Heights University Hospital

All Charges

Charge

Type

Setting

Price

DEEP DISSECT FOOT INF; SGL BUR

Facility

$17,164.20

Service Code	HCPCS 28002
Hospital Charge Code	160000248
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$5,149.26
Rate for Payer: Aetna Medicare Advantage	$5,149.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,376.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,376.87
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	$4,376.87
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,231.35
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,574.63
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

DEEP I&D ABSC - FARM/WRIST

Facility

$12,289.60

Service Code	HCPCS 25028
Hospital Charge Code	1600000522
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.44
Max. Negotiated Rate	$1,843.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44

DEEP I&D ABSC - FARM/WRIST

Facility

$12,289.60

Service Code	HCPCS 25028
Hospital Charge Code	1600000522
Hospital Revenue Code	360
Min. Negotiated Rate	$1,597.65
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,686.88
Rate for Payer: Aetna Medicare Advantage	$3,686.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,133.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,133.85
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	$3,133.85
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.65
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

DEEP I&D THIGH/KNEE

Facility

$16,680.90

Service Code	HCPCS 27301
Hospital Charge Code	16000507
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$5,004.27
Rate for Payer: Aetna Medicare Advantage	$5,004.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,253.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,253.63
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	$4,253.63
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,168.52
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

DEEP I&D THIGH/KNEE

Facility

$16,680.90

Service Code	HCPCS 27301
Hospital Charge Code	16000507
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.14
Max. Negotiated Rate	$2,502.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14

DEEP I&D - UA/ELBOW

Facility

$14,544.60

Service Code	HCPCS 23930
Hospital Charge Code	16000680
Hospital Revenue Code	360
Min. Negotiated Rate	$2,181.69
Max. Negotiated Rate	$2,181.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.69

DEEP I&D - UA/ELBOW

Facility

$14,544.60

Service Code	HCPCS 23930
Hospital Charge Code	16000680
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$4,363.38
Rate for Payer: Aetna Medicare Advantage	$4,363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,708.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,708.87
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	$3,708.87
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.80
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.69
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

DEEP INC FOOT W OP BONE CORTEX

Facility

$19,998.60

Service Code	HCPCS 28005
Hospital Charge Code	16000902
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

DEEP INC FOOT W OP BONE CORTEX

Facility

$19,998.60

Service Code	HCPCS 28005
Hospital Charge Code	16000902
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC

Facility

$30,048.03

Service Code	MSDRG 294
Min. Negotiated Rate	$30,048.03
Max. Negotiated Rate	$30,048.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,048.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,048.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,048.03

DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC

Facility

$22,053.60

Service Code	MSDRG 295
Min. Negotiated Rate	$22,053.60
Max. Negotiated Rate	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,053.60

DEFEROXAMINE 500 MG INJ

Facility

$147.94

Service Code	HCPCS J0895
Hospital Charge Code	6007744
Hospital Revenue Code	636
Min. Negotiated Rate	$22.19
Max. Negotiated Rate	$35.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.19

DEFEROXAMINE 500 MG INJ

Facility

$147.94

Service Code	HCPCS J0895
Hospital Charge Code	6007744
Hospital Revenue Code	636
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$44.38
Rate for Payer: Aetna Commercial	$44.38
Rate for Payer: Aetna Medicare Advantage	$44.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.72
Rate for Payer: Cigna Commercial	$8.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.19

DEFEROXAMINE INJ 500 MG

Facility

$73.00

Hospital Charge Code	6001630
Hospital Revenue Code	636
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$17.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.67
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

DEFEROXAMINE INJ 500 MG

Facility

$73.00

Hospital Charge Code	6001630
Hospital Revenue Code	636
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$21.90
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.67
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

DEFIBRILATOR ICD FORTIFY DR

Facility

$109,010.00

Hospital Charge Code	2709007369
Hospital Revenue Code	272
Min. Negotiated Rate	$14,171.30
Max. Negotiated Rate	$54,505.00
Rate for Payer: Aetna Commercial	$32,703.00
Rate for Payer: Aetna Medicare Advantage	$32,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,797.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,797.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,797.55
Rate for Payer: Cigna Commercial	$54,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,171.30
Rate for Payer: Oxford Commercial	$54,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$16,351.50
Rate for Payer: UnitedHealthcare Commercial	$54,505.00

DEFIBRILATOR ICD FORTIFY DR

Facility

$114,275.00

Hospital Charge Code	2709007370
Hospital Revenue Code	272
Min. Negotiated Rate	$17,141.25
Max. Negotiated Rate	$17,141.25
Rate for Payer: Qualcare PPO/HMO/WC	$17,141.25

DEFIBRILATOR ICD FORTIFY DR

Facility

$109,010.00

Hospital Charge Code	270CH0001
Hospital Revenue Code	278
Min. Negotiated Rate	$16,351.50
Max. Negotiated Rate	$26,380.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26,380.42
Rate for Payer: Qualcare PPO/HMO/WC	$16,351.50

DEFIBRILATOR ICD FORTIFY DR

Facility

$109,010.00

Hospital Charge Code	270CH0001
Hospital Revenue Code	278
Min. Negotiated Rate	$16,351.50
Max. Negotiated Rate	$54,505.00
Rate for Payer: Aetna Commercial	$32,703.00
Rate for Payer: Aetna Medicare Advantage	$32,703.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,797.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,797.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,802.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,797.55
Rate for Payer: Cigna Commercial	$54,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26,380.42
Rate for Payer: Qualcare PPO/HMO/WC	$16,351.50

DEFIBRILATOR ICD FORTIFY DR

Facility

$114,275.00

Hospital Charge Code	2709007370
Hospital Revenue Code	272
Min. Negotiated Rate	$14,855.75
Max. Negotiated Rate	$57,137.50
Rate for Payer: Aetna Commercial	$34,282.50
Rate for Payer: Aetna Medicare Advantage	$34,282.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,140.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,140.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,140.12
Rate for Payer: Cigna Commercial	$57,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,855.75
Rate for Payer: Oxford Commercial	$57,137.50
Rate for Payer: Qualcare PPO/HMO/WC	$17,141.25
Rate for Payer: UnitedHealthcare Commercial	$57,137.50

DEFIBRILATOR ICD FORTIFY DR

Facility

$109,010.00

Hospital Charge Code	2709007369
Hospital Revenue Code	272
Min. Negotiated Rate	$16,351.50
Max. Negotiated Rate	$16,351.50
Rate for Payer: Qualcare PPO/HMO/WC	$16,351.50

DEFIBRILATOR ICD FORTIFY VR

Facility

$105,475.00

Hospital Charge Code	270CH0002
Hospital Revenue Code	278
Min. Negotiated Rate	$15,821.25
Max. Negotiated Rate	$25,524.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,524.95
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25

DEFIBRILATOR ICD FORTIFY VR

Facility

$105,475.00

Hospital Charge Code	2709007368
Hospital Revenue Code	272
Min. Negotiated Rate	$15,821.25
Max. Negotiated Rate	$15,821.25
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25

DEFIBRILATOR ICD FORTIFY VR

Facility

$105,475.00

Hospital Charge Code	2709007368
Hospital Revenue Code	272
Min. Negotiated Rate	$13,711.75
Max. Negotiated Rate	$52,737.50
Rate for Payer: Aetna Commercial	$31,642.50
Rate for Payer: Aetna Medicare Advantage	$31,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,896.12
Rate for Payer: Cigna Commercial	$52,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,711.75
Rate for Payer: Oxford Commercial	$52,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25
Rate for Payer: UnitedHealthcare Commercial	$52,737.50

DEFIBRILATOR ICD FORTIFY VR

Facility

$105,475.00

Hospital Charge Code	270CH0002
Hospital Revenue Code	278
Min. Negotiated Rate	$15,821.25
Max. Negotiated Rate	$52,737.50
Rate for Payer: Aetna Commercial	$31,642.50
Rate for Payer: Aetna Medicare Advantage	$31,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,896.12
Rate for Payer: Cigna Commercial	$52,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,524.95
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25

Know your out-of-pocket cost for care.

All Charges