Heights University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT MATRIX WND 6X3CM/SQCM JW

Facility

$887.19

Hospital Charge Code	270673866W
Hospital Revenue Code	636
Min. Negotiated Rate	$133.08
Max. Negotiated Rate	$443.60
Rate for Payer: Aetna Commercial	$266.16
Rate for Payer: Aetna Medicare Advantage	$266.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.23
Rate for Payer: Cigna Commercial	$443.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.70
Rate for Payer: Qualcare PPO/HMO/WC	$133.08

GRAFT MATRIX WND 6X3CM/SQCM JW

Facility

$887.19

Hospital Charge Code	270673866W
Hospital Revenue Code	636
Min. Negotiated Rate	$133.08
Max. Negotiated Rate	$214.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.70
Rate for Payer: Qualcare PPO/HMO/WC	$133.08

GRAFT MCVL BIF 18/9MM/40CM

Facility

$4,991.25

Hospital Charge Code	270601120
Hospital Revenue Code	278
Min. Negotiated Rate	$748.69
Max. Negotiated Rate	$2,495.62
Rate for Payer: Aetna Commercial	$1,497.38
Rate for Payer: Aetna Medicare Advantage	$1,497.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,272.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,272.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,272.77
Rate for Payer: Cigna Commercial	$2,495.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.88
Rate for Payer: Qualcare PPO/HMO/WC	$748.69

GRAFT MCVL BIF 18/9MM/40CM

Facility

$4,991.25

Hospital Charge Code	270601120
Hospital Revenue Code	278
Min. Negotiated Rate	$748.69
Max. Negotiated Rate	$1,207.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.88
Rate for Payer: Qualcare PPO/HMO/WC	$748.69

GRAFT MCVL BIF 20/10MM/40CM

Facility

$4,991.25

Hospital Charge Code	270601126
Hospital Revenue Code	278
Min. Negotiated Rate	$748.69
Max. Negotiated Rate	$2,495.62
Rate for Payer: Aetna Commercial	$1,497.38
Rate for Payer: Aetna Medicare Advantage	$1,497.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,272.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,272.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,272.77
Rate for Payer: Cigna Commercial	$2,495.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.88
Rate for Payer: Qualcare PPO/HMO/WC	$748.69

GRAFT MCVL BIF 20/10MM/40CM

Facility

$4,991.25

Hospital Charge Code	270601126
Hospital Revenue Code	278
Min. Negotiated Rate	$748.69
Max. Negotiated Rate	$1,207.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.88
Rate for Payer: Qualcare PPO/HMO/WC	$748.69

GRAFT MCVL BIF 24/12MM/40CM

Facility

$3,074.45

Hospital Charge Code	270601142
Hospital Revenue Code	278
Min. Negotiated Rate	$461.17
Max. Negotiated Rate	$1,537.22
Rate for Payer: Aetna Commercial	$922.34
Rate for Payer: Aetna Medicare Advantage	$922.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$783.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$783.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$614.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$783.98
Rate for Payer: Cigna Commercial	$1,537.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.02
Rate for Payer: Qualcare PPO/HMO/WC	$461.17

GRAFT MCVL BIF 24/12MM/40CM

Facility

$3,074.45

Hospital Charge Code	270601142
Hospital Revenue Code	278
Min. Negotiated Rate	$461.17
Max. Negotiated Rate	$744.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$614.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.02
Rate for Payer: Qualcare PPO/HMO/WC	$461.17

GRAFT MCVL DBL ST

Facility

$820.00

Hospital Charge Code	1607134
Hospital Revenue Code	251
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

GRAFT MCVL DBL ST

Facility

$820.00

Hospital Charge Code	1607134
Hospital Revenue Code	251
Min. Negotiated Rate	$106.60
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$246.00
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.60
Rate for Payer: Oxford Commercial	$410.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Commercial	$410.00

GRAFT MCVL DBL VELR *******

Facility

$3,015.00

Hospital Charge Code	1604115
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$1,507.50
Rate for Payer: Aetna Commercial	$904.50
Rate for Payer: Aetna Medicare Advantage	$904.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$768.83
Rate for Payer: Cigna Commercial	$1,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL DBL VELR *******

Facility

$3,015.00

Hospital Charge Code	1604115
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$729.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL DBL VELR 10/60CM***

Facility

$1,944.00

Hospital Charge Code	1604149
Hospital Revenue Code	278
Min. Negotiated Rate	$291.60
Max. Negotiated Rate	$972.00
Rate for Payer: Aetna Commercial	$583.20
Rate for Payer: Aetna Medicare Advantage	$583.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.72
Rate for Payer: Cigna Commercial	$972.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.45
Rate for Payer: Qualcare PPO/HMO/WC	$291.60

GRAFT MCVL DBL VELR 10/60CM***

Facility

$1,944.00

Hospital Charge Code	1604149
Hospital Revenue Code	278
Min. Negotiated Rate	$291.60
Max. Negotiated Rate	$470.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$470.45
Rate for Payer: Qualcare PPO/HMO/WC	$291.60

GRAFT MCVL DBL VELR 16/8MM ***

Facility

$3,015.00

Hospital Charge Code	1604065
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$729.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL DBL VELR 16/8MM ***

Facility

$3,015.00

Hospital Charge Code	1604065
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$1,507.50
Rate for Payer: Aetna Commercial	$904.50
Rate for Payer: Aetna Medicare Advantage	$904.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$768.83
Rate for Payer: Cigna Commercial	$1,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL DBL VELR 16MM *****

Facility

$1,994.00

Hospital Charge Code	1604156
Hospital Revenue Code	278
Min. Negotiated Rate	$299.10
Max. Negotiated Rate	$482.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: Qualcare PPO/HMO/WC	$299.10

GRAFT MCVL DBL VELR 16MM *****

Facility

$1,994.00

Hospital Charge Code	1604156
Hospital Revenue Code	278
Min. Negotiated Rate	$299.10
Max. Negotiated Rate	$997.00
Rate for Payer: Aetna Commercial	$598.20
Rate for Payer: Aetna Medicare Advantage	$598.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.47
Rate for Payer: Cigna Commercial	$997.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: Qualcare PPO/HMO/WC	$299.10

GRAFT MCVL DBL VELR 18/9CM ***

Facility

$3,015.00

Hospital Charge Code	1604081
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$1,507.50
Rate for Payer: Aetna Commercial	$904.50
Rate for Payer: Aetna Medicare Advantage	$904.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$768.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$768.83
Rate for Payer: Cigna Commercial	$1,507.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL DBL VELR 18/9CM ***

Facility

$3,015.00

Hospital Charge Code	1604081
Hospital Revenue Code	278
Min. Negotiated Rate	$452.25
Max. Negotiated Rate	$729.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$603.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.63
Rate for Payer: Qualcare PPO/HMO/WC	$452.25

GRAFT MCVL DBL VELR 22/11CM**

Facility

$2,716.00

Hospital Charge Code	1604180
Hospital Revenue Code	278
Min. Negotiated Rate	$407.40
Max. Negotiated Rate	$657.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: Qualcare PPO/HMO/WC	$407.40

GRAFT MCVL DBL VELR 22/11CM**

Facility

$2,716.00

Hospital Charge Code	1604180
Hospital Revenue Code	278
Min. Negotiated Rate	$407.40
Max. Negotiated Rate	$1,358.00
Rate for Payer: Aetna Commercial	$814.80
Rate for Payer: Aetna Medicare Advantage	$814.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$692.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$692.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$692.58
Rate for Payer: Cigna Commercial	$1,358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: Qualcare PPO/HMO/WC	$407.40

GRAFT MCVL DBL VELR 24/12CM***

Facility

$2,716.00

Hospital Charge Code	1604198
Hospital Revenue Code	278
Min. Negotiated Rate	$407.40
Max. Negotiated Rate	$657.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: Qualcare PPO/HMO/WC	$407.40

GRAFT MCVL DBL VELR 24/12CM***

Facility

$2,716.00

Hospital Charge Code	1604198
Hospital Revenue Code	278
Min. Negotiated Rate	$407.40
Max. Negotiated Rate	$1,358.00
Rate for Payer: Aetna Commercial	$814.80
Rate for Payer: Aetna Medicare Advantage	$814.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$692.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$692.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$692.58
Rate for Payer: Cigna Commercial	$1,358.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.27
Rate for Payer: Qualcare PPO/HMO/WC	$407.40

GRAFT MCVL DBL VELR HMSHLD

Facility

$1,994.00

Hospital Charge Code	1603984
Hospital Revenue Code	278
Min. Negotiated Rate	$299.10
Max. Negotiated Rate	$482.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$398.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$482.55
Rate for Payer: Qualcare PPO/HMO/WC	$299.10

Know your out-of-pocket cost for care.

All Charges