Heights University Hospital

All Charges

Charge

Type

Setting

Price

AFB SENSITIVITY

Facility

$79.00

Service Code	HCPCS 87190
Hospital Charge Code	38475083
Hospital Revenue Code	309
Min. Negotiated Rate	$11.85
Max. Negotiated Rate	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$11.85

AFB SENSITIVITY

Facility

$79.00

Service Code	HCPCS 87190
Hospital Charge Code	38475083
Hospital Revenue Code	309
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.68
Rate for Payer: Aetna Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.78
Rate for Payer: Cigna Commercial	$7.31
Rate for Payer: Cigna Medicare Advantage	$3.65
Rate for Payer: Clover Medicare Advantage	$6.94
Rate for Payer: EmblemHealth Commercial	$21.93
Rate for Payer: Humana Medicare Advantage	$7.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.75
Rate for Payer: Wellcare Medicare Advantage	$7.31

AFB SMEAR

Facility

$152.00

Service Code	HCPCS 87206
Hospital Charge Code	38479466
Hospital Revenue Code	309
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

AFB SMEAR

Facility

$152.00

Service Code	HCPCS 87206
Hospital Charge Code	38479498
Hospital Revenue Code	309
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

AFB SMEAR

Facility

$152.00

Service Code	HCPCS 87206
Hospital Charge Code	38475092
Hospital Revenue Code	309
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

AFB SMEAR

Facility

$152.00

Service Code	HCPCS 87206
Hospital Charge Code	38475092
Hospital Revenue Code	309
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

AFB SMEAR

Facility

$152.00

Service Code	HCPCS 87206
Hospital Charge Code	38479498
Hospital Revenue Code	309
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

AFB SMEAR

Facility

$152.00

Service Code	HCPCS 87206
Hospital Charge Code	38479466
Hospital Revenue Code	309
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

AFFIX II IMPLANT -45MM

Facility

$29,840.00

Hospital Charge Code	270658008
Hospital Revenue Code	278
Min. Negotiated Rate	$4,476.00
Max. Negotiated Rate	$7,221.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,968.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,221.28
Rate for Payer: Qualcare PPO/HMO/WC	$4,476.00

AFFIX II IMPLANT -45MM

Facility

$29,840.00

Hospital Charge Code	270658008
Hospital Revenue Code	278
Min. Negotiated Rate	$4,476.00
Max. Negotiated Rate	$14,920.00
Rate for Payer: Aetna Commercial	$8,952.00
Rate for Payer: Aetna Medicare Advantage	$8,952.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,609.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,609.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,609.20
Rate for Payer: Cigna Commercial	$14,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,221.28
Rate for Payer: Qualcare PPO/HMO/WC	$4,476.00

AFFIXUS CORTICAL BONE SCREW 4X

Facility

$1,323.00

Service Code	HCPCS C1713
Hospital Charge Code	270704517
Hospital Revenue Code	278
Min. Negotiated Rate	$198.45
Max. Negotiated Rate	$320.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.17
Rate for Payer: Qualcare PPO/HMO/WC	$198.45

AFFIXUS CORTICAL BONE SCREW 4X

Facility

$1,323.00

Service Code	HCPCS C1713
Hospital Charge Code	270704517
Hospital Revenue Code	278
Min. Negotiated Rate	$198.45
Max. Negotiated Rate	$661.50
Rate for Payer: Aetna Commercial	$396.90
Rate for Payer: Aetna Medicare Advantage	$396.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.37
Rate for Payer: Cigna Commercial	$661.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.17
Rate for Payer: Qualcare PPO/HMO/WC	$198.45

AFFIXUS CORTICAL BONE SCREW 4X

Facility

$1,323.00

Service Code	HCPCS C1713
Hospital Charge Code	270704513
Hospital Revenue Code	278
Min. Negotiated Rate	$198.45
Max. Negotiated Rate	$320.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.17
Rate for Payer: Qualcare PPO/HMO/WC	$198.45

AFFIXUS CORTICAL BONE SCREW 4X

Facility

$1,323.00

Service Code	HCPCS C1713
Hospital Charge Code	270704513
Hospital Revenue Code	278
Min. Negotiated Rate	$198.45
Max. Negotiated Rate	$661.50
Rate for Payer: Aetna Commercial	$396.90
Rate for Payer: Aetna Medicare Advantage	$396.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.37
Rate for Payer: Cigna Commercial	$661.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.17
Rate for Payer: Qualcare PPO/HMO/WC	$198.45

AFFIXUS HIP FRAC NAIL 125D 13X

Facility

$9,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270705120
Hospital Revenue Code	278
Min. Negotiated Rate	$1,476.75
Max. Negotiated Rate	$4,922.50
Rate for Payer: Aetna Commercial	$2,953.50
Rate for Payer: Aetna Medicare Advantage	$2,953.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,510.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,510.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,969.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,510.47
Rate for Payer: Cigna Commercial	$4,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,382.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,476.75

AFFIXUS HIP FRAC NAIL 125D 13X

Facility

$9,845.00

Service Code	HCPCS C1713
Hospital Charge Code	270705120
Hospital Revenue Code	278
Min. Negotiated Rate	$1,476.75
Max. Negotiated Rate	$2,382.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,969.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,382.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,476.75

AFFIXUS In cap flush impinging

Facility

$790.00

Hospital Charge Code	270679375
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$237.00
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

AFFIXUS In cap flush impinging

Facility

$790.00

Hospital Charge Code	270679375
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

AFFIXUS PROXIMAL HUMERUS RIGHT

Facility

$13,147.30

Service Code	HCPCS C1713
Hospital Charge Code	270704514
Hospital Revenue Code	278
Min. Negotiated Rate	$1,972.10
Max. Negotiated Rate	$6,573.65
Rate for Payer: Aetna Commercial	$3,944.19
Rate for Payer: Aetna Medicare Advantage	$3,944.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,352.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,352.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,629.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,352.56
Rate for Payer: Cigna Commercial	$6,573.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,181.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,972.10

AFFIXUS PROXIMAL HUMERUS RIGHT

Facility

$13,147.30

Service Code	HCPCS C1713
Hospital Charge Code	270704514
Hospital Revenue Code	278
Min. Negotiated Rate	$1,972.10
Max. Negotiated Rate	$3,181.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,629.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,181.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,972.10

AFFIXUX BLUNT TIP SCREW 4 X 40

Facility

$965.00

Service Code	HCPCS C1713
Hospital Charge Code	270688147
Hospital Revenue Code	278
Min. Negotiated Rate	$144.75
Max. Negotiated Rate	$482.50
Rate for Payer: Aetna Commercial	$289.50
Rate for Payer: Aetna Medicare Advantage	$289.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.07
Rate for Payer: Cigna Commercial	$482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$144.75

AFFIXUX BLUNT TIP SCREW 4 X 40

Facility

$965.00

Service Code	HCPCS C1713
Hospital Charge Code	270688147
Hospital Revenue Code	278
Min. Negotiated Rate	$144.75
Max. Negotiated Rate	$233.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$144.75

AFFIXUX HUM CALIB DRILL 3.3MM

Facility

$2,240.00

Hospital Charge Code	270688154
Hospital Revenue Code	272
Min. Negotiated Rate	$291.20
Max. Negotiated Rate	$1,120.00
Rate for Payer: Aetna Commercial	$672.00
Rate for Payer: Aetna Medicare Advantage	$672.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.20
Rate for Payer: Cigna Commercial	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.20
Rate for Payer: Oxford Commercial	$1,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00
Rate for Payer: UnitedHealthcare Commercial	$1,120.00

AFFIXUX HUM CALIB DRILL 3.3MM

Facility

$2,240.00

Hospital Charge Code	270688154
Hospital Revenue Code	272
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$336.00
Rate for Payer: Qualcare PPO/HMO/WC	$336.00

AFIXIS NAIL AR HUMUNIV 7.5 X 2

Facility

$8,765.00

Service Code	HCPCS C1713
Hospital Charge Code	270688146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,314.75
Max. Negotiated Rate	$4,382.50
Rate for Payer: Aetna Commercial	$2,629.50
Rate for Payer: Aetna Medicare Advantage	$2,629.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,235.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,235.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,753.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,235.07
Rate for Payer: Cigna Commercial	$4,382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,314.75

Know your out-of-pocket cost for care.

All Charges