Heights University Hospital

All Charges

Charge

Type

Setting

Price

DHEA-SULFATE

Facility

$306.45

Service Code	HCPCS 82627
Hospital Charge Code	3006194
Hospital Revenue Code	301
Min. Negotiated Rate	$45.97
Max. Negotiated Rate	$45.97
Rate for Payer: Qualcare PPO/HMO/WC	$45.97

DHEA-SULFATE

Facility

$306.45

Service Code	HCPCS 82627
Hospital Charge Code	3006194
Hospital Revenue Code	301
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$72.03
Rate for Payer: Aetna Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.45
Rate for Payer: Cigna Commercial	$22.23
Rate for Payer: Cigna Medicare Advantage	$11.12
Rate for Payer: Clover Medicare Advantage	$21.12
Rate for Payer: EmblemHealth Commercial	$66.69
Rate for Payer: Humana Medicare Advantage	$22.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.97
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.23
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.56
Rate for Payer: Wellcare Medicare Advantage	$22.23

D-HELP DEFOGGER

Facility

$279.31

Hospital Charge Code	270664269
Hospital Revenue Code	272
Min. Negotiated Rate	$41.90
Max. Negotiated Rate	$41.90
Rate for Payer: Qualcare PPO/HMO/WC	$41.90

D-HELP DEFOGGER

Facility

$279.31

Hospital Charge Code	270664269
Hospital Revenue Code	272
Min. Negotiated Rate	$36.31
Max. Negotiated Rate	$139.66
Rate for Payer: Aetna Commercial	$83.79
Rate for Payer: Aetna Medicare Advantage	$83.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.22
Rate for Payer: Cigna Commercial	$139.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.31
Rate for Payer: Oxford Commercial	$139.66
Rate for Payer: Qualcare PPO/HMO/WC	$41.90
Rate for Payer: UnitedHealthcare Commercial	$139.66

DHS COMPRESSION SCREW

Facility

$192.55

Service Code	HCPCS C1713
Hospital Charge Code	270682626
Hospital Revenue Code	278
Min. Negotiated Rate	$28.88
Max. Negotiated Rate	$46.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.60
Rate for Payer: Qualcare PPO/HMO/WC	$28.88

DHS COMPRESSION SCREW

Facility

$192.55

Service Code	HCPCS C1713
Hospital Charge Code	270682626
Hospital Revenue Code	278
Min. Negotiated Rate	$28.88
Max. Negotiated Rate	$96.28
Rate for Payer: Aetna Commercial	$57.77
Rate for Payer: Aetna Medicare Advantage	$57.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.10
Rate for Payer: Cigna Commercial	$96.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.60
Rate for Payer: Qualcare PPO/HMO/WC	$28.88

DHS/DCS COUPLING SCREW LONG

Facility

$479.40

Service Code	HCPCS C1713
Hospital Charge Code	270687790
Hospital Revenue Code	278
Min. Negotiated Rate	$71.91
Max. Negotiated Rate	$239.70
Rate for Payer: Aetna Commercial	$143.82
Rate for Payer: Aetna Medicare Advantage	$143.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.25
Rate for Payer: Cigna Commercial	$239.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.01
Rate for Payer: Qualcare PPO/HMO/WC	$71.91

DHS/DCS COUPLING SCREW LONG

Facility

$479.40

Service Code	HCPCS C1713
Hospital Charge Code	270687790
Hospital Revenue Code	278
Min. Negotiated Rate	$71.91
Max. Negotiated Rate	$116.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.01
Rate for Payer: Qualcare PPO/HMO/WC	$71.91

DHS/DCS WRENCH

Facility

$695.60

Hospital Charge Code	270687789
Hospital Revenue Code	272
Min. Negotiated Rate	$90.43
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$208.68
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.43
Rate for Payer: Oxford Commercial	$347.80
Rate for Payer: Qualcare PPO/HMO/WC	$104.34
Rate for Payer: UnitedHealthcare Commercial	$347.80

DHS/DCS WRENCH

Facility

$695.60

Hospital Charge Code	270687789
Hospital Revenue Code	272
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$104.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

DHS LAG SCREW-90MM

Facility

$1,495.85

Service Code	HCPCS C1713
Hospital Charge Code	270682627
Hospital Revenue Code	278
Min. Negotiated Rate	$224.38
Max. Negotiated Rate	$747.92
Rate for Payer: Aetna Commercial	$448.75
Rate for Payer: Aetna Medicare Advantage	$448.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.44
Rate for Payer: Cigna Commercial	$747.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$362.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.38

DHS LAG SCREW-90MM

Facility

$1,495.85

Service Code	HCPCS C1713
Hospital Charge Code	270682627
Hospital Revenue Code	278
Min. Negotiated Rate	$224.38
Max. Negotiated Rate	$362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$362.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.38

DHS PLATE

Facility

$785.00

Hospital Charge Code	270335052
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$235.50
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

DHS PLATE

Facility

$785.00

Hospital Charge Code	270335052
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

DHS PLATE135/2HOLE/46MM

Facility

$2,555.70

Service Code	HCPCS C1713
Hospital Charge Code	270682725
Hospital Revenue Code	278
Min. Negotiated Rate	$383.36
Max. Negotiated Rate	$618.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.48
Rate for Payer: Qualcare PPO/HMO/WC	$383.36

DHS PLATE135/2HOLE/46MM

Facility

$2,555.70

Service Code	HCPCS C1713
Hospital Charge Code	270682725
Hospital Revenue Code	278
Min. Negotiated Rate	$383.36
Max. Negotiated Rate	$1,277.85
Rate for Payer: Aetna Commercial	$766.71
Rate for Payer: Aetna Medicare Advantage	$766.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$651.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$651.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$511.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$651.70
Rate for Payer: Cigna Commercial	$1,277.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$618.48
Rate for Payer: Qualcare PPO/HMO/WC	$383.36

DHSREAMING HEAD STANDARD

Facility

$2,934.45

Hospital Charge Code	270683136
Hospital Revenue Code	272
Min. Negotiated Rate	$381.48
Max. Negotiated Rate	$1,467.22
Rate for Payer: Aetna Commercial	$880.34
Rate for Payer: Aetna Medicare Advantage	$880.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.28
Rate for Payer: Cigna Commercial	$1,467.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.48
Rate for Payer: Oxford Commercial	$1,467.22
Rate for Payer: Qualcare PPO/HMO/WC	$440.17
Rate for Payer: UnitedHealthcare Commercial	$1,467.22

DHSREAMING HEAD STANDARD

Facility

$2,934.45

Hospital Charge Code	270683136
Hospital Revenue Code	272
Min. Negotiated Rate	$440.17
Max. Negotiated Rate	$440.17
Rate for Payer: Qualcare PPO/HMO/WC	$440.17

DHT/0.125MG/TAB

Facility

$6.00

Hospital Charge Code	60632816
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DHT/0.125MG/TAB

Facility

$6.00

Hospital Charge Code	60632816
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632814
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632814
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632813
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

DHT/0.2MG/TAB

Facility

$6.00

Hospital Charge Code	60632813
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DHT/0.4MG/TAB

Facility

$6.00

Hospital Charge Code	60632815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

Know your out-of-pocket cost for care.

All Charges