Heights University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT SYSTM PARS SUTURE TAPE

Facility

$7,475.00

Hospital Charge Code	270683624
Hospital Revenue Code	272
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

IMPLANT SYSTM PARS SUTURE TAPE

Facility

$7,475.00

Hospital Charge Code	270683624
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

IMPLANT TALIEN TALAR COMPONENT

Facility

$18,750.00

Hospital Charge Code	270656743
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$5,625.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

IMPLANT TALIEN TALAR COMPONENT

Facility

$18,750.00

Hospital Charge Code	270656743
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

IMPLANT TIBIAL COMPONENT T.=1

Facility

$24,750.00

Hospital Charge Code	270656744
Hospital Revenue Code	278
Min. Negotiated Rate	$3,712.50
Max. Negotiated Rate	$5,989.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,989.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,712.50

IMPLANT TIBIAL COMPONENT T.=1

Facility

$24,750.00

Hospital Charge Code	270656744
Hospital Revenue Code	278
Min. Negotiated Rate	$3,712.50
Max. Negotiated Rate	$12,375.00
Rate for Payer: Aetna Commercial	$7,425.00
Rate for Payer: Aetna Medicare Advantage	$7,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,311.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,311.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,311.25
Rate for Payer: Cigna Commercial	$12,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,989.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,712.50

IMPLANT TIGHTROPE ABS

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270663930
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$276.00
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

IMPLANT TIGHTROPE ABS

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270663930
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$222.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

IMPLANT TOE ANGLED 2 487A002

Facility

$10,875.00

Hospital Charge Code	270638424
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$2,631.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

IMPLANT TOE ANGLED 2 487A002

Facility

$10,875.00

Hospital Charge Code	270638424
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$3,262.50
Rate for Payer: Aetna Medicare Advantage	$3,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,773.12
Rate for Payer: Cigna Commercial	$5,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

IMPLANT TOE LARGE NPC 10062

Facility

$3,844.00

Hospital Charge Code	270632589
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE LARGE NPC 10062

Facility

$3,844.00

Hospital Charge Code	270632589
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,153.20
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE LARGE PC 10414

Facility

$4,588.00

Hospital Charge Code	270632585
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$1,110.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE LARGE PC 10414

Facility

$4,588.00

Hospital Charge Code	270632585
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$2,294.00
Rate for Payer: Aetna Commercial	$1,376.40
Rate for Payer: Aetna Medicare Advantage	$1,376.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.94
Rate for Payer: Cigna Commercial	$2,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE MD/LG NPC 14958

Facility

$3,844.00

Hospital Charge Code	270632787
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE MD/LG NPC 14958

Facility

$3,844.00

Hospital Charge Code	270632787
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,153.20
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE MEDIUM NPC 10061

Facility

$4,000.00

Hospital Charge Code	270632587
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IMPLANT TOE MEDIUM NPC 10061

Facility

$4,000.00

Hospital Charge Code	270632587
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

IMPLANT TOE MEDIUM PC 10413

Facility

$4,588.00

Hospital Charge Code	270632583
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$2,294.00
Rate for Payer: Aetna Commercial	$1,376.40
Rate for Payer: Aetna Medicare Advantage	$1,376.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.94
Rate for Payer: Cigna Commercial	$2,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE MEDIUM PC 10413

Facility

$4,588.00

Hospital Charge Code	270632583
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$1,110.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE MED M/L PC 14960

Facility

$4,588.00

Hospital Charge Code	270632584
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$1,110.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE MED M/L PC 14960

Facility

$4,588.00

Hospital Charge Code	270632584
Hospital Revenue Code	278
Min. Negotiated Rate	$688.20
Max. Negotiated Rate	$2,294.00
Rate for Payer: Aetna Commercial	$1,376.40
Rate for Payer: Aetna Medicare Advantage	$1,376.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.94
Rate for Payer: Cigna Commercial	$2,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,110.30
Rate for Payer: Qualcare PPO/HMO/WC	$688.20

IMPLANT TOE M/L NPC 14958

Facility

$3,844.00

Hospital Charge Code	270632588
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE M/L NPC 14958

Facility

$3,844.00

Hospital Charge Code	270632588
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,153.20
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

IMPLANT TOE SGARLATO KIT B

Facility

$1,050.00

Hospital Charge Code	27060877
Hospital Revenue Code	274
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

Know your out-of-pocket cost for care.

All Charges