Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELASE/10GM

Facility

$84.00

Hospital Charge Code	60632928
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

ELASE/10GM

Facility

$84.00

Hospital Charge Code	60632928
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

ELASE-CHLOROMYCETIN/10GM

Facility

$89.00

Hospital Charge Code	60632929
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

ELASE-CHLOROMYCETIN/10GM

Facility

$89.00

Hospital Charge Code	60632929
Hospital Revenue Code	250
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$26.70
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.57
Rate for Payer: Oxford Commercial	$44.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$44.50

ELASTIC BANDAGE

Facility

$40.00

Hospital Charge Code	84202110
Hospital Revenue Code	270
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$20.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$20.00

ELASTIC BANDAGE

Facility

$40.00

Hospital Charge Code	84202110
Hospital Revenue Code	270
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

ELASTIKON 4X 5YD

Facility

$55.00

Hospital Charge Code	270331857
Hospital Revenue Code	272
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

ELASTIKON 4X 5YD

Facility

$55.00

Hospital Charge Code	270331857
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

ELASTOGRAPHY 1ST TAR LESION

Facility

$1,836.40

Service Code	HCPCS 76982
Hospital Charge Code	404276982
Hospital Revenue Code	402
Min. Negotiated Rate	$80.52
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$550.92
Rate for Payer: Aetna Medicare Advantage	$550.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$468.28
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.73
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.46
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

ELASTOGRAPHY 1ST TAR LESION

Facility

$1,836.40

Service Code	HCPCS 76982
Hospital Charge Code	404276982
Hospital Revenue Code	402
Min. Negotiated Rate	$275.46
Max. Negotiated Rate	$275.46
Rate for Payer: Qualcare PPO/HMO/WC	$275.46

ELASTOGRAPHY EA ADDL TARGET

Facility

$1,836.40

Service Code	HCPCS 76983
Hospital Charge Code	404276983
Hospital Revenue Code	402
Min. Negotiated Rate	$275.46
Max. Negotiated Rate	$275.46
Rate for Payer: Qualcare PPO/HMO/WC	$275.46

ELASTOGRAPHY EA ADDL TARGET

Facility

$1,836.40

Service Code	HCPCS 76983
Hospital Charge Code	404276983
Hospital Revenue Code	402
Min. Negotiated Rate	$49.07
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$550.92
Rate for Payer: Aetna Medicare Advantage	$550.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$468.28
Rate for Payer: Cigna Commercial	$68.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.73
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.46
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

ELASTOGRAPHY PARENCHYMA ORGAN

Facility

$1,836.40

Service Code	HCPCS 76981
Hospital Charge Code	404276981
Hospital Revenue Code	402
Min. Negotiated Rate	$90.21
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$550.92
Rate for Payer: Aetna Medicare Advantage	$550.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$468.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$468.28
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.73
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.46
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

ELASTOGRAPHY PARENCHYMA ORGAN

Facility

$1,836.40

Service Code	HCPCS 76981
Hospital Charge Code	404276981
Hospital Revenue Code	402
Min. Negotiated Rate	$275.46
Max. Negotiated Rate	$275.46
Rate for Payer: Qualcare PPO/HMO/WC	$275.46

ELBOW ********

Facility

$225.00

Hospital Charge Code	8002016
Hospital Revenue Code	279
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

ELBOW ********

Facility

$225.00

Hospital Charge Code	8002016
Hospital Revenue Code	279
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

ELBOW 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	94061221
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7308050
Hospital Charge Code	94061221
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

ELBOW 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	94061301
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73080LT
Hospital Charge Code	94061301
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

ELBOW 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	94061303
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

ELBOW 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73080RT
Hospital Charge Code	94061303
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

ELBOW COMP RG 32-8106-000-13

Facility

$2,718.45

Hospital Charge Code	270609045
Hospital Revenue Code	278
Min. Negotiated Rate	$407.77
Max. Negotiated Rate	$1,359.22
Rate for Payer: Aetna Commercial	$815.53
Rate for Payer: Aetna Medicare Advantage	$815.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$693.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$693.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$693.20
Rate for Payer: Cigna Commercial	$1,359.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.86
Rate for Payer: Qualcare PPO/HMO/WC	$407.77

ELBOW COMP RG 32-8106-000-13

Facility

$2,718.45

Hospital Charge Code	270609045
Hospital Revenue Code	278
Min. Negotiated Rate	$407.77
Max. Negotiated Rate	$657.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.86
Rate for Payer: Qualcare PPO/HMO/WC	$407.77

ELBOW TO FINGER SHORT ARM

Facility

$618.00

Service Code	HCPCS 29075
Hospital Charge Code	94186025
Hospital Revenue Code	361
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,443.93
Rate for Payer: Aetna Commercial	$185.40
Rate for Payer: Aetna Medicare Advantage	$185.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.59
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	$157.59
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.34
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,472.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1,443.93

Know your out-of-pocket cost for care.

All Charges