Heights University Hospital

All Charges

Charge

Type

Setting

Price

CL TX PROX TIBIAL FX W SK TRCN

Facility

$14,872.30

Service Code	HCPCS 27532
Hospital Charge Code	16000887
Hospital Revenue Code	360
Min. Negotiated Rate	$2,230.84
Max. Negotiated Rate	$2,230.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,230.84

CL TX RADIAL HD/NK FX: W MANIP

Facility

$2,063.00

Service Code	HCPCS 24655
Hospital Charge Code	16000684
Hospital Revenue Code	360
Min. Negotiated Rate	$309.45
Max. Negotiated Rate	$309.45
Rate for Payer: Qualcare PPO/HMO/WC	$309.45

CL TX RADIAL HD/NK FX: W MANIP

Facility

$2,063.00

Service Code	HCPCS 24655
Hospital Charge Code	16000684
Hospital Revenue Code	360
Min. Negotiated Rate	$268.19
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$618.90
Rate for Payer: Aetna Medicare Advantage	$618.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.07
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	$526.07
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.19
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.45
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CLTX RADL&ULNA FX W MANIP

Facility

$2,244.48

Service Code	HCPCS 25565
Hospital Charge Code	1600000647
Hospital Revenue Code	360
Min. Negotiated Rate	$291.78
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$673.34
Rate for Payer: Aetna Medicare Advantage	$673.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.34
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	$572.34
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.78
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.67
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CLTX RADL&ULNA FX W MANIP

Facility

$2,244.48

Service Code	HCPCS 25565
Hospital Charge Code	1600000647
Hospital Revenue Code	360
Min. Negotiated Rate	$336.67
Max. Negotiated Rate	$336.67
Rate for Payer: Qualcare PPO/HMO/WC	$336.67

CL TX SCAPULA W/MANIP

Facility

$7,914.45

Service Code	HCPCS 23575
Hospital Charge Code	5780035
Hospital Revenue Code	450
Min. Negotiated Rate	$135.68
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$2,374.34
Rate for Payer: Aetna Medicare Advantage	$2,374.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,018.18
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.17

CL TX SCAPULA W/MANIP

Facility

$7,914.45

Service Code	HCPCS 23575
Hospital Charge Code	5780035
Hospital Revenue Code	450
Min. Negotiated Rate	$1,187.17
Max. Negotiated Rate	$1,187.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.17

CL TX SC/TX HMRS SHFT FX W MNP

Facility

$2,232.31

Service Code	HCPCS 24535
Hospital Charge Code	16000683
Hospital Revenue Code	360
Min. Negotiated Rate	$334.85
Max. Negotiated Rate	$334.85
Rate for Payer: Qualcare PPO/HMO/WC	$334.85

CL TX SC/TX HMRS SHFT FX W MNP

Facility

$2,232.31

Service Code	HCPCS 24535
Hospital Charge Code	16000683
Hospital Revenue Code	360
Min. Negotiated Rate	$290.20
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$669.69
Rate for Payer: Aetna Medicare Advantage	$669.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$569.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$569.24
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	$569.24
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.20
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$334.85
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CLTX SHLDR DISL W M;W ANSTH

Facility

$14,397.50

Service Code	HCPCS 23655
Hospital Charge Code	1600000646
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,319.25
Rate for Payer: Aetna Commercial	$4,319.25
Rate for Payer: Aetna Medicare Advantage	$4,319.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,671.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,671.36
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	$3,671.36
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,871.67
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,159.62
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CLTX SHLDR DISL W M;W ANSTH

Facility

$14,397.50

Service Code	HCPCS 23655
Hospital Charge Code	1600000646
Hospital Revenue Code	360
Min. Negotiated Rate	$2,159.62
Max. Negotiated Rate	$2,159.62
Rate for Payer: Qualcare PPO/HMO/WC	$2,159.62

CL TX TARSAL BONE DISC,W ANEST

Facility

$23,899.60

Service Code	HCPCS 28545
Hospital Charge Code	1600000697
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

CL TX TARSAL BONE DISC,W ANEST

Facility

$23,899.60

Service Code	HCPCS 28545
Hospital Charge Code	1600000697
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$7,169.88
Rate for Payer: Aetna Medicare Advantage	$7,169.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,094.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,094.40
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	$6,094.40
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,106.95
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CL TX TIB SHFT FX W MANIP RT

Facility

$19,424.65

Service Code	HCPCS 27752
Hospital Charge Code	1600000286
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,827.40
Rate for Payer: Aetna Commercial	$5,827.40
Rate for Payer: Aetna Medicare Advantage	$5,827.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,953.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,953.29
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	$4,953.29
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,525.20
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,913.70
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CL TX TIB SHFT FX W MANIP RT

Facility

$19,424.65

Service Code	HCPCS 27752
Hospital Charge Code	1600000286
Hospital Revenue Code	360
Min. Negotiated Rate	$2,913.70
Max. Negotiated Rate	$2,913.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,913.70

CL TX TMALL ANKLE FX W MANIP

Facility

$5,332.00

Service Code	HCPCS 27818
Hospital Charge Code	1600000427
Hospital Revenue Code	360
Min. Negotiated Rate	$799.80
Max. Negotiated Rate	$799.80
Rate for Payer: Qualcare PPO/HMO/WC	$799.80

CL TX TMALL ANKLE FX W MANIP

Facility

$5,332.00

Service Code	HCPCS 27818
Hospital Charge Code	1600000427
Hospital Revenue Code	360
Min. Negotiated Rate	$693.16
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$1,599.60
Rate for Payer: Aetna Medicare Advantage	$1,599.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,359.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,359.66
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	$1,359.66
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$693.16
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$799.80
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

CL TX TRANS-SCAPHOPERILU FX W

Facility

$1,241.80

Service Code	HCPCS 25680
Hospital Charge Code	5780065
Hospital Revenue Code	450
Min. Negotiated Rate	$161.43
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$372.54
Rate for Payer: Aetna Medicare Advantage	$372.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.66
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.43
Rate for Payer: Qualcare PPO/HMO/WC	$186.27

CL TX TRANS-SCAPHOPERILU FX W

Facility

$1,241.80

Service Code	HCPCS 25680
Hospital Charge Code	5780065
Hospital Revenue Code	450
Min. Negotiated Rate	$186.27
Max. Negotiated Rate	$186.27
Rate for Payer: Qualcare PPO/HMO/WC	$186.27

CL TX ULNAR SHFT FX W MANIP

Facility

$2,063.00

Service Code	HCPCS 25535
Hospital Charge Code	16000692
Hospital Revenue Code	360
Min. Negotiated Rate	$268.19
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$618.90
Rate for Payer: Aetna Medicare Advantage	$618.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.07
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	$526.07
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.19
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.45
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CL TX ULNAR SHFT FX W MANIP

Facility

$2,063.00

Service Code	HCPCS 25535
Hospital Charge Code	16000692
Hospital Revenue Code	360
Min. Negotiated Rate	$309.45
Max. Negotiated Rate	$309.45
Rate for Payer: Qualcare PPO/HMO/WC	$309.45

CL TX WB DSTL TIB FX W MANIP

Facility

$6,728.28

Service Code	HCPCS 27828
Hospital Charge Code	1600000715
Hospital Revenue Code	360
Min. Negotiated Rate	$1,009.24
Max. Negotiated Rate	$1,009.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.24

CL TX WB DSTL TIB FX W MANIP

Facility

$15,476.60

Service Code	HCPCS 27825
Hospital Charge Code	16000480
Hospital Revenue Code	360
Min. Negotiated Rate	$2,321.49
Max. Negotiated Rate	$2,321.49
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.49

CL TX WB DSTL TIB FX W MANIP

Facility

$15,476.60

Service Code	HCPCS 27825
Hospital Charge Code	16000480
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,642.98
Rate for Payer: Aetna Commercial	$4,642.98
Rate for Payer: Aetna Medicare Advantage	$4,642.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,946.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,946.53
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	$3,946.53
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,011.96
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,321.49
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CL TX WB DSTL TIB FX W MANIP

Facility

$6,728.28

Service Code	HCPCS 27828
Hospital Charge Code	1600000715
Hospital Revenue Code	360
Min. Negotiated Rate	$874.68
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$2,018.48
Rate for Payer: Aetna Medicare Advantage	$2,018.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,715.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,715.71
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	$1,715.71
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$874.68
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.24
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

Know your out-of-pocket cost for care.

All Charges