Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

ER CL TX TIB FX RPOX W/O MAN

Facility

$1,268.90

Service Code	HCPCS 27550
Hospital Charge Code	5700594
Hospital Revenue Code	450
Min. Negotiated Rate	$190.34
Max. Negotiated Rate	$190.34
Rate for Payer: Qualcare PPO/HMO/WC	$190.34

ER CL TX TIB FX RPOX W/O MAN

Facility

$1,268.90

Service Code	HCPCS 27550
Hospital Charge Code	5700594
Hospital Revenue Code	450
Min. Negotiated Rate	$164.96
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$380.67
Rate for Payer: Aetna Medicare Advantage	$380.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$323.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$323.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$323.57
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.96
Rate for Payer: Qualcare PPO/HMO/WC	$190.34

ER CL TX TIB SH FX W/O MAN

Facility

$563.75

Service Code	HCPCS 27750
Hospital Charge Code	5700595
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	$165.00
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 TIB SH FX W/O MAN

Facility

$563.75

Service Code	HCPCS 27750
Hospital Charge Code	5700595
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 TOE FX W/O MANI EACH

Facility

$563.75

Service Code	HCPCS 28510
Hospital Charge Code	5700610
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 CL TX TOE FX W/O MANI EACH

Facility

$563.75

Service Code	HCPCS 28510
Hospital Charge Code	5700610
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 TRIMAL ANKLE FX W/MAN

Facility

$563.75

Service Code	HCPCS 27818
Hospital Charge Code	5700606
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 TRIMAL ANKLE FX W/MAN

Facility

$563.75

Service Code	HCPCS 27818
Hospital Charge Code	5700606
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	$244.73
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 TRIMAL ANKLE FX W/O M

Facility

$563.75

Service Code	HCPCS 27816
Hospital Charge Code	5700605
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	$149.72
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 TRIMAL ANKLE FX W/O M

Facility

$563.75

Service Code	HCPCS 27816
Hospital Charge Code	5700605
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 ULNAR FX PROX W/O ANE

Facility

$563.75

Service Code	HCPCS 24670
Hospital Charge Code	5700564
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 ULNAR FX PROX W/O ANE

Facility

$563.75

Service Code	HCPCS 24670
Hospital Charge Code	5700564
Hospital Revenue Code	450
Min. Negotiated Rate	$55.66
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	$55.66
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 ULNAR SHAFT FX W/O AN

Facility

$563.75

Service Code	HCPCS 25530
Hospital Charge Code	5700565
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	$111.09
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 ULNAR SHAFT FX W/O AN

Facility

$563.75

Service Code	HCPCS 25530
Hospital Charge Code	5700565
Hospital Revenue Code	450
Min. Negotiated Rate	$84.56
Max. Negotiated Rate	$84.56
Rate for Payer: Qualcare PPO/HMO/WC	$84.56

ER CMP RPR SCA/ARM/LEG 1.1-2.5

Facility

$1,723.35

Service Code	HCPCS 13120
Hospital Charge Code	5700717
Hospital Revenue Code	450
Min. Negotiated Rate	$258.50
Max. Negotiated Rate	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.50

ER CMP RPR SCA/ARM/LEG 1.1-2.5

Facility

$1,723.35

Service Code	HCPCS 13120
Hospital Charge Code	5700717
Hospital Revenue Code	450
Min. Negotiated Rate	$115.92
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$517.00
Rate for Payer: Aetna Medicare Advantage	$517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.45
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	$439.45
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.04
Rate for Payer: Qualcare PPO/HMO/WC	$258.50

ER CMP RPR SCA/ARM/LEG 2.6-7.5

Facility

$2,974.62

Service Code	HCPCS 13121
Hospital Charge Code	5700455
Hospital Revenue Code	450
Min. Negotiated Rate	$182.44
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$892.39
Rate for Payer: Aetna Medicare Advantage	$892.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.53
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.70
Rate for Payer: Qualcare PPO/HMO/WC	$446.19

ER CMP RPR SCA/ARM/LEG 2.6-7.5

Facility

$2,974.62

Service Code	HCPCS 13121
Hospital Charge Code	5700455
Hospital Revenue Code	450
Min. Negotiated Rate	$446.19
Max. Negotiated Rate	$446.19
Rate for Payer: Qualcare PPO/HMO/WC	$446.19

ER COLL BLOOD VAD IMPLANT

Facility

$694.20

Service Code	HCPCS 36591
Hospital Charge Code	5700781
Hospital Revenue Code	450
Min. Negotiated Rate	$104.13
Max. Negotiated Rate	$104.13
Rate for Payer: Qualcare PPO/HMO/WC	$104.13

ER COLL BLOOD VAD IMPLANT

Facility

$694.20

Service Code	HCPCS 36591
Hospital Charge Code	5700781
Hospital Revenue Code	450
Min. Negotiated Rate	$90.25
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$208.26
Rate for Payer: Aetna Medicare Advantage	$208.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.02
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.13

ER COLLECTION CAP BLOOD SPEC

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	5700831
Hospital Revenue Code	450
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

ER COLLECTION CAP BLOOD SPEC

Facility

$14.00

Service Code	HCPCS 36416
Hospital Charge Code	5700831
Hospital Revenue Code	450
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

ER-COMPLEX ANYAREA>7.5CM

Facility

$5,095.00

Service Code	HCPCS 13160
Hospital Charge Code	5790015
Hospital Revenue Code	450
Min. Negotiated Rate	$764.25
Max. Negotiated Rate	$764.25
Rate for Payer: Qualcare PPO/HMO/WC	$764.25

ER-COMPLEX ANYAREA>7.5CM

Facility

$5,095.00

Service Code	HCPCS 13160
Hospital Charge Code	5790015
Hospital Revenue Code	450
Min. Negotiated Rate	$292.21
Max. Negotiated Rate	$8,439.01
Rate for Payer: Aetna Better Health Medicaid	$5,064.59
Rate for Payer: Aetna Commercial	$1,528.50
Rate for Payer: Aetna Medicare Advantage	$1,528.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,299.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,299.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,299.22
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$662.35
Rate for Payer: Qualcare PPO/HMO/WC	$764.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88

Know your out-of-pocket cost for care.

All Charges