Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER-CLAVICLE FRACTURE-BIL

Facility

$612.00

Hospital Charge Code	5790325
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-CLAVICLE FRACTURE-BIL

Facility

$612.00

Hospital Charge Code	5790325
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 CLD TX METACARPAL W/O ANES

Facility

$562.50

Service Code	HCPCS 26600
Hospital Charge Code	5700461
Hospital Revenue Code	450
Min. Negotiated Rate	$84.38
Max. Negotiated Rate	$84.38
Rate for Payer: Qualcare PPO/HMO/WC	$84.38

ER CLD TX METACARPAL W/O ANES

Facility

$562.50

Service Code	HCPCS 26600
Hospital Charge Code	5700461
Hospital Revenue Code	450
Min. Negotiated Rate	$73.12
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$168.75
Rate for Payer: Aetna Medicare Advantage	$168.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.44
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.12
Rate for Payer: Qualcare PPO/HMO/WC	$84.38

ER CLD TX PATELLR DIS W/O ANES

Facility

$889.49

Service Code	HCPCS 27560
Hospital Charge Code	5700460
Hospital Revenue Code	450
Min. Negotiated Rate	$133.42
Max. Negotiated Rate	$133.42
Rate for Payer: Qualcare PPO/HMO/WC	$133.42

ER CLD TX PATELLR DIS W/O ANES

Facility

$889.49

Service Code	HCPCS 27560
Hospital Charge Code	5700460
Hospital Revenue Code	450
Min. Negotiated Rate	$115.63
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$266.85
Rate for Payer: Aetna Medicare Advantage	$266.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.82
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.63
Rate for Payer: Qualcare PPO/HMO/WC	$133.42

ER CLECT BLD CNTR PRIPHRL CAT

Facility

$335.40

Service Code	HCPCS 36591
Hospital Charge Code	5700782
Hospital Revenue Code	450
Min. Negotiated Rate	$50.31
Max. Negotiated Rate	$50.31
Rate for Payer: Qualcare PPO/HMO/WC	$50.31

ER CLECT BLD CNTR PRIPHRL CAT

Facility

$335.40

Service Code	HCPCS 36591
Hospital Charge Code	5700782
Hospital Revenue Code	450
Min. Negotiated Rate	$43.60
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$100.62
Rate for Payer: Aetna Medicare Advantage	$100.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.53
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.60
Rate for Payer: Qualcare PPO/HMO/WC	$50.31

ER-CLOSED BIMAL AKL FX-BI

Facility

$1,827.00

Hospital Charge Code	5790605
Hospital Revenue Code	450
Min. Negotiated Rate	$237.51
Max. Negotiated Rate	$913.50
Rate for Payer: Aetna Commercial	$548.10
Rate for Payer: Aetna Medicare Advantage	$548.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.88
Rate for Payer: Cigna Commercial	$913.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.51
Rate for Payer: Qualcare PPO/HMO/WC	$274.05

ER-CLOSED BIMAL AKL FX-BI

Facility

$1,827.00

Hospital Charge Code	5790605
Hospital Revenue Code	450
Min. Negotiated Rate	$274.05
Max. Negotiated Rate	$274.05
Rate for Payer: Qualcare PPO/HMO/WC	$274.05

ER CLOSED TX BENNET FX

Facility

$2,622.50

Service Code	HCPCS 26645
Hospital Charge Code	5700751
Hospital Revenue Code	450
Min. Negotiated Rate	$393.38
Max. Negotiated Rate	$393.38
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER CLOSED TX BENNET FX

Facility

$2,622.50

Service Code	HCPCS 26645
Hospital Charge Code	5700751
Hospital Revenue Code	450
Min. Negotiated Rate	$179.50
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$786.75
Rate for Payer: Aetna Medicare Advantage	$786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$668.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$668.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$668.74
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.93
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER-CLOSED TX DISTAL FX-BI

Facility

$351.00

Hospital Charge Code	5790445
Hospital Revenue Code	450
Min. Negotiated Rate	$45.63
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna Commercial	$105.30
Rate for Payer: Aetna Medicare Advantage	$105.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.50
Rate for Payer: Cigna Commercial	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.63
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

ER-CLOSED TX DISTAL FX-BI

Facility

$351.00

Hospital Charge Code	5790445
Hospital Revenue Code	450
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

ER-CLOSED TX FX ANKLE-BIL

Facility

$498.00

Hospital Charge Code	5790590
Hospital Revenue Code	450
Min. Negotiated Rate	$74.70
Max. Negotiated Rate	$74.70
Rate for Payer: Qualcare PPO/HMO/WC	$74.70

ER-CLOSED TX FX ANKLE-BIL

Facility

$498.00

Hospital Charge Code	5790590
Hospital Revenue Code	450
Min. Negotiated Rate	$64.74
Max. Negotiated Rate	$249.00
Rate for Payer: Aetna Commercial	$149.40
Rate for Payer: Aetna Medicare Advantage	$149.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.99
Rate for Payer: Cigna Commercial	$249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.74
Rate for Payer: Qualcare PPO/HMO/WC	$74.70

ER CLOSED TX MANDIBLE W/O MANI

Facility

$1,873.45

Service Code	HCPCS 21450
Hospital Charge Code	5700727
Hospital Revenue Code	450
Min. Negotiated Rate	$41.74
Max. Negotiated Rate	$1,284.36
Rate for Payer: Aetna Commercial	$562.03
Rate for Payer: Aetna Medicare Advantage	$562.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$477.73
Rate for Payer: Cigna Commercial	$1,284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.55
Rate for Payer: Qualcare PPO/HMO/WC	$281.02

ER CLOSED TX MANDIBLE W/O MANI

Facility

$1,873.45

Service Code	HCPCS 21450
Hospital Charge Code	5700727
Hospital Revenue Code	450
Min. Negotiated Rate	$281.02
Max. Negotiated Rate	$281.02
Rate for Payer: Qualcare PPO/HMO/WC	$281.02

ER CLOSED TX NASAL FX W/O ANE

Facility

$796.25

Service Code	HCPCS 21310
Hospital Charge Code	5700551
Hospital Revenue Code	450
Min. Negotiated Rate	$119.44
Max. Negotiated Rate	$119.44
Rate for Payer: Qualcare PPO/HMO/WC	$119.44

ER CLOSED TX NASAL FX W/O ANE

Facility

$796.25

Service Code	HCPCS 21310
Hospital Charge Code	5700551
Hospital Revenue Code	450
Min. Negotiated Rate	$103.51
Max. Negotiated Rate	$398.12
Rate for Payer: Aetna Commercial	$238.88
Rate for Payer: Aetna Medicare Advantage	$238.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.04
Rate for Payer: Cigna Commercial	$398.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.51
Rate for Payer: Qualcare PPO/HMO/WC	$119.44

ER CLOSED TX NASAL FX W/O STAB

Facility

$7,901.60

Service Code	HCPCS 21315
Hospital Charge Code	5700724
Hospital Revenue Code	450
Min. Negotiated Rate	$72.45
Max. Negotiated Rate	$3,694.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.24
Rate for Payer: Aetna Commercial	$2,370.48
Rate for Payer: Aetna Medicare Advantage	$2,370.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,014.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,014.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,014.91
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,027.21

ER CLOSED TX NASAL FX W/O STAB

Facility

$7,901.60

Service Code	HCPCS 21315
Hospital Charge Code	5700724
Hospital Revenue Code	450
Min. Negotiated Rate	$1,185.24
Max. Negotiated Rate	$1,185.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.24

ER CLOSED TX NASAL FX W STAB

Facility

$12,892.65

Service Code	HCPCS 21320
Hospital Charge Code	5700725
Hospital Revenue Code	450
Min. Negotiated Rate	$116.85
Max. Negotiated Rate	$7,895.42
Rate for Payer: Aetna Commercial	$3,867.80
Rate for Payer: Aetna Medicare Advantage	$3,867.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,287.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,287.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,287.63
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,676.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,933.90

ER CLOSED TX NASAL FX W STAB

Facility

$12,892.65

Service Code	HCPCS 21320
Hospital Charge Code	5700725
Hospital Revenue Code	450
Min. Negotiated Rate	$1,933.90
Max. Negotiated Rate	$1,933.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,933.90

ER CLOSED TX POST ANTH DISWOAN

Facility

$2,006.25

Service Code	HCPCS 27265
Hospital Charge Code	5700485
Hospital Revenue Code	450
Min. Negotiated Rate	$200.85
Max. Negotiated Rate	$601.88
Rate for Payer: Aetna Commercial	$601.88
Rate for Payer: Aetna Medicare Advantage	$601.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$511.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$511.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$511.59
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.81
Rate for Payer: Qualcare PPO/HMO/WC	$300.94

Know your out-of-pocket cost for care.

All Charges