Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER CL TX MED MALL FX W/MANI

Facility

$9,025.20

Service Code	HCPCS 27762
Hospital Charge Code	5700597
Hospital Revenue Code	450
Min. Negotiated Rate	$190.78
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$2,707.56
Rate for Payer: Aetna Medicare Advantage	$2,707.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,301.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,301.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,301.43
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,173.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.78

ER CL TX MED MALL FX W/MANI

Facility

$9,025.20

Service Code	HCPCS 27762
Hospital Charge Code	5700597
Hospital Revenue Code	450
Min. Negotiated Rate	$1,353.78
Max. Negotiated Rate	$1,353.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.78

ER CL TX MED MALL FX W/O MAN

Facility

$563.75

Service Code	HCPCS 27760
Hospital Charge Code	5700596
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	$149.90
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 CL TX MED MALL FX W/O MAN

Facility

$563.75

Service Code	HCPCS 27760
Hospital Charge Code	5700596
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX METAC FX W/MAN EACH

Facility

$563.75

Service Code	HCPCS 26605
Hospital Charge Code	5700578
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX METAC FX W/MAN EACH

Facility

$563.75

Service Code	HCPCS 26605
Hospital Charge Code	5700578
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	$136.64
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 CL TX PATELLAR FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27520
Hospital Charge Code	5700592
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	$149.73
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 CL TX PATELLAR FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27520
Hospital Charge Code	5700592
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX PHAL SH FX W/MAN EACH

Facility

$563.75

Service Code	HCPCS 26725
Hospital Charge Code	5700582
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX PHAL SH FX W/MAN EACH

Facility

$563.75

Service Code	HCPCS 26725
Hospital Charge Code	5700582
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	$115.92
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 CL TX POST MALL FX W/MANI

Facility

$563.75

Service Code	HCPCS 27768
Hospital Charge Code	5700599
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX POST MALL FX W/MANI

Facility

$563.75

Service Code	HCPCS 27768
Hospital Charge Code	5700599
Hospital Revenue Code	450
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$3,829.26
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) PPO	$143.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX POST MALL FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27767
Hospital Charge Code	5700598
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX POST MALL FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27767
Hospital Charge Code	5700598
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) 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 CL TX PROX FIB FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27780
Hospital Charge Code	5700600
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	$108.67
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 CL TX PROX FIB FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27780
Hospital Charge Code	5700600
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX PROX HUM FX W/MAN/TRA

Facility

$9,025.20

Service Code	HCPCS 23605
Hospital Charge Code	5700556
Hospital Revenue Code	450
Min. Negotiated Rate	$229.05
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$2,707.56
Rate for Payer: Aetna Medicare Advantage	$2,707.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,301.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,301.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$229.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,301.43
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,173.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.78

ER CL TX PROX HUM FX W/MAN/TRA

Facility

$9,025.20

Service Code	HCPCS 23605
Hospital Charge Code	5700556
Hospital Revenue Code	450
Min. Negotiated Rate	$1,353.78
Max. Negotiated Rate	$1,353.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.78

ER CL TX RADIAL/ULNAR FX W ANE

Facility

$563.75

Service Code	HCPCS 25565
Hospital Charge Code	5700567
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX RADIAL/ULNAR FX W ANE

Facility

$563.75

Service Code	HCPCS 25565
Hospital Charge Code	5700567
Hospital Revenue Code	450
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$3,829.26
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	$255.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX THIGH FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27267
Hospital Charge Code	5700588
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX THIGH FX W/O MANI

Facility

$563.75

Service Code	HCPCS 27267
Hospital Charge Code	5700588
Hospital Revenue Code	450
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$7,791.93
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) PPO	$143.76
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX THIGH W/MANI

Facility

$563.75

Service Code	HCPCS 27268
Hospital Charge Code	5700589
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX THIGH W/MANI

Facility

$563.75

Service Code	HCPCS 27268
Hospital Charge Code	5700589
Hospital Revenue Code	450
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$3,829.26
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) PPO	$143.76
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.29
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CL TX TIB FX PROX W/O MAN

Facility

$563.75

Service Code	HCPCS 27530
Hospital Charge Code	5700593
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	$178.71
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

Know your out-of-pocket cost for care.

All Charges