Heights University Hospital

All Charges

Charge

Type

Setting

Price

FIBERSTICK 1.3MM SUTURE TAPE

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	270703173
Hospital Revenue Code	278
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.38
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBERSTICK 1.3MM SUTURE TAPE

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	270703173
Hospital Revenue Code	278
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$94.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.38
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FIBERSTITCH 1.5

Facility

$2,832.50

Hospital Charge Code	270702600
Hospital Revenue Code	278
Min. Negotiated Rate	$424.88
Max. Negotiated Rate	$1,416.25
Rate for Payer: Aetna Commercial	$849.75
Rate for Payer: Aetna Medicare Advantage	$849.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.29
Rate for Payer: Cigna Commercial	$1,416.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: Qualcare PPO/HMO/WC	$424.88

FIBERSTITCH 1.5

Facility

$2,832.50

Hospital Charge Code	270702600
Hospital Revenue Code	278
Min. Negotiated Rate	$424.88
Max. Negotiated Rate	$685.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: Qualcare PPO/HMO/WC	$424.88

FIBERSTITCH IMPLANT 1.5 CURVED

Facility

$2,832.50

Service Code	HCPCS C1889
Hospital Charge Code	270703169
Hospital Revenue Code	278
Min. Negotiated Rate	$424.88
Max. Negotiated Rate	$685.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: Qualcare PPO/HMO/WC	$424.88

FIBERSTITCH IMPLANT 1.5 CURVED

Facility

$2,832.50

Service Code	HCPCS C1889
Hospital Charge Code	270703169
Hospital Revenue Code	278
Min. Negotiated Rate	$424.88
Max. Negotiated Rate	$1,416.25
Rate for Payer: Aetna Commercial	$849.75
Rate for Payer: Aetna Medicare Advantage	$849.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$566.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.29
Rate for Payer: Cigna Commercial	$1,416.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$685.47
Rate for Payer: Qualcare PPO/HMO/WC	$424.88

FIBER SUPER 270 RE HF0200RSSMS

Facility

$4,464.00

Hospital Charge Code	270634053
Hospital Revenue Code	272
Min. Negotiated Rate	$580.32
Max. Negotiated Rate	$2,232.00
Rate for Payer: Aetna Commercial	$1,339.20
Rate for Payer: Aetna Medicare Advantage	$1,339.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.32
Rate for Payer: Cigna Commercial	$2,232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.32
Rate for Payer: Oxford Commercial	$2,232.00
Rate for Payer: Qualcare PPO/HMO/WC	$669.60
Rate for Payer: UnitedHealthcare Commercial	$2,232.00

FIBER SUPER 270 RE HF0200RSSMS

Facility

$4,464.00

Hospital Charge Code	270634053
Hospital Revenue Code	272
Min. Negotiated Rate	$669.60
Max. Negotiated Rate	$669.60
Rate for Payer: Qualcare PPO/HMO/WC	$669.60

FIBERTACK SUT ANCHOR KNOTLESS

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270695226
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

FIBERTACK SUT ANCHOR KNOTLESS

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270695226
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

FIBER TAK

Facility

$2,100.00

Service Code	HCPCS C1781
Hospital Charge Code	270688600
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

FIBER TAK

Facility

$2,100.00

Service Code	HCPCS C1781
Hospital Charge Code	270688600
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$630.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

FIBERTAK

Facility

$1,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270681070
Hospital Revenue Code	278
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$962.50
Rate for Payer: Aetna Commercial	$577.50
Rate for Payer: Aetna Medicare Advantage	$577.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$490.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$490.88
Rate for Payer: Cigna Commercial	$962.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

FIBERTAK

Facility

$1,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270681070
Hospital Revenue Code	278
Min. Negotiated Rate	$288.75
Max. Negotiated Rate	$465.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.85
Rate for Payer: Qualcare PPO/HMO/WC	$288.75

FIBERTAK 1.3MM

Facility

$11,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270682058
Hospital Revenue Code	278
Min. Negotiated Rate	$1,743.75
Max. Negotiated Rate	$5,812.50
Rate for Payer: Aetna Commercial	$3,487.50
Rate for Payer: Aetna Medicare Advantage	$3,487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,964.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,964.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,964.38
Rate for Payer: Cigna Commercial	$5,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,813.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,743.75

FIBERTAK 1.3MM

Facility

$11,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270682058
Hospital Revenue Code	278
Min. Negotiated Rate	$1,743.75
Max. Negotiated Rate	$2,813.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,813.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,743.75

FIBERTAK BIT DRILL

Facility

$475.00

Hospital Charge Code	270681073
Hospital Revenue Code	272
Min. Negotiated Rate	$61.75
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.75
Rate for Payer: Oxford Commercial	$237.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$237.50

FIBERTAK BIT DRILL

Facility

$475.00

Hospital Charge Code	270681073
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

FIBERTAK BLUE AND STTPE WH/BLK

Facility

$2,548.00

Service Code	HCPCS C1713
Hospital Charge Code	270699200
Hospital Revenue Code	278
Min. Negotiated Rate	$382.20
Max. Negotiated Rate	$616.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.62
Rate for Payer: Qualcare PPO/HMO/WC	$382.20

FIBERTAK BLUE AND STTPE WH/BLK

Facility

$2,548.00

Service Code	HCPCS C1713
Hospital Charge Code	270699200
Hospital Revenue Code	278
Min. Negotiated Rate	$382.20
Max. Negotiated Rate	$1,274.00
Rate for Payer: Aetna Commercial	$764.40
Rate for Payer: Aetna Medicare Advantage	$764.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$649.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$649.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$649.74
Rate for Payer: Cigna Commercial	$1,274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.62
Rate for Payer: Qualcare PPO/HMO/WC	$382.20

FIBERTAK BUTTON SYST AR-3680

Facility

$3,945.00

Service Code	HCPCS C1713
Hospital Charge Code	270692481
Hospital Revenue Code	278
Min. Negotiated Rate	$591.75
Max. Negotiated Rate	$954.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$789.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.69
Rate for Payer: Qualcare PPO/HMO/WC	$591.75

FIBERTAK BUTTON SYST AR-3680

Facility

$3,945.00

Service Code	HCPCS C1713
Hospital Charge Code	270692481
Hospital Revenue Code	278
Min. Negotiated Rate	$591.75
Max. Negotiated Rate	$1,972.50
Rate for Payer: Aetna Commercial	$1,183.50
Rate for Payer: Aetna Medicare Advantage	$1,183.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,005.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,005.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$789.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,005.98
Rate for Payer: Cigna Commercial	$1,972.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$954.69
Rate for Payer: Qualcare PPO/HMO/WC	$591.75

FIBERTAK CURVED KIT DISP

Facility

$975.00

Hospital Charge Code	270689680
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

FIBERTAK CURVED KIT DISP

Facility

$975.00

Hospital Charge Code	270689680
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

FIBER TAK KNOTLESS HIP

Facility

$2,225.00

Hospital Charge Code	270687982
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

Know your out-of-pocket cost for care.

All Charges