$13,433.75

Hospital Charge Code	270671236
Hospital Revenue Code	278
Min. Negotiated Rate	$2,015.06
Max. Negotiated Rate	$3,250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06

BONE VOID FILLER 10CC 25X100X4

Facility

$13,433.75

Hospital Charge Code	270671236
Hospital Revenue Code	278
Min. Negotiated Rate	$2,015.06
Max. Negotiated Rate	$6,716.88
Rate for Payer: Aetna Commercial	$4,030.12
Rate for Payer: Aetna Medicare Advantage	$4,030.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,425.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,686.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,425.61
Rate for Payer: Cigna Commercial	$6,716.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,250.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.06

Know your out-of-pocket cost for care.

All Charges