Heights University Hospital

All Charges

Charge

Type

Setting

Price

TENDON ACHILLES 10MM DOWEL

Facility

$13,026.25

Service Code	HCPCS C1762
Hospital Charge Code	270668501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.94
Max. Negotiated Rate	$3,152.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.94

TENDON ACHILLES 10MM DOWEL

Facility

$13,026.25

Service Code	HCPCS C1762
Hospital Charge Code	270668501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,953.94
Max. Negotiated Rate	$6,513.12
Rate for Payer: Aetna Commercial	$3,907.88
Rate for Payer: Aetna Medicare Advantage	$3,907.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,321.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,321.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,605.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,321.69
Rate for Payer: Cigna Commercial	$6,513.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,152.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,953.94

TENDON ACHILLES ALGRAFT 130200

Facility

$4,994.75

Hospital Charge Code	270633903
Hospital Revenue Code	278
Min. Negotiated Rate	$749.21
Max. Negotiated Rate	$2,497.38
Rate for Payer: Aetna Commercial	$1,498.42
Rate for Payer: Aetna Medicare Advantage	$1,498.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,273.66
Rate for Payer: Cigna Commercial	$2,497.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.73
Rate for Payer: Qualcare PPO/HMO/WC	$749.21

TENDON ACHILLES ALGRAFT 130200

Facility

$4,994.75

Hospital Charge Code	270633903
Hospital Revenue Code	278
Min. Negotiated Rate	$749.21
Max. Negotiated Rate	$1,208.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$998.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,208.73
Rate for Payer: Qualcare PPO/HMO/WC	$749.21

TENDON ACHILLES FF 930210

Facility

$2,863.25

Hospital Charge Code	270620344
Hospital Revenue Code	278
Min. Negotiated Rate	$429.49
Max. Negotiated Rate	$692.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.91
Rate for Payer: Qualcare PPO/HMO/WC	$429.49

TENDON ACHILLES FF 930210

Facility

$2,863.25

Hospital Charge Code	270620344
Hospital Revenue Code	278
Min. Negotiated Rate	$429.49
Max. Negotiated Rate	$1,431.62
Rate for Payer: Aetna Commercial	$858.98
Rate for Payer: Aetna Medicare Advantage	$858.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.13
Rate for Payer: Cigna Commercial	$1,431.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.91
Rate for Payer: Qualcare PPO/HMO/WC	$429.49

TENDON ACHILLES W/BONE 021604

Facility

$3,729.65

Hospital Charge Code	270617936
Hospital Revenue Code	278
Min. Negotiated Rate	$559.45
Max. Negotiated Rate	$1,864.83
Rate for Payer: Aetna Commercial	$1,118.89
Rate for Payer: Aetna Medicare Advantage	$1,118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$951.06
Rate for Payer: Cigna Commercial	$1,864.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: Qualcare PPO/HMO/WC	$559.45

TENDON ACHILLES W/BONE 021604

Facility

$3,729.65

Hospital Charge Code	270617936
Hospital Revenue Code	278
Min. Negotiated Rate	$559.45
Max. Negotiated Rate	$902.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.58
Rate for Payer: Qualcare PPO/HMO/WC	$559.45

TENDON ACHILLES W/CALCANEOUS

Facility

$4,439.25

Hospital Charge Code	270633002
Hospital Revenue Code	278
Min. Negotiated Rate	$665.89
Max. Negotiated Rate	$2,219.62
Rate for Payer: Aetna Commercial	$1,331.78
Rate for Payer: Aetna Medicare Advantage	$1,331.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,132.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$887.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,132.01
Rate for Payer: Cigna Commercial	$2,219.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.30
Rate for Payer: Qualcare PPO/HMO/WC	$665.89

TENDON ACHILLES W/CALCANEOUS

Facility

$4,439.25

Hospital Charge Code	270633002
Hospital Revenue Code	278
Min. Negotiated Rate	$665.89
Max. Negotiated Rate	$1,074.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$887.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,074.30
Rate for Payer: Qualcare PPO/HMO/WC	$665.89

TENDON ACHIL W/BONE STR 770765

Facility

$7,440.00

Hospital Charge Code	270627269
Hospital Revenue Code	278
Min. Negotiated Rate	$1,116.00
Max. Negotiated Rate	$1,800.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.00

TENDON ACHIL W/BONE STR 770765

Facility

$7,440.00

Hospital Charge Code	270627269
Hospital Revenue Code	278
Min. Negotiated Rate	$1,116.00
Max. Negotiated Rate	$3,720.00
Rate for Payer: Aetna Commercial	$2,232.00
Rate for Payer: Aetna Medicare Advantage	$2,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,897.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,897.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,897.20
Rate for Payer: Cigna Commercial	$3,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,800.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,116.00

TENDON ANCHORS 8

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270690426
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

TENDON ANCHORS 8

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687116
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

TENDON ANCHORS 8

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270687116
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

TENDON ANCHORS 8

Facility

$3,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270690426
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

TENDON ANTEOR TIBIALIS 77-0332

Facility

$5,456.00

Hospital Charge Code	270625868
Hospital Revenue Code	278
Min. Negotiated Rate	$818.40
Max. Negotiated Rate	$1,320.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,320.35
Rate for Payer: Qualcare PPO/HMO/WC	$818.40

TENDON ANTEOR TIBIALIS 77-0332

Facility

$5,456.00

Hospital Charge Code	270625868
Hospital Revenue Code	278
Min. Negotiated Rate	$818.40
Max. Negotiated Rate	$2,728.00
Rate for Payer: Aetna Commercial	$1,636.80
Rate for Payer: Aetna Medicare Advantage	$1,636.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,091.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,391.28
Rate for Payer: Cigna Commercial	$2,728.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,320.35
Rate for Payer: Qualcare PPO/HMO/WC	$818.40

TENDON ANTERIOR 11X325 TIBIAL

Facility

$11,010.00

Hospital Charge Code	270647883
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

TENDON ANTERIOR 11X325 TIBIAL

Facility

$11,010.00

Hospital Charge Code	270647883
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$3,303.00
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

TENDON ANTERIOR TIBIALIS *22cm

Facility

$7,075.00

Hospital Charge Code	270639509
Hospital Revenue Code	272
Min. Negotiated Rate	$919.75
Max. Negotiated Rate	$3,537.50
Rate for Payer: Aetna Commercial	$2,122.50
Rate for Payer: Aetna Medicare Advantage	$2,122.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,804.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,804.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,804.12
Rate for Payer: Cigna Commercial	$3,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.75
Rate for Payer: Oxford Commercial	$3,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,061.25
Rate for Payer: UnitedHealthcare Commercial	$3,537.50

TENDON ANTERIOR TIBIALIS *22cm

Facility

$7,075.00

Hospital Charge Code	270639509
Hospital Revenue Code	272
Min. Negotiated Rate	$1,061.25
Max. Negotiated Rate	$1,061.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,061.25

TENDON ANTERIOR TIBIALIS 26cm

Facility

$6,815.10

Hospital Charge Code	270630691
Hospital Revenue Code	278
Min. Negotiated Rate	$1,022.26
Max. Negotiated Rate	$3,407.55
Rate for Payer: Aetna Commercial	$2,044.53
Rate for Payer: Aetna Medicare Advantage	$2,044.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,737.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,737.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,363.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,737.85
Rate for Payer: Cigna Commercial	$3,407.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,649.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,022.26

TENDON ANTERIOR TIBIALIS 26cm

Facility

$6,815.10

Hospital Charge Code	270630691
Hospital Revenue Code	278
Min. Negotiated Rate	$1,022.26
Max. Negotiated Rate	$1,649.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,363.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,649.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,022.26

TENDON ANTERIOR TIBIALS 430335

Facility

$7,075.00

Hospital Charge Code	270635223
Hospital Revenue Code	278
Min. Negotiated Rate	$1,061.25
Max. Negotiated Rate	$1,712.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,712.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,061.25

Know your out-of-pocket cost for care.

All Charges