Heights University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY DYNAGRAFT 1CC 71010

Facility

$1,196.85

Hospital Charge Code	270615405
Hospital Revenue Code	278
Min. Negotiated Rate	$179.53
Max. Negotiated Rate	$598.42
Rate for Payer: Aetna Commercial	$359.06
Rate for Payer: Aetna Medicare Advantage	$359.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$305.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$305.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$239.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$305.20
Rate for Payer: Cigna Commercial	$598.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.64
Rate for Payer: Qualcare PPO/HMO/WC	$179.53

PUTTY FAST SET 10cc STERILE

Facility

$11,953.65

Hospital Charge Code	270636083
Hospital Revenue Code	278
Min. Negotiated Rate	$1,793.05
Max. Negotiated Rate	$5,976.82
Rate for Payer: Aetna Commercial	$3,586.09
Rate for Payer: Aetna Medicare Advantage	$3,586.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,048.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,048.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,048.18
Rate for Payer: Cigna Commercial	$5,976.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,892.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,793.05

PUTTY FAST SET 10cc STERILE

Facility

$11,953.65

Hospital Charge Code	270636083
Hospital Revenue Code	278
Min. Negotiated Rate	$1,793.05
Max. Negotiated Rate	$2,892.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,892.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,793.05

PUTTY FAST SET 5cc SRS-005-FSP

Facility

$7,533.00

Hospital Charge Code	270637031
Hospital Revenue Code	278
Min. Negotiated Rate	$1,129.95
Max. Negotiated Rate	$3,766.50
Rate for Payer: Aetna Commercial	$2,259.90
Rate for Payer: Aetna Medicare Advantage	$2,259.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,920.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,920.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,920.91
Rate for Payer: Cigna Commercial	$3,766.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,822.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,129.95

PUTTY FAST SET 5cc SRS-005-FSP

Facility

$7,533.00

Hospital Charge Code	270637031
Hospital Revenue Code	278
Min. Negotiated Rate	$1,129.95
Max. Negotiated Rate	$1,822.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,822.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,129.95

PUTTY FIBER APEX 10CC

Facility

$16,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697835
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

PUTTY FIBER APEX 10CC

Facility

$16,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697835
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

PUTTY FIBERGRAFT BG 1CC

Facility

$2,049.00

Service Code	HCPCS C1713
Hospital Charge Code	270698988
Hospital Revenue Code	278
Min. Negotiated Rate	$307.35
Max. Negotiated Rate	$1,024.50
Rate for Payer: Aetna Commercial	$614.70
Rate for Payer: Aetna Medicare Advantage	$614.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.50
Rate for Payer: Cigna Commercial	$1,024.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.86
Rate for Payer: Qualcare PPO/HMO/WC	$307.35

PUTTY FIBERGRAFT BG 1CC

Facility

$2,049.00

Service Code	HCPCS C1713
Hospital Charge Code	270698988
Hospital Revenue Code	278
Min. Negotiated Rate	$307.35
Max. Negotiated Rate	$495.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$409.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.86
Rate for Payer: Qualcare PPO/HMO/WC	$307.35

PUTTY FIBERGRAFT BG 6ML

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270700130
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$2,835.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PUTTY FIBERGRAFT BG 6ML

Facility

$9,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270700130
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

PUTTY GRAFTON 10CC 943110

Facility

$3,412.00

Hospital Charge Code	270607537
Hospital Revenue Code	278
Min. Negotiated Rate	$511.80
Max. Negotiated Rate	$1,706.00
Rate for Payer: Aetna Commercial	$1,023.60
Rate for Payer: Aetna Medicare Advantage	$1,023.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.06
Rate for Payer: Cigna Commercial	$1,706.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.70
Rate for Payer: Qualcare PPO/HMO/WC	$511.80

PUTTY GRAFTON 10CC 943110

Facility

$3,412.00

Hospital Charge Code	270607537
Hospital Revenue Code	278
Min. Negotiated Rate	$511.80
Max. Negotiated Rate	$825.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.70
Rate for Payer: Qualcare PPO/HMO/WC	$511.80

PUTTY GRAFTON 10c STER 343110

Facility

$5,410.00

Service Code	HCPCS C9359
Hospital Charge Code	270631283
Hospital Revenue Code	278
Min. Negotiated Rate	$811.50
Max. Negotiated Rate	$2,705.00
Rate for Payer: Aetna Commercial	$1,623.00
Rate for Payer: Aetna Medicare Advantage	$1,623.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,379.55
Rate for Payer: Cigna Commercial	$2,705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: Qualcare PPO/HMO/WC	$811.50

PUTTY GRAFTON 10c STER 343110

Facility

$5,410.00

Service Code	HCPCS C9359
Hospital Charge Code	270631283
Hospital Revenue Code	278
Min. Negotiated Rate	$811.50
Max. Negotiated Rate	$1,309.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: Qualcare PPO/HMO/WC	$811.50

PUTTY GRAFTON 2.5CC 123103

Facility

$2,525.00

Service Code	HCPCS C9359
Hospital Charge Code	270617953
Hospital Revenue Code	278
Min. Negotiated Rate	$378.75
Max. Negotiated Rate	$1,262.50
Rate for Payer: Aetna Commercial	$757.50
Rate for Payer: Aetna Medicare Advantage	$757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$643.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$643.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$643.88
Rate for Payer: Cigna Commercial	$1,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.05
Rate for Payer: Qualcare PPO/HMO/WC	$378.75

PUTTY GRAFTON 2.5CC 123103

Facility

$2,525.00

Service Code	HCPCS C9359
Hospital Charge Code	270617953
Hospital Revenue Code	278
Min. Negotiated Rate	$378.75
Max. Negotiated Rate	$611.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$611.05
Rate for Payer: Qualcare PPO/HMO/WC	$378.75

PUTTY GRAFTON 5CC 123105

Facility

$4,585.00

Service Code	HCPCS C9359
Hospital Charge Code	270613259
Hospital Revenue Code	278
Min. Negotiated Rate	$687.75
Max. Negotiated Rate	$2,292.50
Rate for Payer: Aetna Commercial	$1,375.50
Rate for Payer: Aetna Medicare Advantage	$1,375.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,169.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,169.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,169.17
Rate for Payer: Cigna Commercial	$2,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,109.57
Rate for Payer: Qualcare PPO/HMO/WC	$687.75

PUTTY GRAFTON 5CC 123105

Facility

$4,585.00

Service Code	HCPCS C9359
Hospital Charge Code	270613259
Hospital Revenue Code	278
Min. Negotiated Rate	$687.75
Max. Negotiated Rate	$1,109.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$917.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,109.57
Rate for Payer: Qualcare PPO/HMO/WC	$687.75

PUTTY GRAFTON 5CC PRETX 523105

Facility

$3,510.00

Service Code	HCPCS C9359
Hospital Charge Code	270622366
Hospital Revenue Code	278
Min. Negotiated Rate	$526.50
Max. Negotiated Rate	$1,755.00
Rate for Payer: Aetna Commercial	$1,053.00
Rate for Payer: Aetna Medicare Advantage	$1,053.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$895.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$895.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$702.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$895.05
Rate for Payer: Cigna Commercial	$1,755.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$849.42
Rate for Payer: Qualcare PPO/HMO/WC	$526.50

PUTTY GRAFTON 5CC PRETX 523105

Facility

$3,510.00

Service Code	HCPCS C9359
Hospital Charge Code	270622366
Hospital Revenue Code	278
Min. Negotiated Rate	$526.50
Max. Negotiated Rate	$849.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$849.42
Rate for Payer: Qualcare PPO/HMO/WC	$526.50

PUTTY GRAFTON DBM 10CC

Facility

$7,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270692666
Hospital Revenue Code	278
Min. Negotiated Rate	$1,067.25
Max. Negotiated Rate	$3,557.50
Rate for Payer: Aetna Commercial	$2,134.50
Rate for Payer: Aetna Medicare Advantage	$2,134.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,814.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,814.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,814.33
Rate for Payer: Cigna Commercial	$3,557.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,721.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,067.25

PUTTY GRAFTON DBM 10CC

Facility

$7,115.00

Service Code	HCPCS C1713
Hospital Charge Code	270692666
Hospital Revenue Code	278
Min. Negotiated Rate	$1,067.25
Max. Negotiated Rate	$1,721.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,423.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,721.83
Rate for Payer: Qualcare PPO/HMO/WC	$1,067.25

PUTTY GRAFTON DBM 10CC 123110

Facility

$5,366.75

Hospital Charge Code	270608088
Hospital Revenue Code	278
Min. Negotiated Rate	$805.01
Max. Negotiated Rate	$1,298.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,073.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.75
Rate for Payer: Qualcare PPO/HMO/WC	$805.01

PUTTY GRAFTON DBM 10CC 123110

Facility

$5,366.75

Hospital Charge Code	270608088
Hospital Revenue Code	278
Min. Negotiated Rate	$805.01
Max. Negotiated Rate	$2,683.38
Rate for Payer: Aetna Commercial	$1,610.03
Rate for Payer: Aetna Medicare Advantage	$1,610.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,368.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,368.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,073.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,368.52
Rate for Payer: Cigna Commercial	$2,683.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.75
Rate for Payer: Qualcare PPO/HMO/WC	$805.01

Know your out-of-pocket cost for care.

All Charges