Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$173.88
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	$173.88
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 HUM COND FX W/O MAN

Facility

$906.60

Service Code	HCPCS 24576
Hospital Charge Code	5700743
Hospital Revenue Code	450
Min. Negotiated Rate	$96.60
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	$96.60
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 HUM COND FX W/O MAN

Facility

$906.60

Service Code	HCPCS 24576
Hospital Charge Code	5700743
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 HUM EPI FX W MANI

Facility

$1,125.13

Service Code	HCPCS 24565
Hospital Charge Code	5700742
Hospital Revenue Code	450
Min. Negotiated Rate	$168.77
Max. Negotiated Rate	$168.77
Rate for Payer: Qualcare PPO/HMO/WC	$168.77

ER CLSD TX HUM EPI FX W MANI

Facility

$1,125.13

Service Code	HCPCS 24565
Hospital Charge Code	5700742
Hospital Revenue Code	450
Min. Negotiated Rate	$146.27
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$337.54
Rate for Payer: Aetna Medicare Advantage	$337.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.91
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.27
Rate for Payer: Qualcare PPO/HMO/WC	$168.77

ER CLSD TX HUM EPI FX W/O ANES

Facility

$563.75

Service Code	HCPCS 24560
Hospital Charge Code	5700561
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	$132.82
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 EPI FX W/O ANES

Facility

$563.75

Service Code	HCPCS 24560
Hospital Charge Code	5700561
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 LUNA DISLOC W/MANIP

Facility

$8,605.25

Service Code	HCPCS 25690
Hospital Charge Code	323025690
Hospital Revenue Code	450
Min. Negotiated Rate	$1,290.79
Max. Negotiated Rate	$1,290.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,290.79

ER CLSD TX LUNA DISLOC W/MANIP

Facility

$8,605.25

Service Code	HCPCS 25690
Hospital Charge Code	323025690
Hospital Revenue Code	450
Min. Negotiated Rate	$228.01
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$2,581.57
Rate for Payer: Aetna Medicare Advantage	$2,581.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,194.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,194.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,194.34
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,118.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,290.79

ER CLSD TX METACARPO W MANI

Facility

$787.35

Service Code	HCPCS 26742
Hospital Charge Code	5700829
Hospital Revenue Code	450
Min. Negotiated Rate	$118.10
Max. Negotiated Rate	$118.10
Rate for Payer: Qualcare PPO/HMO/WC	$118.10

ER CLSD TX METACARPO W MANI

Facility

$787.35

Service Code	HCPCS 26742
Hospital Charge Code	5700829
Hospital Revenue Code	450
Min. Negotiated Rate	$102.36
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$236.21
Rate for Payer: Aetna Medicare Advantage	$236.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.77
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.36
Rate for Payer: Qualcare PPO/HMO/WC	$118.10

ER CLSD TX MONTEGGIA FX DISLOC

Facility

$10,062.15

Service Code	HCPCS 24620
Hospital Charge Code	5700745
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 MONTEGGIA FX DISLOC

Facility

$10,062.15

Service Code	HCPCS 24620
Hospital Charge Code	5700745
Hospital Revenue Code	450
Min. Negotiated Rate	$252.56
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	$252.56
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 NURSEMAID ELBOW W A

Facility

$563.75

Service Code	HCPCS 24640
Hospital Charge Code	5700562
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
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	$43.47
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 NURSEMAID ELBOW W A

Facility

$563.75

Service Code	HCPCS 24640
Hospital Charge Code	5700562
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 OF TBIAL FX-BI

Facility

$453.00

Hospital Charge Code	5790565
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 OF TBIAL FX-BI

Facility

$453.00

Hospital Charge Code	5790565
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 PROX FIB SFT W MAN

Facility

$10,062.15

Service Code	HCPCS 27781
Hospital Charge Code	5700765
Hospital Revenue Code	450
Min. Negotiated Rate	$108.67
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	$108.67
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 PROX FIB SFT W MAN

Facility

$10,062.15

Service Code	HCPCS 27781
Hospital Charge Code	5700765
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 PROX HUM FX W/O ANE

Facility

$563.75

Service Code	HCPCS 23600
Hospital Charge Code	5700555
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	$147.31
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 PROX HUM FX W/O ANE

Facility

$563.75

Service Code	HCPCS 23600
Hospital Charge Code	5700555
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 RADIAL SFT FX W MAN

Facility

$8,575.05

Service Code	HCPCS 25505
Hospital Charge Code	5700747
Hospital Revenue Code	450
Min. Negotiated Rate	$1,286.26
Max. Negotiated Rate	$1,286.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.26

ER CLSD TX RADIAL SFT FX W MAN

Facility

$8,575.05

Service Code	HCPCS 25505
Hospital Charge Code	5700747
Hospital Revenue Code	450
Min. Negotiated Rate	$173.88
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$2,572.51
Rate for Payer: Aetna Medicare Advantage	$2,572.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,186.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,186.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,186.64
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,114.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.26

ER CLSD TX RADIAL SFT FX W/O M

Facility

$906.60

Service Code	HCPCS 25500
Hospital Charge Code	5700746
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 RADIAL SFT FX W/O M

Facility

$906.60

Service Code	HCPCS 25500
Hospital Charge Code	5700746
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	$123.79
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

Know your out-of-pocket cost for care.

All Charges