Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER INT REP NEK HAD FOT > 30 CM

Facility

$1,723.35

Service Code	HCPCS 12047
Hospital Charge Code	5700712
Hospital Revenue Code	450
Min. Negotiated Rate	$258.50
Max. Negotiated Rate	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.50

ER INT REP NEK HAD FOT > 30 CM

Facility

$1,723.35

Service Code	HCPCS 12047
Hospital Charge Code	5700712
Hospital Revenue Code	450
Min. Negotiated Rate	$224.04
Max. Negotiated Rate	$4,913.48
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	$224.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.45
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.04
Rate for Payer: Qualcare PPO/HMO/WC	$258.50

ER INT REP NEK HAD FOT7.6-12.5

Facility

$2,910.20

Service Code	HCPCS 12044
Hospital Charge Code	5700533
Hospital Revenue Code	450
Min. Negotiated Rate	$127.73
Max. Negotiated Rate	$1,760.02
Rate for Payer: Aetna Better Health Medicaid	$1,607.24
Rate for Payer: Aetna Commercial	$873.06
Rate for Payer: Aetna Medicare Advantage	$873.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$742.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$742.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$742.10
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.33
Rate for Payer: Qualcare PPO/HMO/WC	$436.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38

ER INT REP NEK HAD FOT7.6-12.5

Facility

$2,910.20

Service Code	HCPCS 12044
Hospital Charge Code	5700533
Hospital Revenue Code	450
Min. Negotiated Rate	$436.53
Max. Negotiated Rate	$436.53
Rate for Payer: Qualcare PPO/HMO/WC	$436.53

ER INT REP NEK HAND FOOT TO2.5

Facility

$668.75

Service Code	HCPCS 12041
Hospital Charge Code	5700531
Hospital Revenue Code	450
Min. Negotiated Rate	$72.45
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$200.62
Rate for Payer: Aetna Medicare Advantage	$200.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.53
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	$170.53
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.94
Rate for Payer: Qualcare PPO/HMO/WC	$100.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

ER INT REP NEK HAND FOOT TO2.5

Facility

$668.75

Service Code	HCPCS 12041
Hospital Charge Code	5700531
Hospital Revenue Code	450
Min. Negotiated Rate	$100.31
Max. Negotiated Rate	$100.31
Rate for Payer: Qualcare PPO/HMO/WC	$100.31

ER INT REP NEK TO TRUN 12.6-20

Facility

$737.50

Service Code	HCPCS 12035
Hospital Charge Code	5700530
Hospital Revenue Code	450
Min. Negotiated Rate	$95.88
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$221.25
Rate for Payer: Aetna Medicare Advantage	$221.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.06
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.88
Rate for Payer: Qualcare PPO/HMO/WC	$110.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

ER INT REP NEK TO TRUN 12.6-20

Facility

$737.50

Service Code	HCPCS 12035
Hospital Charge Code	5700530
Hospital Revenue Code	450
Min. Negotiated Rate	$110.62
Max. Negotiated Rate	$110.62
Rate for Payer: Qualcare PPO/HMO/WC	$110.62

ER INT REP NEK TO TRUN 20.1-30

Facility

$1,723.35

Service Code	HCPCS 12036
Hospital Charge Code	5700708
Hospital Revenue Code	450
Min. Negotiated Rate	$187.85
Max. Negotiated Rate	$1,760.02
Rate for Payer: Aetna Better Health Medicaid	$1,607.24
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	$187.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.45
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.04
Rate for Payer: Qualcare PPO/HMO/WC	$258.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38

ER INT REP NEK TO TRUN 20.1-30

Facility

$1,723.35

Service Code	HCPCS 12036
Hospital Charge Code	5700708
Hospital Revenue Code	450
Min. Negotiated Rate	$258.50
Max. Negotiated Rate	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.50

ER INT REP NEK TO TRUN 2.5-7.5

Facility

$687.50

Service Code	HCPCS 12032
Hospital Charge Code	5700528
Hospital Revenue Code	450
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$103.12
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

ER INT REP NEK TO TRUN 2.5-7.5

Facility

$687.50

Service Code	HCPCS 12032
Hospital Charge Code	5700528
Hospital Revenue Code	450
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$206.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

ER INT REP NEK TO TRUN >30 CM

Facility

$1,723.35

Service Code	HCPCS 12037
Hospital Charge Code	5700709
Hospital Revenue Code	450
Min. Negotiated Rate	$221.10
Max. Negotiated Rate	$9,062.33
Rate for Payer: Aetna Better Health Medicaid	$8,884.64
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	$221.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.45
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.04
Rate for Payer: Qualcare PPO/HMO/WC	$258.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,062.33

ER INT REP NEK TO TRUN >30 CM

Facility

$1,723.35

Service Code	HCPCS 12037
Hospital Charge Code	5700709
Hospital Revenue Code	450
Min. Negotiated Rate	$258.50
Max. Negotiated Rate	$258.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.50

ER INT REP NEK TO TRUN7.6-12.5

Facility

$718.75

Service Code	HCPCS 12034
Hospital Charge Code	5700529
Hospital Revenue Code	450
Min. Negotiated Rate	$107.81
Max. Negotiated Rate	$107.81
Rate for Payer: Qualcare PPO/HMO/WC	$107.81

ER INT REP NEK TO TRUN7.6-12.5

Facility

$718.75

Service Code	HCPCS 12034
Hospital Charge Code	5700529
Hospital Revenue Code	450
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$215.62
Rate for Payer: Aetna Medicare Advantage	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.28
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.44
Rate for Payer: Qualcare PPO/HMO/WC	$107.81
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

ER INT REP NEK TO TRUN TO 2.5

Facility

$668.75

Service Code	HCPCS 12031
Hospital Charge Code	5700527
Hospital Revenue Code	450
Min. Negotiated Rate	$72.45
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$200.62
Rate for Payer: Aetna Medicare Advantage	$200.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.53
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	$170.53
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.94
Rate for Payer: Qualcare PPO/HMO/WC	$100.31

ER INT REP NEK TO TRUN TO 2.5

Facility

$668.75

Service Code	HCPCS 12031
Hospital Charge Code	5700527
Hospital Revenue Code	450
Min. Negotiated Rate	$100.31
Max. Negotiated Rate	$100.31
Rate for Payer: Qualcare PPO/HMO/WC	$100.31

ER INTUBATION

Facility

$722.60

Service Code	HCPCS 31500
Hospital Charge Code	5700034
Hospital Revenue Code	450
Min. Negotiated Rate	$108.39
Max. Negotiated Rate	$108.39
Rate for Payer: Qualcare PPO/HMO/WC	$108.39

ER INTUBATION

Facility

$722.60

Service Code	HCPCS 31500
Hospital Charge Code	5700034
Hospital Revenue Code	450
Min. Negotiated Rate	$56.76
Max. Negotiated Rate	$640.73
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$216.78
Rate for Payer: Aetna Medicare Advantage	$216.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.26
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$108.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73

ER INTUBATION

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5700288
Hospital Revenue Code	450
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$191.72
Rate for Payer: Qualcare PPO/HMO/WC	$191.72

ER INTUBATION

Facility

$1,278.15

Service Code	HCPCS 31500
Hospital Charge Code	5700288
Hospital Revenue Code	450
Min. Negotiated Rate	$56.76
Max. Negotiated Rate	$640.73
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$383.44
Rate for Payer: Aetna Medicare Advantage	$383.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.93
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.16
Rate for Payer: Qualcare PPO/HMO/WC	$191.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73

ER INTUBATION PROCEDURE****

Facility

$223.00

Hospital Charge Code	8004020
Hospital Revenue Code	272
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$111.50
Rate for Payer: Aetna Commercial	$66.90
Rate for Payer: Aetna Medicare Advantage	$66.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.87
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.99
Rate for Payer: Oxford Commercial	$111.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.45
Rate for Payer: UnitedHealthcare Commercial	$111.50

ER INTUBATION PROCEDURE****

Facility

$223.00

Hospital Charge Code	8004020
Hospital Revenue Code	272
Min. Negotiated Rate	$33.45
Max. Negotiated Rate	$33.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.45

ER-IP FINGER DISLOCAT-BIL

Facility

$612.00

Hospital Charge Code	5790540
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

Know your out-of-pocket cost for care.

All Charges