Heights University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT TENDON TIBIAL 9.5x350

Facility

$9,750.00

Hospital Charge Code	270654925
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

GRAFT TENDON TIBIAL 9.5x350

Facility

$9,750.00

Hospital Charge Code	270654925
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

GRAFT THERAGENESIS 4CM X 3 CM

Facility

$7,000.00

Hospital Charge Code	270695637
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

GRAFT THERAGENESIS 4CM X 3 CM

Facility

$7,000.00

Hospital Charge Code	270695637
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

GRAFT THERAGENSIS 8X 12 CM

Facility

$16,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695640
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

GRAFT THERAGENSIS 8X 12 CM

Facility

$16,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695640
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

GRAFT THERASKIN 3X6IN

Facility

$14,225.00

Service Code	HCPCS Q4121
Hospital Charge Code	270690262
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

GRAFT THERASKIN 3X6IN

Facility

$14,225.00

Service Code	HCPCS Q4121
Hospital Charge Code	270690262
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$4,267.50
Rate for Payer: Aetna Commercial	$4,267.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

GRAFT THINWALL 10mm70cm

Facility

$6,230.00

Service Code	HCPCS C1768
Hospital Charge Code	270640440
Hospital Revenue Code	278
Min. Negotiated Rate	$934.50
Max. Negotiated Rate	$1,507.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,507.66
Rate for Payer: Qualcare PPO/HMO/WC	$934.50

GRAFT THINWALL 10mm70cm

Facility

$6,230.00

Service Code	HCPCS C1768
Hospital Charge Code	270640440
Hospital Revenue Code	278
Min. Negotiated Rate	$934.50
Max. Negotiated Rate	$3,115.00
Rate for Payer: Aetna Commercial	$1,869.00
Rate for Payer: Aetna Medicare Advantage	$1,869.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,588.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,588.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,588.65
Rate for Payer: Cigna Commercial	$3,115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,507.66
Rate for Payer: Qualcare PPO/HMO/WC	$934.50

GRAFT THINWALL 8mm 80cm

Facility

$5,500.00

Service Code	HCPCS C1768
Hospital Charge Code	270601122
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

GRAFT THINWALL 8mm 80cm

Facility

$5,500.00

Service Code	HCPCS C1768
Hospital Charge Code	270601122
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

GRAFT TIBIAL CORT STRUT 450571

Facility

$3,540.00

Hospital Charge Code	270640532
Hospital Revenue Code	278
Min. Negotiated Rate	$531.00
Max. Negotiated Rate	$1,770.00
Rate for Payer: Aetna Commercial	$1,062.00
Rate for Payer: Aetna Medicare Advantage	$1,062.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$902.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$902.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$902.70
Rate for Payer: Cigna Commercial	$1,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.68
Rate for Payer: Qualcare PPO/HMO/WC	$531.00

GRAFT TIBIAL CORT STRUT 450571

Facility

$3,540.00

Hospital Charge Code	270640532
Hospital Revenue Code	278
Min. Negotiated Rate	$531.00
Max. Negotiated Rate	$856.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$708.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$856.68
Rate for Payer: Qualcare PPO/HMO/WC	$531.00

GRAFT TRUNK GORE3 28X14X16

Facility

$49,675.00

Hospital Charge Code	270645163
Hospital Revenue Code	278
Min. Negotiated Rate	$7,451.25
Max. Negotiated Rate	$24,837.50
Rate for Payer: Aetna Commercial	$14,902.50
Rate for Payer: Aetna Medicare Advantage	$14,902.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,667.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,667.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,667.12
Rate for Payer: Cigna Commercial	$24,837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,021.35
Rate for Payer: Qualcare PPO/HMO/WC	$7,451.25

GRAFT TRUNK GORE3 28X14X16

Facility

$49,675.00

Hospital Charge Code	270645163
Hospital Revenue Code	278
Min. Negotiated Rate	$7,451.25
Max. Negotiated Rate	$12,021.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,021.35
Rate for Payer: Qualcare PPO/HMO/WC	$7,451.25

GRAFT VASC 6mmDIAx40cm AG640

Facility

$4,518.85

Hospital Charge Code	270635597
Hospital Revenue Code	278
Min. Negotiated Rate	$677.83
Max. Negotiated Rate	$1,093.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,093.56
Rate for Payer: Qualcare PPO/HMO/WC	$677.83

GRAFT VASC 6mmDIAx40cm AG640

Facility

$4,518.85

Hospital Charge Code	270635597
Hospital Revenue Code	278
Min. Negotiated Rate	$677.83
Max. Negotiated Rate	$2,259.43
Rate for Payer: Aetna Commercial	$1,355.65
Rate for Payer: Aetna Medicare Advantage	$1,355.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,152.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,152.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,152.31
Rate for Payer: Cigna Commercial	$2,259.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,093.56
Rate for Payer: Qualcare PPO/HMO/WC	$677.83

GRAFT VASCULAR 4-7MM 45CM

Facility

$6,300.00

Service Code	HCPCS C1768
Hospital Charge Code	270647607
Hospital Revenue Code	278
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$3,150.00
Rate for Payer: Aetna Commercial	$1,890.00
Rate for Payer: Aetna Medicare Advantage	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,606.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,606.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,606.50
Rate for Payer: Cigna Commercial	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,524.60
Rate for Payer: Qualcare PPO/HMO/WC	$945.00

GRAFT VASCULAR 4-7MM 45CM

Facility

$3,380.00

Hospital Charge Code	270647608
Hospital Revenue Code	278
Min. Negotiated Rate	$507.00
Max. Negotiated Rate	$817.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$817.96
Rate for Payer: Qualcare PPO/HMO/WC	$507.00

GRAFT VASCULAR 4-7MM 45CM

Facility

$3,380.00

Hospital Charge Code	270647608
Hospital Revenue Code	278
Min. Negotiated Rate	$507.00
Max. Negotiated Rate	$1,690.00
Rate for Payer: Aetna Commercial	$1,014.00
Rate for Payer: Aetna Medicare Advantage	$1,014.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$861.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$861.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$861.90
Rate for Payer: Cigna Commercial	$1,690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$817.96
Rate for Payer: Qualcare PPO/HMO/WC	$507.00

GRAFT VASCULAR 4-7MM 45CM

Facility

$6,300.00

Service Code	HCPCS C1768
Hospital Charge Code	270647607
Hospital Revenue Code	278
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$1,524.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,524.60
Rate for Payer: Qualcare PPO/HMO/WC	$945.00

GRAFT VASCULAR 6MM 30CMRS 40CM

Facility

$3,260.00

Service Code	HCPCS C1768
Hospital Charge Code	270645781
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$1,630.00
Rate for Payer: Aetna Commercial	$978.00
Rate for Payer: Aetna Medicare Advantage	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$831.30
Rate for Payer: Cigna Commercial	$1,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

GRAFT VASCULAR 6MM 30CMRS 40CM

Facility

$3,260.00

Service Code	HCPCS C1768
Hospital Charge Code	270645781
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$788.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

GRAFT VASCULAR 6MM 30CM RS 70C

Facility

$4,485.00

Service Code	HCPCS C1768
Hospital Charge Code	270618552
Hospital Revenue Code	278
Min. Negotiated Rate	$672.75
Max. Negotiated Rate	$1,085.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$897.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,085.37
Rate for Payer: Qualcare PPO/HMO/WC	$672.75

Know your out-of-pocket cost for care.

All Charges