Heights University Hospital

All Charges

Charge

Type

Setting

Price

CLUB HOUSE GROUP THERAPY NON M

Facility

$433.40

Service Code	HCPCS 90849
Hospital Charge Code	87504160
Hospital Revenue Code	913
Min. Negotiated Rate	$56.34
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$130.02
Rate for Payer: Aetna Medicare Advantage	$130.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.52
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.34
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

CLUB HOUSE GROUP THERAPY NON M

Facility

$433.40

Service Code	HCPCS 90849
Hospital Charge Code	87504160
Hospital Revenue Code	913
Min. Negotiated Rate	$65.01
Max. Negotiated Rate	$65.01
Rate for Payer: Qualcare PPO/HMO/WC	$65.01

CL,URINE RANDOM

Facility

$517.00

Service Code	HCPCS 82340
Hospital Charge Code	38479032
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.54
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.09
Rate for Payer: Cigna Commercial	$6.03
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.73
Rate for Payer: EmblemHealth Commercial	$18.09
Rate for Payer: Humana Medicare Advantage	$6.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.39
Rate for Payer: Wellcare Medicare Advantage	$6.03

CL,URINE RANDOM

Facility

$517.00

Service Code	HCPCS 82340
Hospital Charge Code	38479032
Hospital Revenue Code	301
Min. Negotiated Rate	$77.55
Max. Negotiated Rate	$77.55
Rate for Payer: Qualcare PPO/HMO/WC	$77.55

CLUSTER SHELL CEMENTLESS 60MM

Facility

$5,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706143
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CLUSTER SHELL CEMENTLESS 60MM

Facility

$5,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706143
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

C-MATCH REINSTATE RESLTD UNITS

Facility

$100.00

Service Code	HCPCS 86920
Hospital Charge Code	3100344
Hospital Revenue Code	300
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

C-MATCH REINSTATE RESLTD UNITS

Facility

$100.00

Service Code	HCPCS 86920
Hospital Charge Code	3100344
Hospital Revenue Code	300
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

CMFLG TAILORSPLNT 3/32 2.4MM

Facility

$410.75

Hospital Charge Code	270663150
Hospital Revenue Code	270
Min. Negotiated Rate	$53.40
Max. Negotiated Rate	$205.38
Rate for Payer: Aetna Commercial	$123.22
Rate for Payer: Aetna Medicare Advantage	$123.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.74
Rate for Payer: Cigna Commercial	$205.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.40
Rate for Payer: Oxford Commercial	$205.38
Rate for Payer: Qualcare PPO/HMO/WC	$61.61
Rate for Payer: UnitedHealthcare Commercial	$205.38

CMFLG TAILORSPLNT 3/32 2.4MM

Facility

$410.75

Hospital Charge Code	270663150
Hospital Revenue Code	270
Min. Negotiated Rate	$61.61
Max. Negotiated Rate	$61.61
Rate for Payer: Qualcare PPO/HMO/WC	$61.61

CMNTLESFMORLSTEMSTD2SZ14CORAIL

Facility

$42,030.00

Hospital Charge Code	270663841
Hospital Revenue Code	278
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$10,171.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

CMNTLESFMORLSTEMSTD2SZ14CORAIL

Facility

$42,030.00

Hospital Charge Code	270663841
Hospital Revenue Code	278
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$21,015.00
Rate for Payer: Aetna Commercial	$12,609.00
Rate for Payer: Aetna Medicare Advantage	$12,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,717.65
Rate for Payer: Cigna Commercial	$21,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

C MOTOR EVOKED UPPR&LWR LIMBS

Facility

$5,325.60

Service Code	HCPCS 95939
Hospital Charge Code	321095939
Hospital Revenue Code	920
Min. Negotiated Rate	$798.84
Max. Negotiated Rate	$798.84
Rate for Payer: Qualcare PPO/HMO/WC	$798.84

C MOTOR EVOKED UPPR&LWR LIMBS

Facility

$5,325.60

Service Code	HCPCS 95939
Hospital Charge Code	321095939
Hospital Revenue Code	920
Min. Negotiated Rate	$235.88
Max. Negotiated Rate	$2,044.99
Rate for Payer: Aetna Commercial	$1,597.68
Rate for Payer: Aetna Medicare Advantage	$1,597.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,358.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,358.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,358.03
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.33
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$798.84
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CMPLX REPAIR TRUNK 2.6-7.5 cm

Facility

$5,105.84

Service Code	HCPCS 13101
Hospital Charge Code	16000198
Hospital Revenue Code	360
Min. Negotiated Rate	$663.76
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,531.75
Rate for Payer: Aetna Medicare Advantage	$1,531.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,301.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,301.99
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	$1,301.99
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.76
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.88
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CMPLX REPAIR TRUNK 2.6-7.5 cm

Facility

$5,105.84

Service Code	HCPCS 13101
Hospital Charge Code	16000198
Hospital Revenue Code	360
Min. Negotiated Rate	$765.88
Max. Negotiated Rate	$765.88
Rate for Payer: Qualcare PPO/HMO/WC	$765.88

CMPLX RPR TRUNK ADDL 5CM/<

Facility

$4,899.30

Service Code	HCPCS 13102
Hospital Charge Code	16000261
Hospital Revenue Code	360
Min. Negotiated Rate	$734.89
Max. Negotiated Rate	$734.89
Rate for Payer: Qualcare PPO/HMO/WC	$734.89

CMPLX RPR TRUNK ADDL 5CM/<

Facility

$4,899.30

Service Code	HCPCS 13102
Hospital Charge Code	16000261
Hospital Revenue Code	360
Min. Negotiated Rate	$64.82
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,469.79
Rate for Payer: Aetna Medicare Advantage	$1,469.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.32
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	$1,249.32
Rate for Payer: Cigna Commercial	$64.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$636.91
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$734.89
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

C MRSA SCREEN

Facility

$735.08

Service Code	HCPCS 87081
Hospital Charge Code	3008878
Hospital Revenue Code	309
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.48
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.29
Rate for Payer: Cigna Commercial	$6.63
Rate for Payer: Cigna Medicare Advantage	$3.31
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.26
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.03
Rate for Payer: Wellcare Medicare Advantage	$6.63

C MRSA SCREEN

Facility

$735.08

Service Code	HCPCS 87081
Hospital Charge Code	3008878
Hospital Revenue Code	309
Min. Negotiated Rate	$110.26
Max. Negotiated Rate	$110.26
Rate for Payer: Qualcare PPO/HMO/WC	$110.26

CMV AB CSF

Facility

$188.85

Service Code	HCPCS 86644
Hospital Charge Code	3035093
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

CMV AB CSF

Facility

$188.85

Service Code	HCPCS 86644
Hospital Charge Code	3035093
Hospital Revenue Code	302
Min. Negotiated Rate	$28.33
Max. Negotiated Rate	$28.33
Rate for Payer: Qualcare PPO/HMO/WC	$28.33

CMV AB (IGG)

Facility

$390.00

Service Code	HCPCS 86644
Hospital Charge Code	39900231
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

CMV AB (IGG)

Facility

$390.00

Service Code	HCPCS 86644
Hospital Charge Code	39900231
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CMV AB (IGG,IGM) I

Facility

$667.59

Service Code	HCPCS 86644
Hospital Charge Code	39990092A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

Know your out-of-pocket cost for care.

All Charges