Heights University Hospital

All Charges

Charge

Type

Setting

Price

TIGHT ROPE ABS BUTTON 8X12MM

Facility

$715.00

Service Code	HCPCS C1713
Hospital Charge Code	270669603
Hospital Revenue Code	278
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$357.50
Rate for Payer: Aetna Commercial	$214.50
Rate for Payer: Aetna Medicare Advantage	$214.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.32
Rate for Payer: Cigna Commercial	$357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.03
Rate for Payer: Qualcare PPO/HMO/WC	$107.25

TIGHTROPE ABS IMPLANT OPEN

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	270666957
Hospital Revenue Code	278
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TIGHTROPE ABS IMPLANT OPEN

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	270666957
Hospital Revenue Code	278
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TIGHTROPE ABS ROUND 20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690896
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TIGHTROPE ABS ROUND 20MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270690896
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$336.00
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

TIGHT ROPE ACL FIBERTAG

Facility

$4,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695231
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,437.50
Rate for Payer: Aetna Commercial	$1,462.50
Rate for Payer: Aetna Medicare Advantage	$1,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,243.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,243.12
Rate for Payer: Cigna Commercial	$2,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

TIGHT ROPE ACL FIBERTAG

Facility

$4,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695231
Hospital Revenue Code	278
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$1,179.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,179.75
Rate for Payer: Qualcare PPO/HMO/WC	$731.25

TIGHT ROPE BUTTON EXTENDER

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270669639
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

TIGHT ROPE BUTTON EXTENDER

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270669639
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

TIGHTROPE BUTTRESS PLATE

Facility

$5,125.00

Hospital Charge Code	270670742
Hospital Revenue Code	278
Min. Negotiated Rate	$768.75
Max. Negotiated Rate	$1,240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,240.25
Rate for Payer: Qualcare PPO/HMO/WC	$768.75

TIGHTROPE BUTTRESS PLATE

Facility

$5,125.00

Hospital Charge Code	270670742
Hospital Revenue Code	278
Min. Negotiated Rate	$768.75
Max. Negotiated Rate	$2,562.50
Rate for Payer: Aetna Commercial	$1,537.50
Rate for Payer: Aetna Medicare Advantage	$1,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,306.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,306.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,306.88
Rate for Payer: Cigna Commercial	$2,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,240.25
Rate for Payer: Qualcare PPO/HMO/WC	$768.75

TIGHTROPE KNOTLESS SS

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270683274
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$2,200.00
Rate for Payer: Aetna Commercial	$1,320.00
Rate for Payer: Aetna Medicare Advantage	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.00
Rate for Payer: Cigna Commercial	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

TIGHTROPE KNOTLESS SS

Facility

$4,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270683274
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$1,064.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

TIGHTROPE KNOTLESS TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684365
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
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) NJ Health	$1,495.00
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	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHTROPE KNOTLESS TITANIUM XP

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270684365
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

TIGHT ROPE MINI 4.5X14MM

Facility

$3,400.00

Hospital Charge Code	270670500
Hospital Revenue Code	278
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$822.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.80
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

TIGHT ROPE MINI 4.5X14MM

Facility

$3,400.00

Hospital Charge Code	270670500
Hospital Revenue Code	278
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Aetna Commercial	$1,020.00
Rate for Payer: Aetna Medicare Advantage	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$867.00
Rate for Payer: Cigna Commercial	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$822.80
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

TIGHTROPE MINI REPAIR KIT

Facility

$3,750.00

Hospital Charge Code	270670041
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

TIGHTROPE MINI REPAIR KIT

Facility

$3,750.00

Hospital Charge Code	270670041
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

TIGHTROPE MINI SYST CMC

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693763
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

TIGHTROPE MINI SYST CMC

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693763
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

TIGHTROPE MINI W/INSERT

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270676820
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$907.50
Rate for Payer: Aetna Medicare Advantage	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.38
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

TIGHTROPE MINI W/INSERT

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270676820
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

TIGHTROPE RT W/10MM FLIPCUTTER

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270675758
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,012.50
Rate for Payer: Aetna Medicare Advantage	$1,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.62
Rate for Payer: Cigna Commercial	$1,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

TIGHTROPE RT W/10MM FLIPCUTTER

Facility

$3,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270675758
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$816.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$816.75
Rate for Payer: Qualcare PPO/HMO/WC	$506.25

Know your out-of-pocket cost for care.

All Charges