Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER ADMIN BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	5700032
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

ER ADMIN BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	5700032
Hospital Revenue Code	391
Min. Negotiated Rate	$182.49
Max. Negotiated Rate	$1,050.61
Rate for Payer: Aetna Commercial	$421.12
Rate for Payer: Aetna Medicare Advantage	$421.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.96
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.49
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$756.00

ER ADMINISTRATION IMMUNIZATION

Facility

$72.75

Service Code	HCPCS 90471
Hospital Charge Code	5700275
Hospital Revenue Code	771
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$21.82
Rate for Payer: Aetna Medicare Advantage	$21.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.55
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.46
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.91
Rate for Payer: UnitedHealthcare Commercial	$103.00

ER ADMINISTRATION IMMUNIZATION

Facility

$72.75

Service Code	HCPCS 90471
Hospital Charge Code	5700275
Hospital Revenue Code	771
Min. Negotiated Rate	$10.91
Max. Negotiated Rate	$10.91
Rate for Payer: Qualcare PPO/HMO/WC	$10.91

ER AIRWAY INHALATION TREATMENT

Facility

$467.85

Service Code	HCPCS 94640
Hospital Charge Code	5700655
Hospital Revenue Code	410
Min. Negotiated Rate	$70.18
Max. Negotiated Rate	$70.18
Rate for Payer: Qualcare PPO/HMO/WC	$70.18

ER AIRWAY INHALATION TREATMENT

Facility

$467.85

Service Code	HCPCS 94640
Hospital Charge Code	5700655
Hospital Revenue Code	410
Min. Negotiated Rate	$42.55
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$140.35
Rate for Payer: Aetna Medicare Advantage	$140.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.30
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.82
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.18
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

ER AIRWAY INHALATION TX SUBSEQ

Facility

$467.85

Service Code	HCPCS 9464076
Hospital Charge Code	5701016
Hospital Revenue Code	410
Min. Negotiated Rate	$60.82
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$140.35
Rate for Payer: Aetna Medicare Advantage	$140.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.30
Rate for Payer: Cigna Commercial	$233.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.82
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.18
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

ER AIRWAY INHALATION TX SUBSEQ

Facility

$467.85

Service Code	HCPCS 9464076
Hospital Charge Code	5701016
Hospital Revenue Code	410
Min. Negotiated Rate	$70.18
Max. Negotiated Rate	$70.18
Rate for Payer: Qualcare PPO/HMO/WC	$70.18

ER ANESTHESIA IV CONSCIOUS SED

Facility

$336.00

Hospital Charge Code	5700010
Hospital Revenue Code	370
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$100.80
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$168.00

ER ANESTHESIA IV CONSCIOUS SED

Facility

$336.00

Hospital Charge Code	5700010
Hospital Revenue Code	370
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

ER-ANKLE DISLOCATED-BILAT

Facility

$612.00

Hospital Charge Code	5790620
Hospital Revenue Code	450
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-ANKLE DISLOCATED-BILAT

Facility

$612.00

Hospital Charge Code	5790620
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-ANTERIOR SEG EYE OTHER

Facility

$1,817.00

Service Code	HCPCS 66999
Hospital Charge Code	5790215
Hospital Revenue Code	450
Min. Negotiated Rate	$236.21
Max. Negotiated Rate	$5,495.84
Rate for Payer: Aetna Commercial	$545.10
Rate for Payer: Aetna Medicare Advantage	$545.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$463.33
Rate for Payer: Cigna Commercial	$5,495.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.21
Rate for Payer: Qualcare PPO/HMO/WC	$272.55

ER-ANTERIOR SEG EYE OTHER

Facility

$1,817.00

Service Code	HCPCS 66999
Hospital Charge Code	5790215
Hospital Revenue Code	450
Min. Negotiated Rate	$272.55
Max. Negotiated Rate	$272.55
Rate for Payer: Qualcare PPO/HMO/WC	$272.55

ER APPLICATION FINGER SPLINT

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	5700310
Hospital Revenue Code	450
Min. Negotiated Rate	$48.42
Max. Negotiated Rate	$48.42
Rate for Payer: Qualcare PPO/HMO/WC	$48.42

ER APPLICATION FINGER SPLINT

Facility

$322.82

Service Code	HCPCS 29130
Hospital Charge Code	5700310
Hospital Revenue Code	450
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$96.85
Rate for Payer: Aetna Medicare Advantage	$96.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.32
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.97
Rate for Payer: Qualcare PPO/HMO/WC	$48.42

ER APPLICATION FOREARM SPLINT

Facility

$988.72

Service Code	HCPCS 29125
Hospital Charge Code	5700305
Hospital Revenue Code	450
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$296.62
Rate for Payer: Aetna Medicare Advantage	$296.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.12
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.53
Rate for Payer: Qualcare PPO/HMO/WC	$148.31

ER APPLICATION FOREARM SPLINT

Facility

$988.72

Service Code	HCPCS 29125
Hospital Charge Code	5700305
Hospital Revenue Code	450
Min. Negotiated Rate	$148.31
Max. Negotiated Rate	$148.31
Rate for Payer: Qualcare PPO/HMO/WC	$148.31

ER APPLICATION HAND/WRIST CAST

Facility

$244.50

Service Code	HCPCS 29085
Hospital Charge Code	5700365
Hospital Revenue Code	450
Min. Negotiated Rate	$36.67
Max. Negotiated Rate	$36.67
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

ER APPLICATION HAND/WRIST CAST

Facility

$244.50

Service Code	HCPCS 29085
Hospital Charge Code	5700365
Hospital Revenue Code	450
Min. Negotiated Rate	$31.79
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$73.35
Rate for Payer: Aetna Medicare Advantage	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.35
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.79
Rate for Payer: Qualcare PPO/HMO/WC	$36.67

ER APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	5700372
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

ER APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	5700372
Hospital Revenue Code	450
Min. Negotiated Rate	$60.34
Max. Negotiated Rate	$666.07
Rate for Payer: Aetna Commercial	$408.13
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.91
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.86
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

ER APPLICATION LONG ARM SPLINT

Facility

$777.42

Service Code	HCPCS 29105
Hospital Charge Code	5700330
Hospital Revenue Code	450
Min. Negotiated Rate	$116.61
Max. Negotiated Rate	$116.61
Rate for Payer: Qualcare PPO/HMO/WC	$116.61

ER APPLICATION LONG ARM SPLINT

Facility

$777.42

Service Code	HCPCS 29105
Hospital Charge Code	5700330
Hospital Revenue Code	450
Min. Negotiated Rate	$43.04
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$233.23
Rate for Payer: Aetna Medicare Advantage	$233.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.24
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.06
Rate for Payer: Qualcare PPO/HMO/WC	$116.61

ER APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	5700355
Hospital Revenue Code	450
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

Know your out-of-pocket cost for care.

All Charges