Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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) NJ Health	$1,415.00
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	$1,712.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,061.25

TENDON ANT TIBIA *22cm 443017

Facility

$12,000.00

Hospital Charge Code	270640524
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

TENDON ANT TIBIA *22cm 443017

Facility

$12,000.00

Hospital Charge Code	270640524
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

TENDON ANT TIBIALIS 30 453017

Facility

$8,475.00

Hospital Charge Code	270637459
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$2,050.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

TENDON ANT TIBIALIS 30 453017

Facility

$8,475.00

Hospital Charge Code	270637459
Hospital Revenue Code	278
Min. Negotiated Rate	$1,271.25
Max. Negotiated Rate	$4,237.50
Rate for Payer: Aetna Commercial	$2,542.50
Rate for Payer: Aetna Medicare Advantage	$2,542.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,161.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,161.12
Rate for Payer: Cigna Commercial	$4,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,050.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,271.25

TENDON ANT TIBIALS 30X9 430335

Facility

$8,175.00

Hospital Charge Code	270642495
Hospital Revenue Code	278
Min. Negotiated Rate	$1,226.25
Max. Negotiated Rate	$4,087.50
Rate for Payer: Aetna Commercial	$2,452.50
Rate for Payer: Aetna Medicare Advantage	$2,452.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,084.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,084.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,635.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,084.62
Rate for Payer: Cigna Commercial	$4,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,978.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,226.25

TENDON ANT TIBIALS 30X9 430335

Facility

$8,175.00

Hospital Charge Code	270642495
Hospital Revenue Code	278
Min. Negotiated Rate	$1,226.25
Max. Negotiated Rate	$1,978.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,978.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,226.25

TENDONASIS SEMI 8x250MM

Facility

$7,565.00

Service Code	HCPCS C1762
Hospital Charge Code	270660383
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.75
Max. Negotiated Rate	$3,782.50
Rate for Payer: Aetna Commercial	$2,269.50
Rate for Payer: Aetna Medicare Advantage	$2,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,929.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,929.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,513.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,929.08
Rate for Payer: Cigna Commercial	$3,782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.75

TENDONASIS SEMI 8x250MM

Facility

$7,565.00

Service Code	HCPCS C1762
Hospital Charge Code	270660383
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.75
Max. Negotiated Rate	$1,830.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,513.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.75

TENDON BIOCLEANSE TIBIAL POSTE

Facility

$13,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270663884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$6,500.00
Rate for Payer: Cigna Commercial	$6,500.00
Rate for Payer: Aetna Commercial	$3,900.00
Rate for Payer: Aetna Medicare Advantage	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

TENDON BIOCLEANSE TIBIAL POSTE

Facility

$13,000.00

Service Code	HCPCS C1762
Hospital Charge Code	270663884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$3,146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,146.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,950.00

TENDON BMT 77-0783

Facility

$5,825.65

Hospital Charge Code	270625869
Hospital Revenue Code	278
Min. Negotiated Rate	$873.85
Max. Negotiated Rate	$2,912.82
Rate for Payer: Aetna Commercial	$1,747.69
Rate for Payer: Aetna Medicare Advantage	$1,747.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,485.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,485.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,165.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,485.54
Rate for Payer: Cigna Commercial	$2,912.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,409.81
Rate for Payer: Qualcare PPO/HMO/WC	$873.85

TENDON BMT 77-0783

Facility

$5,825.65

Hospital Charge Code	270625869
Hospital Revenue Code	278
Min. Negotiated Rate	$873.85
Max. Negotiated Rate	$1,409.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,165.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,409.81
Rate for Payer: Qualcare PPO/HMO/WC	$873.85

TENDON BONE HEMI W/QUAD 130010

Facility

$12,796.90

Hospital Charge Code	270638616
Hospital Revenue Code	278
Min. Negotiated Rate	$1,919.54
Max. Negotiated Rate	$3,096.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,559.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,096.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,919.54

TENDON BONE HEMI W/QUAD 130010

Facility

$12,796.90

Hospital Charge Code	270638616
Hospital Revenue Code	278
Min. Negotiated Rate	$1,919.54
Max. Negotiated Rate	$6,398.45
Rate for Payer: Aetna Commercial	$3,839.07
Rate for Payer: Aetna Medicare Advantage	$3,839.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,263.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,263.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,559.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,263.21
Rate for Payer: Cigna Commercial	$6,398.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,096.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,919.54

TENDON GRACILIS

Facility

$5,512.50

Service Code	HCPCS C1762
Hospital Charge Code	270668349
Hospital Revenue Code	278
Min. Negotiated Rate	$826.88
Max. Negotiated Rate	$1,334.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.03
Rate for Payer: Qualcare PPO/HMO/WC	$826.88

TENDON GRACILIS

Facility

$5,512.50

Service Code	HCPCS C1762
Hospital Charge Code	270668349
Hospital Revenue Code	278
Min. Negotiated Rate	$826.88
Max. Negotiated Rate	$2,756.25
Rate for Payer: Aetna Commercial	$1,653.75
Rate for Payer: Aetna Medicare Advantage	$1,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,405.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,405.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,102.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,405.69
Rate for Payer: Cigna Commercial	$2,756.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.03
Rate for Payer: Qualcare PPO/HMO/WC	$826.88

TENDON GRACLLIS 200-259 330165

Facility

$2,856.85

Hospital Charge Code	270621432
Hospital Revenue Code	278
Min. Negotiated Rate	$428.53
Max. Negotiated Rate	$1,428.42
Rate for Payer: Aetna Commercial	$857.05
Rate for Payer: Aetna Medicare Advantage	$857.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$728.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$728.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$571.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$728.50
Rate for Payer: Cigna Commercial	$1,428.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$691.36
Rate for Payer: Qualcare PPO/HMO/WC	$428.53

TENDON GRACLLIS 200-259 330165

Facility

$2,856.85

Hospital Charge Code	270621432
Hospital Revenue Code	278
Min. Negotiated Rate	$428.53
Max. Negotiated Rate	$691.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$571.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$691.36
Rate for Payer: Qualcare PPO/HMO/WC	$428.53

TENDONITIS, MYOSITIS AND BURSITIS WITH MCC

Facility

$54,980.58

Service Code	MSDRG 557
Min. Negotiated Rate	$16,225.92
Max. Negotiated Rate	$54,980.58
Rate for Payer: Aetna Commercial	$50,138.09
Rate for Payer: Aetna Medicare Advantage	$16,225.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,004.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,004.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,326.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,004.52
Rate for Payer: Cigna Commercial	$31,999.57
Rate for Payer: Cigna Medicare Advantage	$18,326.86
Rate for Payer: Clover Medicare Advantage	$17,410.52
Rate for Payer: EmblemHealth Commercial	$54,980.58
Rate for Payer: Humana Medicare Advantage	$18,876.67
Rate for Payer: Oxford Commercial	$19,998.81
Rate for Payer: UnitedHealthcare Commercial	$22,700.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,326.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19,426.47
Rate for Payer: Wellcare Medicare Advantage	$18,326.86

TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC

Facility

$37,748.01

Service Code	MSDRG 558
Min. Negotiated Rate	$9,747.12
Max. Negotiated Rate	$37,748.01
Rate for Payer: Aetna Commercial	$30,118.60
Rate for Payer: Aetna Medicare Advantage	$9,747.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,258.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,258.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,582.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,258.96
Rate for Payer: Cigna Commercial	$19,222.56
Rate for Payer: Cigna Medicare Advantage	$12,582.67
Rate for Payer: Clover Medicare Advantage	$11,953.54
Rate for Payer: EmblemHealth Commercial	$37,748.01
Rate for Payer: Humana Medicare Advantage	$12,960.15
Rate for Payer: Oxford Commercial	$12,013.54
Rate for Payer: UnitedHealthcare Commercial	$13,636.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,582.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,337.63
Rate for Payer: Wellcare Medicare Advantage	$12,582.67

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$13,216.63

Service Code	APR-DRG 3171
Min. Negotiated Rate	$8,482.76
Max. Negotiated Rate	$13,216.63
Rate for Payer: Aetna Better Health Medicaid	$12,957.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,216.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8,482.76

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$48,168.49

Service Code	APR-DRG 3174
Min. Negotiated Rate	$45,507.44
Max. Negotiated Rate	$48,168.49
Rate for Payer: Aetna Better Health Medicaid	$45,507.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$46,417.59
Rate for Payer: Wellpoint Medicaid Managed Care	$48,168.49

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$17,046.35

Service Code	APR-DRG 3172
Min. Negotiated Rate	$11,900.42
Max. Negotiated Rate	$17,046.35
Rate for Payer: Aetna Better Health Medicaid	$16,712.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,046.35
Rate for Payer: Wellpoint Medicaid Managed Care	$11,900.42

TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES

Facility

$25,732.45

Service Code	APR-DRG 3173
Min. Negotiated Rate	$20,437.44
Max. Negotiated Rate	$25,732.45
Rate for Payer: Aetna Better Health Medicaid	$25,227.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,732.45
Rate for Payer: Wellpoint Medicaid Managed Care	$20,437.44

Know your out-of-pocket cost for care.

All Charges