Heights University Hospital

All Charges

Charge

Type

Setting

Price

FIBER TAK KNOTLESS HIP

Facility

$2,225.00

Hospital Charge Code	270687982
Hospital Revenue Code	272
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

FIBERTAK KNOTLSS 2.6 BLK/BLUE

Facility

$1,056.25

Service Code	HCPCS C1713
Hospital Charge Code	270699201
Hospital Revenue Code	278
Min. Negotiated Rate	$158.44
Max. Negotiated Rate	$528.12
Rate for Payer: Aetna Commercial	$316.88
Rate for Payer: Aetna Medicare Advantage	$316.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.34
Rate for Payer: Cigna Commercial	$528.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.61
Rate for Payer: Qualcare PPO/HMO/WC	$158.44

FIBERTAK KNOTLSS 2.6 BLK/BLUE

Facility

$1,056.25

Service Code	HCPCS C1713
Hospital Charge Code	270699201
Hospital Revenue Code	278
Min. Negotiated Rate	$158.44
Max. Negotiated Rate	$255.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.61
Rate for Payer: Qualcare PPO/HMO/WC	$158.44

FIBERTAK RC DOUBLOAD TAPE BL/W

Facility

$1,850.00

Hospital Charge Code	270681323
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

FIBERTAK RC DOUBLOAD TAPE BL/W

Facility

$1,850.00

Hospital Charge Code	270681323
Hospital Revenue Code	272
Min. Negotiated Rate	$240.50
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$555.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.50
Rate for Payer: Oxford Commercial	$925.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$925.00

FIBERTAK SPEEDBRIDGE IMPL 4.75

Facility

$13,364.25

Service Code	HCPCS C1713
Hospital Charge Code	270703103
Hospital Revenue Code	278
Min. Negotiated Rate	$2,004.64
Max. Negotiated Rate	$3,234.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,672.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,234.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,004.64

FIBERTAK SPEEDBRIDGE IMPL 4.75

Facility

$13,364.25

Service Code	HCPCS C1713
Hospital Charge Code	270703103
Hospital Revenue Code	278
Min. Negotiated Rate	$2,004.64
Max. Negotiated Rate	$6,682.12
Rate for Payer: Aetna Commercial	$4,009.28
Rate for Payer: Aetna Medicare Advantage	$4,009.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,407.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,407.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,672.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,407.88
Rate for Payer: Cigna Commercial	$6,682.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,234.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,004.64

FIBERTAK STRAIGHT KIT DISP

Facility

$875.00

Hospital Charge Code	270689681
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

FIBERTAK STRAIGHT KIT DISP

Facility

$875.00

Hospital Charge Code	270689681
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

FIBER TAPE 2MM

Facility

$630.00

Hospital Charge Code	270662177
Hospital Revenue Code	272
Min. Negotiated Rate	$81.90
Max. Negotiated Rate	$315.00
Rate for Payer: Aetna Commercial	$189.00
Rate for Payer: Aetna Medicare Advantage	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.65
Rate for Payer: Cigna Commercial	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.90
Rate for Payer: Oxford Commercial	$315.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$315.00

FIBER TAPE 2MM

Facility

$630.00

Hospital Charge Code	270662177
Hospital Revenue Code	272
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

FIBER TAPE 2MM 7 BLUE

Facility

$250.00

Hospital Charge Code	270664798
Hospital Revenue Code	270
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$125.00

FIBER TAPE 2MM 7 BLUE

Facility

$250.00

Hospital Charge Code	270664798
Hospital Revenue Code	270
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBER TAPE 54,2mm BLUE

Facility

$475.00

Hospital Charge Code	270655833
Hospital Revenue Code	271
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

FIBER TAPE 54,2mm BLUE

Facility

$475.00

Hospital Charge Code	270655833
Hospital Revenue Code	271
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

FIBER TAPE BLUE ST NEEDLE 2mm

Facility

$250.00

Hospital Charge Code	270678377
Hospital Revenue Code	272
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$125.00

FIBER TAPE BLUE ST NEEDLE 2mm

Facility

$250.00

Hospital Charge Code	270678377
Hospital Revenue Code	272
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

FIBERTAPE CERLAGE SUTURE

Facility

$2,250.00

Hospital Charge Code	270686292
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

FIBERTAPE CERLAGE SUTURE

Facility

$2,250.00

Hospital Charge Code	270686292
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

FIBERTAPE CUTTER

Facility

$5,250.00

Hospital Charge Code	270675962
Hospital Revenue Code	272
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$787.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

FIBERTAPE CUTTER

Facility

$5,250.00

Hospital Charge Code	270675962
Hospital Revenue Code	272
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$682.50
Rate for Payer: Oxford Commercial	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$787.50
Rate for Payer: UnitedHealthcare Commercial	$2,625.00

FIBERTAPE STERNAL CLOSURE W TA

Facility

$901.25

Service Code	HCPCS C1765
Hospital Charge Code	270706199
Hospital Revenue Code	278
Min. Negotiated Rate	$135.19
Max. Negotiated Rate	$450.62
Rate for Payer: Aetna Commercial	$270.38
Rate for Payer: Aetna Medicare Advantage	$270.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.82
Rate for Payer: Cigna Commercial	$450.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.19

FIBERTAPE STERNAL CLOSURE W TA

Facility

$901.25

Service Code	HCPCS C1765
Hospital Charge Code	270706199
Hospital Revenue Code	278
Min. Negotiated Rate	$135.19
Max. Negotiated Rate	$218.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.10
Rate for Payer: Qualcare PPO/HMO/WC	$135.19

FIBERTAPE STRAIGHT PASSER

Facility

$1,158.75

Hospital Charge Code	270705444
Hospital Revenue Code	272
Min. Negotiated Rate	$150.64
Max. Negotiated Rate	$579.38
Rate for Payer: Aetna Commercial	$347.62
Rate for Payer: Aetna Medicare Advantage	$347.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.48
Rate for Payer: Cigna Commercial	$579.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.64
Rate for Payer: Oxford Commercial	$579.38
Rate for Payer: Qualcare PPO/HMO/WC	$173.81
Rate for Payer: UnitedHealthcare Commercial	$579.38

FIBERTAPE STRAIGHT PASSER

Facility

$1,158.75

Hospital Charge Code	270705444
Hospital Revenue Code	272
Min. Negotiated Rate	$173.81
Max. Negotiated Rate	$173.81
Rate for Payer: Qualcare PPO/HMO/WC	$173.81

Know your out-of-pocket cost for care.

All Charges