Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	5700355
Hospital Revenue Code	450
Min. Negotiated Rate	$65.79
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	$65.79
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 SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	5700370
Hospital Revenue Code	450
Min. Negotiated Rate	$48.30
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	$48.30
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 SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	5700370
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 SHRT LEG SPLINT

Facility

$1,250.02

Service Code	HCPCS 29515
Hospital Charge Code	5700320
Hospital Revenue Code	450
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ER APPLICATION SHRT LEG SPLINT

Facility

$1,250.02

Service Code	HCPCS 29515
Hospital Charge Code	5700320
Hospital Revenue Code	450
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$375.01
Rate for Payer: Aetna Medicare Advantage	$375.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.76
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

ER-APPLI LONG LEG CAST-BI

Facility

$698.00

Hospital Charge Code	5790740
Hospital Revenue Code	450
Min. Negotiated Rate	$90.74
Max. Negotiated Rate	$349.00
Rate for Payer: Aetna Commercial	$209.40
Rate for Payer: Aetna Medicare Advantage	$209.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.99
Rate for Payer: Cigna Commercial	$349.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.74
Rate for Payer: Qualcare PPO/HMO/WC	$104.70

ER-APPLI LONG LEG CAST-BI

Facility

$698.00

Hospital Charge Code	5790740
Hospital Revenue Code	450
Min. Negotiated Rate	$104.70
Max. Negotiated Rate	$104.70
Rate for Payer: Qualcare PPO/HMO/WC	$104.70

ER-APPLY FINGER CAST-BI

Facility

$325.00

Hospital Charge Code	5790700
Hospital Revenue Code	450
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

ER-APPLY FINGER CAST-BI

Facility

$325.00

Hospital Charge Code	5790700
Hospital Revenue Code	450
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

ER AR/PULSE OXIMETRY SINGLE DE

Facility

$503.00

Service Code	HCPCS 94760
Hospital Charge Code	5780300
Hospital Revenue Code	460
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

ER AR/PULSE OXIMETRY SINGLE DE

Facility

$503.00

Service Code	HCPCS 94760
Hospital Charge Code	5780300
Hospital Revenue Code	460
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$150.90
Rate for Payer: Aetna Medicare Advantage	$150.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.26
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.39
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ER ARTERIAL PNCTR DIAGNOSIS

Facility

$68.75

Service Code	HCPCS 36600
Hospital Charge Code	5700641
Hospital Revenue Code	450
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$20.62
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

ER ARTERIAL PNCTR DIAGNOSIS

Facility

$68.75

Service Code	HCPCS 36600
Hospital Charge Code	5700641
Hospital Revenue Code	450
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

ER ARTHROCENTESIS INT JOINT

Facility

$740.00

Service Code	HCPCS 20605
Hospital Charge Code	5700549
Hospital Revenue Code	450
Min. Negotiated Rate	$29.30
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$222.00
Rate for Payer: Aetna Medicare Advantage	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.70
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.20
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER ARTHROCENTESIS INT JOINT

Facility

$740.00

Service Code	HCPCS 20605
Hospital Charge Code	5700549
Hospital Revenue Code	450
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$111.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER ARTHROCENTESIS MAJOR JOINT

Facility

$740.00

Service Code	HCPCS 20610
Hospital Charge Code	5700550
Hospital Revenue Code	450
Min. Negotiated Rate	$45.06
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$222.00
Rate for Payer: Aetna Medicare Advantage	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.70
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.20
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER ARTHROCENTESIS MAJOR JOINT

Facility

$740.00

Service Code	HCPCS 20610
Hospital Charge Code	5700550
Hospital Revenue Code	450
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$111.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER ARTHROCENTESIS, SMALL JOINT

Facility

$740.00

Service Code	HCPCS 20600
Hospital Charge Code	5700548
Hospital Revenue Code	450
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$111.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER ARTHROCENTESIS, SMALL JOINT

Facility

$740.00

Service Code	HCPCS 20600
Hospital Charge Code	5700548
Hospital Revenue Code	450
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$222.00
Rate for Payer: Aetna Medicare Advantage	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.70
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.20
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	5700783
Hospital Revenue Code	450
Min. Negotiated Rate	$143.97
Max. Negotiated Rate	$143.97
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

ER ARTRIAL LINE INSERT PERCU

Facility

$959.80

Service Code	HCPCS 36620
Hospital Charge Code	5700783
Hospital Revenue Code	450
Min. Negotiated Rate	$26.93
Max. Negotiated Rate	$287.94
Rate for Payer: Aetna Commercial	$287.94
Rate for Payer: Aetna Medicare Advantage	$287.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.75
Rate for Payer: Cigna Commercial	$43.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.77
Rate for Payer: Qualcare PPO/HMO/WC	$143.97

ER ASPIR BLADDER TROCAR INTCAT

Facility

$599.40

Service Code	HCPCS 51101
Hospital Charge Code	5700797
Hospital Revenue Code	450
Min. Negotiated Rate	$89.91
Max. Negotiated Rate	$89.91
Rate for Payer: Qualcare PPO/HMO/WC	$89.91

ER ASPIR BLADDER TROCAR INTCAT

Facility

$599.40

Service Code	HCPCS 51101
Hospital Charge Code	5700797
Hospital Revenue Code	450
Min. Negotiated Rate	$77.92
Max. Negotiated Rate	$2,044.99
Rate for Payer: Aetna Commercial	$179.82
Rate for Payer: Aetna Medicare Advantage	$179.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.85
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.92
Rate for Payer: Qualcare PPO/HMO/WC	$89.91

ER-AUTOGRAFT <=100 SQCM

Facility

$4,776.00

Service Code	HCPCS 15120
Hospital Charge Code	5790030
Hospital Revenue Code	450
Min. Negotiated Rate	$559.54
Max. Negotiated Rate	$8,439.01
Rate for Payer: Aetna Commercial	$1,432.80
Rate for Payer: Aetna Medicare Advantage	$1,432.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,217.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,217.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,217.88
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$620.88
Rate for Payer: Qualcare PPO/HMO/WC	$716.40

ER-AUTOGRAFT <=100 SQCM

Facility

$4,776.00

Service Code	HCPCS 15120
Hospital Charge Code	5790030
Hospital Revenue Code	450
Min. Negotiated Rate	$716.40
Max. Negotiated Rate	$716.40
Rate for Payer: Qualcare PPO/HMO/WC	$716.40

Know your out-of-pocket cost for care.

All Charges