Heights University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT XENMATRIX AB 4 X 8 CM

Facility

$30,300.00

Service Code	HCPCS C1781
Hospital Charge Code	270684825
Hospital Revenue Code	278
Min. Negotiated Rate	$4,545.00
Max. Negotiated Rate	$15,150.00
Rate for Payer: Aetna Commercial	$9,090.00
Rate for Payer: Aetna Medicare Advantage	$9,090.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,726.50
Rate for Payer: Cigna Commercial	$15,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,332.60
Rate for Payer: Qualcare PPO/HMO/WC	$4,545.00

GRAFT ZE AAA LEG EX TFLE-16-88

Facility

$14,320.00

Hospital Charge Code	270637297V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,148.00
Max. Negotiated Rate	$7,160.00
Rate for Payer: Aetna Commercial	$4,296.00
Rate for Payer: Aetna Medicare Advantage	$4,296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,651.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,651.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,651.60
Rate for Payer: Cigna Commercial	$7,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,465.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.00

GRAFT ZE AAA LEG EX TFLE-16-88

Facility

$14,320.00

Hospital Charge Code	270637297V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,148.00
Max. Negotiated Rate	$3,465.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,864.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,465.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.00

GRAFT ZEN AAA LEG EXT TFLE1454

Facility

$13,392.00

Hospital Charge Code	270634077
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$3,240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZEN AAA LEG EXT TFLE1454

Facility

$13,392.00

Hospital Charge Code	270634077
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$6,696.00
Rate for Payer: Aetna Commercial	$4,017.60
Rate for Payer: Aetna Medicare Advantage	$4,017.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,414.96
Rate for Payer: Cigna Commercial	$6,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZEN AAA LEG EXT TFLE1854

Facility

$13,392.00

Hospital Charge Code	270634076
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$3,240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZEN AAA LEG EXT TFLE1854

Facility

$14,980.00

Hospital Charge Code	270634076V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$3,625.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

GRAFT ZEN AAA LEG EXT TFLE1854

Facility

$14,980.00

Hospital Charge Code	270634076V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,247.00
Max. Negotiated Rate	$7,490.00
Rate for Payer: Aetna Commercial	$4,494.00
Rate for Payer: Aetna Medicare Advantage	$4,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,819.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,996.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,819.90
Rate for Payer: Cigna Commercial	$7,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,625.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,247.00

GRAFT ZEN AAA LEG EXT TFLE1854

Facility

$13,392.00

Hospital Charge Code	270634076
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$6,696.00
Rate for Payer: Aetna Commercial	$4,017.60
Rate for Payer: Aetna Medicare Advantage	$4,017.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,414.96
Rate for Payer: Cigna Commercial	$6,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZEN AAA LEG EXT TFLE1871

Facility

$13,392.00

Hospital Charge Code	270634075
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$3,240.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZEN AAA LEG EXT TFLE1871

Facility

$13,392.00

Hospital Charge Code	270634075
Hospital Revenue Code	278
Min. Negotiated Rate	$2,008.80
Max. Negotiated Rate	$6,696.00
Rate for Payer: Aetna Commercial	$4,017.60
Rate for Payer: Aetna Medicare Advantage	$4,017.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,414.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,678.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,414.96
Rate for Payer: Cigna Commercial	$6,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,240.86
Rate for Payer: Qualcare PPO/HMO/WC	$2,008.80

GRAFT ZEN AAA LEG EXT TFLE2254

Facility

$13,500.00

Hospital Charge Code	270637296V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

GRAFT ZEN AAA LEG EXT TFLE2254

Facility

$13,500.00

Hospital Charge Code	270637296V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00

GRAFT ZEN AAA LEG ILI TFLE2088

Facility

$13,500.00

Hospital Charge Code	270638291
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

GRAFT ZEN AAA LEG ILI TFLE2088

Facility

$14,320.00

Hospital Charge Code	270638291V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,148.00
Max. Negotiated Rate	$3,465.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,864.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,465.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.00

GRAFT ZEN AAA LEG ILI TFLE2088

Facility

$14,320.00

Hospital Charge Code	270638291V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,148.00
Max. Negotiated Rate	$7,160.00
Rate for Payer: Aetna Commercial	$4,296.00
Rate for Payer: Aetna Medicare Advantage	$4,296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,651.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,651.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,651.60
Rate for Payer: Cigna Commercial	$7,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,465.44
Rate for Payer: Qualcare PPO/HMO/WC	$2,148.00

GRAFT ZEN AAA LEG ILI TFLE2088

Facility

$13,500.00

Hospital Charge Code	270638291
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

GRAFT ZEN AAA LEG TFLE-16-88

Facility

$13,500.00

Hospital Charge Code	270637297
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

GRAFT ZEN AAA LEG TFLE-16-88

Facility

$13,500.00

Hospital Charge Code	270637297
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

GRAFT ZEN AAA MAIN BOD TFB3074

Facility

$37,000.00

Hospital Charge Code	270637295V
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$11,100.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MAIN BOD TFB3074

Facility

$37,000.00

Hospital Charge Code	270637295V
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$8,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$11,100.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290V
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$18,500.00
Rate for Payer: Aetna Commercial	$11,100.00
Rate for Payer: Aetna Medicare Advantage	$11,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,435.00
Rate for Payer: Cigna Commercial	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290V
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$8,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

GRAFT ZEN AAA MAN BODY TFB3695

Facility

$37,000.00

Hospital Charge Code	270638290
Hospital Revenue Code	278
Min. Negotiated Rate	$5,550.00
Max. Negotiated Rate	$8,954.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,954.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,550.00

Know your out-of-pocket cost for care.

All Charges