Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER CLSD PROX FINGER FX W/O EAC

Facility

$563.75

Service Code	HCPCS 26720
Hospital Charge Code	5700581
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD PROX FINGER FX W/O EAC

Facility

$563.75

Service Code	HCPCS 26720
Hospital Charge Code	5700581
Hospital Revenue Code	450
Min. Negotiated Rate	$56.92
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$169.12
Rate for Payer: Aetna Medicare Advantage	$169.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.76
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD RADIAL/ULNAR FX W/O AN

Facility

$563.75

Service Code	HCPCS 25560
Hospital Charge Code	5700566
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD RADIAL/ULNAR FX W/O AN

Facility

$563.75

Service Code	HCPCS 25560
Hospital Charge Code	5700566
Hospital Revenue Code	450
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$169.12
Rate for Payer: Aetna Medicare Advantage	$169.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.76
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD SUPRA/TRANSCON FX W MA

Facility

$2,622.50

Service Code	HCPCS 24535
Hospital Charge Code	5700741
Hospital Revenue Code	450
Min. Negotiated Rate	$393.38
Max. Negotiated Rate	$393.38
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER CLSD SUPRA/TRANSCON FX W MA

Facility

$2,622.50

Service Code	HCPCS 24535
Hospital Charge Code	5700741
Hospital Revenue Code	450
Min. Negotiated Rate	$248.75
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	$248.75
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 CLSD TX CALCANEUS W/O MAN

Facility

$906.60

Service Code	HCPCS 28400
Hospital Charge Code	5700768
Hospital Revenue Code	450
Min. Negotiated Rate	$135.99
Max. Negotiated Rate	$135.99
Rate for Payer: Qualcare PPO/HMO/WC	$135.99

ER CLSD TX CALCANEUS W/O MAN

Facility

$906.60

Service Code	HCPCS 28400
Hospital Charge Code	5700768
Hospital Revenue Code	450
Min. Negotiated Rate	$117.86
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$271.98
Rate for Payer: Aetna Medicare Advantage	$271.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.18
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.86
Rate for Payer: Qualcare PPO/HMO/WC	$135.99

ER CLSD TX CLAVICLE W/ MANIP

Facility

$10,062.15

Service Code	HCPCS 23505
Hospital Charge Code	5700731
Hospital Revenue Code	450
Min. Negotiated Rate	$147.31
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$3,018.64
Rate for Payer: Aetna Medicare Advantage	$3,018.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,565.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,565.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,565.85
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,509.32

ER CLSD TX CLAVICLE W/ MANIP

Facility

$10,062.15

Service Code	HCPCS 23505
Hospital Charge Code	5700731
Hospital Revenue Code	450
Min. Negotiated Rate	$1,509.32
Max. Negotiated Rate	$1,509.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,509.32

ER CLSD TX DISLO SHLD W/O ANES

Facility

$563.75

Service Code	HCPCS 23650
Hospital Charge Code	5700558
Hospital Revenue Code	450
Min. Negotiated Rate	$62.79
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$169.12
Rate for Payer: Aetna Medicare Advantage	$169.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.76
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD TX DISLO SHLD W/O ANES

Facility

$563.75

Service Code	HCPCS 23650
Hospital Charge Code	5700558
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD TX FEMORAL SFT W MAN

Facility

$10,062.15

Service Code	HCPCS 27502
Hospital Charge Code	5700761
Hospital Revenue Code	450
Min. Negotiated Rate	$389.33
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$3,018.64
Rate for Payer: Aetna Medicare Advantage	$3,018.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,565.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,565.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$389.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,565.85
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,308.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,509.32

ER CLSD TX FEMORAL SFT W MAN

Facility

$10,062.15

Service Code	HCPCS 27502
Hospital Charge Code	5700761
Hospital Revenue Code	450
Min. Negotiated Rate	$1,509.32
Max. Negotiated Rate	$1,509.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,509.32

ER CLSD TX FEMORAL SFT WO MAN

Facility

$2,622.50

Service Code	HCPCS 27500
Hospital Charge Code	5700760
Hospital Revenue Code	450
Min. Negotiated Rate	$250.71
Max. Negotiated Rate	$786.75
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	$250.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$668.74
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$340.93
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER CLSD TX FEMORAL SFT WO MAN

Facility

$2,622.50

Service Code	HCPCS 27500
Hospital Charge Code	5700760
Hospital Revenue Code	450
Min. Negotiated Rate	$393.38
Max. Negotiated Rate	$393.38
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

ER-CLSD TX FX FNGR/THB-BI

Facility

$453.00

Hospital Charge Code	5790530
Hospital Revenue Code	450
Min. Negotiated Rate	$58.89
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$135.90
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.89
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-CLSD TX FX FNGR/THB-BI

Facility

$453.00

Hospital Charge Code	5790530
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-CLSD TX FX TBL SHFT-BI

Facility

$453.00

Hospital Charge Code	5790585
Hospital Revenue Code	450
Min. Negotiated Rate	$58.89
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$135.90
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.89
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-CLSD TX FX TBL SHFT-BI

Facility

$453.00

Hospital Charge Code	5790585
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER CLSD TX GREAT TOE W/ MAN

Facility

$906.60

Service Code	HCPCS 28495
Hospital Charge Code	5700771
Hospital Revenue Code	450
Min. Negotiated Rate	$135.99
Max. Negotiated Rate	$135.99
Rate for Payer: Qualcare PPO/HMO/WC	$135.99

ER CLSD TX GREAT TOE W/ MAN

Facility

$906.60

Service Code	HCPCS 28495
Hospital Charge Code	5700771
Hospital Revenue Code	450
Min. Negotiated Rate	$69.66
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$271.98
Rate for Payer: Aetna Medicare Advantage	$271.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.18
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.86
Rate for Payer: Qualcare PPO/HMO/WC	$135.99

ER CLSD TX GR TUB FX W/O MAN

Facility

$563.75

Service Code	HCPCS 23620
Hospital Charge Code	5700557
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD TX GR TUB FX W/O MAN

Facility

$563.75

Service Code	HCPCS 23620
Hospital Charge Code	5700557
Hospital Revenue Code	450
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$169.12
Rate for Payer: Aetna Medicare Advantage	$169.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.76
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CLSD TX HUM COND FX W MAN

Facility

$2,622.50

Service Code	HCPCS 24577
Hospital Charge Code	5700744
Hospital Revenue Code	450
Min. Negotiated Rate	$393.38
Max. Negotiated Rate	$393.38
Rate for Payer: Qualcare PPO/HMO/WC	$393.38

Know your out-of-pocket cost for care.

All Charges