Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELBOW TO FINGER SHORT ARM

Facility

$618.00

Service Code	HCPCS 29075
Hospital Charge Code	94186025
Hospital Revenue Code	361
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

ELBOW - TWO VIEWS-BIL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	94061219
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-BIL

Facility

$5,100.00

Service Code	HCPCS 7307050
Hospital Charge Code	94061219
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ELBOW - TWO VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73070LT
Hospital Charge Code	94061297
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ELBOW - TWO VIEWS-LT

Facility

$5,100.00

Service Code	HCPCS 73070LT
Hospital Charge Code	94061297
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73070RT
Hospital Charge Code	94061299
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ELBOW - TWO VIEWS-RT

Facility

$5,100.00

Service Code	HCPCS 73070RT
Hospital Charge Code	94061299
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ELBOW VENT W/SUNCTION PORT RT

Facility

$2.26

Hospital Charge Code	270643699
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.34

ELBOW VENT W/SUNCTION PORT RT

Facility

$2.26

Hospital Charge Code	270643699
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$1.13
Rate for Payer: Aetna Commercial	$0.68
Rate for Payer: Aetna Medicare Advantage	$0.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.58
Rate for Payer: Cigna Commercial	$1.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.29
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.34
Rate for Payer: UnitedHealthcare Commercial	$1.13

ELDEPRYL/5MG/TAB

Facility

$15.00

Hospital Charge Code	60632930
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

ELDEPRYL/5MG/TAB

Facility

$15.00

Hospital Charge Code	60632930
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

ELECRODE PAIRED 4 CHANNEL SET

Facility

$910.00

Hospital Charge Code	270690260
Hospital Revenue Code	272
Min. Negotiated Rate	$118.30
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$273.00
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.30
Rate for Payer: Oxford Commercial	$455.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.50
Rate for Payer: UnitedHealthcare Commercial	$455.00

ELECRODE PAIRED 4 CHANNEL SET

Facility

$910.00

Hospital Charge Code	270690260
Hospital Revenue Code	272
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$136.50
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

ELECTIVE HIP JOINT REPLACEMENT

Facility

$21,951.86

Service Code	APR-DRG 3242
Min. Negotiated Rate	$21,521.43
Max. Negotiated Rate	$21,951.86
Rate for Payer: Aetna Better Health Medicaid	$21,521.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,951.86

ELECTIVE HIP JOINT REPLACEMENT

Facility

$30,123.95

Service Code	APR-DRG 3243
Min. Negotiated Rate	$29,533.28
Max. Negotiated Rate	$30,123.95
Rate for Payer: Aetna Better Health Medicaid	$29,533.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,123.95

ELECTIVE HIP JOINT REPLACEMENT

Facility

$47,958.25

Service Code	APR-DRG 3244
Min. Negotiated Rate	$47,017.89
Max. Negotiated Rate	$47,958.25
Rate for Payer: Aetna Better Health Medicaid	$47,017.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$47,958.25

ELECTIVE HIP JOINT REPLACEMENT

Facility

$20,147.25

Service Code	APR-DRG 3241
Min. Negotiated Rate	$19,752.21
Max. Negotiated Rate	$20,147.25
Rate for Payer: Aetna Better Health Medicaid	$19,752.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,147.25

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$20,051.74

Service Code	APR-DRG 3261
Min. Negotiated Rate	$19,658.57
Max. Negotiated Rate	$20,051.74
Rate for Payer: Aetna Better Health Medicaid	$19,658.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,051.74

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$41,354.85

Service Code	APR-DRG 3264
Min. Negotiated Rate	$40,543.97
Max. Negotiated Rate	$41,354.85
Rate for Payer: Aetna Better Health Medicaid	$40,543.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$41,354.85

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$30,330.39

Service Code	APR-DRG 3263
Min. Negotiated Rate	$29,735.68
Max. Negotiated Rate	$30,330.39
Rate for Payer: Aetna Better Health Medicaid	$29,735.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,330.39

ELECTIVE KNEE JOINT REPLACEMENT

Facility

$21,176.66

Service Code	APR-DRG 3262
Min. Negotiated Rate	$20,761.43
Max. Negotiated Rate	$21,176.66
Rate for Payer: Aetna Better Health Medicaid	$20,761.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,176.66

ELECTODE 22FR 25 DEG CUT LOOP

Facility

$560.00

Hospital Charge Code	270678698
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

ELECTODE 22FR 25 DEG CUT LOOP

Facility

$560.00

Hospital Charge Code	270678698
Hospital Revenue Code	272
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$280.00

ELECTODE 22FR ANGLED CUTTING

Facility

$560.00

Hospital Charge Code	270678697
Hospital Revenue Code	272
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Commercial	$280.00

ELECTODE 22FR ANGLED CUTTING

Facility

$560.00

Hospital Charge Code	270678697
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

Know your out-of-pocket cost for care.

All Charges