Heights University Hospital

All Charges

Charge

Type

Setting

Price

CITRATE (URINE)

Facility

$338.45

Service Code	HCPCS 82507
Hospital Charge Code	3009172
Hospital Revenue Code	301
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$90.07
Rate for Payer: Aetna Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.86
Rate for Payer: Cigna Commercial	$27.80
Rate for Payer: Cigna Medicare Advantage	$13.90
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$29.47
Rate for Payer: Wellcare Medicare Advantage	$27.80

CITRATE (URINE)

Facility

$338.45

Service Code	HCPCS 82507
Hospital Charge Code	3009172
Hospital Revenue Code	301
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

CITRATE URINE

Facility

$431.00

Service Code	HCPCS 82507
Hospital Charge Code	38473125
Hospital Revenue Code	301
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

CITRATE URINE

Facility

$431.00

Service Code	HCPCS 82507
Hospital Charge Code	38473125
Hospital Revenue Code	301
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$90.07
Rate for Payer: Aetna Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.86
Rate for Payer: Cigna Commercial	$27.80
Rate for Payer: Cigna Medicare Advantage	$13.90
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$29.47
Rate for Payer: Wellcare Medicare Advantage	$27.80

CITREFIX IMPLANT 2.9X12.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700363
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

CITREFIX IMPLANT 2.9X12.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700363
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

CITREFIX IMPLANT 3.5X15.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700361
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

CITREFIX IMPLANT 3.5X15.5MM

Facility

$3,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270700361
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

CITREFIX XPRESS IMPL2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700362
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$3,927.50
Rate for Payer: Aetna Commercial	$2,356.50
Rate for Payer: Aetna Medicare Advantage	$2,356.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,003.03
Rate for Payer: Cigna Commercial	$3,927.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS IMPL2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700362
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$1,900.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS IMPL3.5X15.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700364
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$3,927.50
Rate for Payer: Aetna Commercial	$2,356.50
Rate for Payer: Aetna Medicare Advantage	$2,356.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,003.03
Rate for Payer: Cigna Commercial	$3,927.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS IMPL3.5X15.5MM

Facility

$7,855.00

Service Code	HCPCS C1889
Hospital Charge Code	270700364
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$1,900.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS SYS 2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1713
Hospital Charge Code	270700346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$3,927.50
Rate for Payer: Aetna Commercial	$2,356.50
Rate for Payer: Aetna Medicare Advantage	$2,356.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,003.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,003.03
Rate for Payer: Cigna Commercial	$3,927.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS SYS 2.9X12.5MM

Facility

$7,855.00

Service Code	HCPCS C1713
Hospital Charge Code	270700346
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.25
Max. Negotiated Rate	$1,900.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,571.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,900.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,178.25

CITREFIX XPRESS SYS 4.5X24MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270700371
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

CITREFIX XPRESS SYS 4.5X24MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270700371
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

CITREGEN TENDON SIZING SYSTEM

Facility

$994.85

Hospital Charge Code	270701085
Hospital Revenue Code	279
Min. Negotiated Rate	$129.33
Max. Negotiated Rate	$497.43
Rate for Payer: Aetna Commercial	$298.45
Rate for Payer: Aetna Medicare Advantage	$298.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.69
Rate for Payer: Cigna Commercial	$497.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.33
Rate for Payer: Oxford Commercial	$497.43
Rate for Payer: Qualcare PPO/HMO/WC	$149.23
Rate for Payer: UnitedHealthcare Commercial	$497.43

CITREGEN TENDON SIZING SYSTEM

Facility

$994.85

Hospital Charge Code	270701085
Hospital Revenue Code	279
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$149.23
Rate for Payer: Qualcare PPO/HMO/WC	$149.23

CITRILOCK XPRESS IMPL SYS 5X15

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

CITRILOCK XPRESS IMPL SYS 5X15

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270701086
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

CK5/6-IHC

Facility

$2,164.00

Service Code	HCPCS 88342
Hospital Charge Code	4016883424
Hospital Revenue Code	310
Min. Negotiated Rate	$324.60
Max. Negotiated Rate	$324.60
Rate for Payer: Qualcare PPO/HMO/WC	$324.60

CK5/6-IHC

Facility

$2,164.00

Service Code	HCPCS 88342
Hospital Charge Code	4016883424
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$649.20
Rate for Payer: Aetna Commercial	$649.20
Rate for Payer: Aetna Medicare Advantage	$649.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$551.82
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CK ISOENZYMES

Facility

$403.00

Service Code	HCPCS 82552
Hospital Charge Code	38472007
Hospital Revenue Code	301
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.06
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.19
Rate for Payer: Wellcare Medicare Advantage	$13.39

CK ISOENZYMES

Facility

$83.00

Service Code	HCPCS 82552
Hospital Charge Code	3035131A
Hospital Revenue Code	301
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

CK ISOENZYMES

Facility

$83.00

Service Code	HCPCS 82552
Hospital Charge Code	3035131A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.06
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.19
Rate for Payer: Wellcare Medicare Advantage	$13.39

Know your out-of-pocket cost for care.

All Charges