Heights University Hospital

All Charges

Charge

Type

Setting

Price

DX ER ANKLE COMPLETE BILA

Facility

$250.00

Service Code	HCPCS 7361050
Hospital Charge Code	94270105
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER ANKLE COMPLETE LT

Facility

$332.00

Service Code	HCPCS 73610LT
Hospital Charge Code	94270223
Hospital Revenue Code	320
Min. Negotiated Rate	$49.80
Max. Negotiated Rate	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$49.80

DX ER ANKLE COMPLETE LT

Facility

$332.00

Service Code	HCPCS 73610LT
Hospital Charge Code	94270223
Hospital Revenue Code	320
Min. Negotiated Rate	$43.16
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$99.60
Rate for Payer: Aetna Medicare Advantage	$99.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.66
Rate for Payer: Cigna Commercial	$166.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.16
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER ANKLE COMPLETE RT

Facility

$6,601.19

Service Code	HCPCS 73610RT
Hospital Charge Code	94270225
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER ANKLE COMPLETE RT

Facility

$6,601.19

Service Code	HCPCS 73610RT
Hospital Charge Code	94270225
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

DX ER BONE EVAL INFANT

Facility

$553.00

Service Code	HCPCS 77076
Hospital Charge Code	94270069
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$165.90
Rate for Payer: Aetna Medicare Advantage	$165.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.01
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.89
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.95
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

DX ER BONE EVAL INFANT

Facility

$553.00

Service Code	HCPCS 77076
Hospital Charge Code	94270069
Hospital Revenue Code	320
Min. Negotiated Rate	$82.95
Max. Negotiated Rate	$82.95
Rate for Payer: Qualcare PPO/HMO/WC	$82.95

DX ER CERVICAL SPINE 2 VW

Facility

$378.00

Service Code	HCPCS 72040
Hospital Charge Code	94270039
Hospital Revenue Code	320
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$56.70
Rate for Payer: Qualcare PPO/HMO/WC	$56.70

DX ER CERVICAL SPINE 2 VW

Facility

$378.00

Service Code	HCPCS 72040
Hospital Charge Code	94270039
Hospital Revenue Code	320
Min. Negotiated Rate	$33.19
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$242.34
Rate for Payer: Aetna Commercial	$113.40
Rate for Payer: Aetna Medicare Advantage	$113.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.39
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.70
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$247.19

DX ER CERVICAL SPINE COMP

Facility

$817.00

Service Code	HCPCS 72052
Hospital Charge Code	94270041
Hospital Revenue Code	320
Min. Negotiated Rate	$122.55
Max. Negotiated Rate	$122.55
Rate for Payer: Qualcare PPO/HMO/WC	$122.55

DX ER CERVICAL SPINE COMP

Facility

$817.00

Service Code	HCPCS 72052
Hospital Charge Code	94270041
Hospital Revenue Code	320
Min. Negotiated Rate	$59.02
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$309.88
Rate for Payer: Aetna Commercial	$245.10
Rate for Payer: Aetna Medicare Advantage	$245.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.34
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.21
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.55
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$316.08

DX ER CERV SPINE CROSTABL

Facility

$250.00

Service Code	HCPCS 72020
Hospital Charge Code	94270037
Hospital Revenue Code	320
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

DX ER CERV SPINE CROSTABL

Facility

$250.00

Service Code	HCPCS 72020
Hospital Charge Code	94270037
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

DX ER CHEST MULTIPLE VIEW

Facility

$416.00

Service Code	HCPCS 71030
Hospital Charge Code	94270027
Hospital Revenue Code	324
Min. Negotiated Rate	$54.08
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$124.80
Rate for Payer: Aetna Medicare Advantage	$124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.08
Rate for Payer: Cigna Commercial	$208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.08
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.40
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER CHEST MULTIPLE VIEW

Facility

$416.00

Service Code	HCPCS 71030
Hospital Charge Code	94270027
Hospital Revenue Code	324
Min. Negotiated Rate	$62.40
Max. Negotiated Rate	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$62.40

DX ER CHEST SINGLE VIEW

Facility

$582.98

Service Code	HCPCS 71010
Hospital Charge Code	94270023
Hospital Revenue Code	324
Min. Negotiated Rate	$75.79
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$1,212.34
Rate for Payer: Aetna Commercial	$174.89
Rate for Payer: Aetna Medicare Advantage	$174.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.66
Rate for Payer: Cigna Commercial	$291.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.79
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.45
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,236.59

DX ER CHEST SINGLE VIEW

Facility

$582.98

Service Code	HCPCS 71010
Hospital Charge Code	94270023
Hospital Revenue Code	324
Min. Negotiated Rate	$87.45
Max. Negotiated Rate	$87.45
Rate for Payer: Qualcare PPO/HMO/WC	$87.45

DX ER CHEST TWO VIEWS

Facility

$610.00

Service Code	HCPCS 71020
Hospital Charge Code	94270025
Hospital Revenue Code	324
Min. Negotiated Rate	$79.30
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$1,212.34
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,236.59

DX ER CHEST TWO VIEWS

Facility

$610.00

Service Code	HCPCS 71020
Hospital Charge Code	94270025
Hospital Revenue Code	324
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

DX ER CLAVICLE COMP BIL

Facility

$250.00

Service Code	HCPCS 7300050
Hospital Charge Code	94270073
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

DX ER CLAVICLE COMP BIL

Facility

$250.00

Service Code	HCPCS 7300050
Hospital Charge Code	94270073
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER CLAVICLE COMPLET LT

Facility

$284.00

Service Code	HCPCS 73000LT
Hospital Charge Code	94270129
Hospital Revenue Code	320
Min. Negotiated Rate	$36.92
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$85.20
Rate for Payer: Aetna Medicare Advantage	$85.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.42
Rate for Payer: Cigna Commercial	$142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.92
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.60
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER CLAVICLE COMPLET LT

Facility

$284.00

Service Code	HCPCS 73000LT
Hospital Charge Code	94270129
Hospital Revenue Code	320
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$42.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

DX ER CLAVICLE COMP RT

Facility

$250.00

Service Code	HCPCS 73000RT
Hospital Charge Code	94270131
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

DX ER CLAVICLE COMP RT

Facility

$250.00

Service Code	HCPCS 73000RT
Hospital Charge Code	94270131
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

Know your out-of-pocket cost for care.

All Charges