Heights University Hospital

All Charges

Charge

Type

Setting

Price

FIBERTAPE TENDON COMPRESSION

Facility

$3,000.00

Hospital Charge Code	270686294
Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

FIBERTAPE TENDON COMPRESSION

Facility

$3,000.00

Hospital Charge Code	270686294
Hospital Revenue Code	272
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00

FIBERWIRE

Facility

$110.00

Hospital Charge Code	270656515
Hospital Revenue Code	271
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBERWIRE

Facility

$110.00

Hospital Charge Code	270656515
Hospital Revenue Code	271
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

FIBER WIRE 0 38

Facility

$110.00

Hospital Charge Code	270681225
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: UnitedHealthcare Commercial	$55.00

FIBER WIRE 0 38

Facility

$110.00

Hospital Charge Code	270681225
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBERWIRE 2-0

Facility

$110.00

Hospital Charge Code	270659179
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

FIBERWIRE 2-0

Facility

$110.00

Hospital Charge Code	270659179
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBERWIRE #2 2.4x12MM

Facility

$2,180.00

Hospital Charge Code	270672002
Hospital Revenue Code	272
Min. Negotiated Rate	$327.00
Max. Negotiated Rate	$327.00
Rate for Payer: Qualcare PPO/HMO/WC	$327.00

FIBERWIRE #2 2.4x12MM

Facility

$2,180.00

Hospital Charge Code	270672002
Hospital Revenue Code	272
Min. Negotiated Rate	$283.40
Max. Negotiated Rate	$1,090.00
Rate for Payer: Aetna Commercial	$654.00
Rate for Payer: Aetna Medicare Advantage	$654.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$555.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$555.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$555.90
Rate for Payer: Cigna Commercial	$1,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.40
Rate for Payer: Oxford Commercial	$1,090.00
Rate for Payer: Qualcare PPO/HMO/WC	$327.00
Rate for Payer: UnitedHealthcare Commercial	$1,090.00

FIBER WIRE 2/5 METRIC

Facility

$110.00

Hospital Charge Code	270668477
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBER WIRE 2/5 METRIC

Facility

$110.00

Hospital Charge Code	270668477
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

FIBERWIRE #2 DOUBLE W/NEEDLE

Facility

$240.00

Hospital Charge Code	270676222
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$120.00

FIBERWIRE #2 DOUBLE W/NEEDLE

Facility

$240.00

Hospital Charge Code	270676222
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

FIBERWIRE #2 TPR 36MM 1.2 CIRC

Facility

$110.00

Hospital Charge Code	270684048
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

FIBERWIRE #2 TPR 36MM 1.2 CIRC

Facility

$110.00

Hospital Charge Code	270684048
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

FIBERWIRE CRVD NDL 26 MM 1/2 C

Facility

$95.00

Hospital Charge Code	270689196
Hospital Revenue Code	272
Min. Negotiated Rate	$12.35
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.35
Rate for Payer: Oxford Commercial	$47.50
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$47.50

FIBERWIRE CRVD NDL 26 MM 1/2 C

Facility

$95.00

Hospital Charge Code	270689196
Hospital Revenue Code	272
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

FIBERWIRE FIBERSTICK 2-0

Facility

$210.00

Hospital Charge Code	270691001
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

FIBERWIRE FIBERSTICK 2-0

Facility

$210.00

Hospital Charge Code	270691001
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$105.00

FIBERWIRE GRASPER

Facility

$7,475.00

Hospital Charge Code	270656516
Hospital Revenue Code	271
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

FIBERWIRE GRASPER

Facility

$7,475.00

Hospital Charge Code	270656516
Hospital Revenue Code	271
Min. Negotiated Rate	$971.75
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.75
Rate for Payer: Oxford Commercial	$3,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$3,737.50

FIBERWIRE MENISCAL 2-0 SMALL

Facility

$360.00

Service Code	HCPCS A4649
Hospital Charge Code	270697672
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

FIBERWIRE MENISCAL 2-0 SMALL

Facility

$360.00

Service Code	HCPCS A4649
Hospital Charge Code	270697672
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

FIB LAS 550 MIC HOL DHBFSF550D

Facility

$1,310.00

Hospital Charge Code	270640373
Hospital Revenue Code	272
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$196.50
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

Know your out-of-pocket cost for care.

All Charges