Heights University Hospital

All Charges

Charge

Type

Setting

Price

TENODESIS LG TENDON BICEPTSLT

Facility

$44,916.00

Service Code	HCPCS 23430
Hospital Charge Code	16000324
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

TENODESIS LG TENDON BICEPTSLT

Facility

$44,916.00

Service Code	HCPCS 23430
Hospital Charge Code	16000324
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$13,474.80
Rate for Payer: Aetna Medicare Advantage	$13,474.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,453.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,453.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,453.58
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,839.08
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

TENODESIS OF BICEPS TNDNAT EL

Facility

$44,916.00

Service Code	HCPCS 24340
Hospital Charge Code	16000614
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

TENODESIS OF BICEPS TNDNAT EL

Facility

$44,916.00

Service Code	HCPCS 24340
Hospital Charge Code	16000614
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$13,474.80
Rate for Payer: Aetna Medicare Advantage	$13,474.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,453.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,453.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,453.58
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,839.08
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

TENOFOVIR 25MG TABLET

Facility

$326.89

Service Code	NDC 61958230101
Hospital Charge Code	6063943395
Hospital Revenue Code	250
Min. Negotiated Rate	$49.03
Max. Negotiated Rate	$49.03
Rate for Payer: Qualcare PPO/HMO/WC	$49.03

TENOFOVIR 25MG TABLET

Facility

$326.89

Service Code	NDC 61958230101
Hospital Charge Code	6063943395
Hospital Revenue Code	250
Min. Negotiated Rate	$42.50
Max. Negotiated Rate	$163.44
Rate for Payer: Aetna Commercial	$98.07
Rate for Payer: Aetna Medicare Advantage	$98.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$163.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.50
Rate for Payer: Oxford Commercial	$163.44
Rate for Payer: Qualcare PPO/HMO/WC	$49.03
Rate for Payer: UnitedHealthcare Commercial	$163.44

TENOFOVIR 300 MG TAB

Facility

$250.11

Service Code	NDC 61958040101
Hospital Charge Code	60629216
Hospital Revenue Code	250
Min. Negotiated Rate	$32.51
Max. Negotiated Rate	$125.06
Rate for Payer: Aetna Commercial	$75.03
Rate for Payer: Aetna Medicare Advantage	$75.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.78
Rate for Payer: Cigna Commercial	$125.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.51
Rate for Payer: Oxford Commercial	$125.06
Rate for Payer: Qualcare PPO/HMO/WC	$37.52
Rate for Payer: UnitedHealthcare Commercial	$125.06

TENOFOVIR 300 MG TAB

Facility

$250.11

Service Code	NDC 61958040101
Hospital Charge Code	60629216
Hospital Revenue Code	250
Min. Negotiated Rate	$37.52
Max. Negotiated Rate	$37.52
Rate for Payer: Qualcare PPO/HMO/WC	$37.52

TENOGLIDE TENSON PROTECTOR

Facility

$14,160.05

Service Code	HCPCS C9356
Hospital Charge Code	270688263
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.01
Max. Negotiated Rate	$7,080.02
Rate for Payer: Aetna Commercial	$4,248.02
Rate for Payer: Aetna Medicare Advantage	$4,248.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,610.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,610.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,610.81
Rate for Payer: Cigna Commercial	$7,080.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.01

TENOGLIDE TENSON PROTECTOR

Facility

$14,160.05

Service Code	HCPCS C9356
Hospital Charge Code	270688263
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.01
Max. Negotiated Rate	$3,426.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.01

TENOMYOTOMY SHOULDER,SINGLE R

Facility

$30,595.00

Service Code	HCPCS 23405
Hospital Charge Code	16000502
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

TENOMYOTOMY SHOULDER,SINGLE R

Facility

$30,595.00

Service Code	HCPCS 23405
Hospital Charge Code	16000502
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$9,178.50
Rate for Payer: Aetna Medicare Advantage	$9,178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,801.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,801.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,801.73
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,977.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

TENORETIC-100/TAB

Facility

$5.00

Hospital Charge Code	60634400
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

TENORETIC-100/TAB

Facility

$5.00

Hospital Charge Code	60634400
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

TENORETIC 50/TAB

Facility

$6.00

Hospital Charge Code	60633984
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TENORETIC 50/TAB

Facility

$6.00

Hospital Charge Code	60633984
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

TENORMIN/100MG/TAB

Facility

$5.00

Hospital Charge Code	60633985
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

TENORMIN/100MG/TAB

Facility

$5.00

Hospital Charge Code	60633987
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

TENORMIN/100MG/TAB

Facility

$5.00

Hospital Charge Code	60633985
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

TENORMIN/100MG/TAB

Facility

$5.00

Hospital Charge Code	60633987
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

TENORMIN/50MG/TAB

Facility

$7.00

Hospital Charge Code	60633986
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

TENORMIN/50MG/TAB

Facility

$5.00

Hospital Charge Code	60633988
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

TENORMIN/50MG/TAB

Facility

$5.00

Hospital Charge Code	60633988
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

TENORMIN/50MG/TAB

Facility

$7.00

Hospital Charge Code	60633986
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

TENOTMY OP FLEXOR,TOE SINGLE

Facility

$21,066.25

Service Code	HCPCS 28232
Hospital Charge Code	16000416
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,319.88
Rate for Payer: Aetna Commercial	$6,319.88
Rate for Payer: Aetna Medicare Advantage	$6,319.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,371.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,371.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,371.89
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.61
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

Know your out-of-pocket cost for care.

All Charges