Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER REPAIR TENDON HAND/FINGER

Facility

$5,964.50

Service Code	HCPCS 26356
Hospital Charge Code	5700283
Hospital Revenue Code	450
Min. Negotiated Rate	$397.96
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$1,789.35
Rate for Payer: Aetna Medicare Advantage	$1,789.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,520.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,520.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$397.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,520.95
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$775.38
Rate for Payer: Qualcare PPO/HMO/WC	$894.67

ER REPAIR TENDON HAND/FINGER

Facility

$5,964.50

Service Code	HCPCS 26356
Hospital Charge Code	5700283
Hospital Revenue Code	450
Min. Negotiated Rate	$894.67
Max. Negotiated Rate	$894.67
Rate for Payer: Qualcare PPO/HMO/WC	$894.67

ER REP FING EXT TDN PR/SC EACH

Facility

$8,605.25

Service Code	HCPCS 26418
Hospital Charge Code	5700575
Hospital Revenue Code	450
Min. Negotiated Rate	$146.57
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	$146.57
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 REP FING EXT TDN PR/SC EACH

Facility

$8,605.25

Service Code	HCPCS 26418
Hospital Charge Code	5700575
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-REPLACE TUNNEL CV CATH

Facility

$7,156.00

Service Code	HCPCS 36578
Hospital Charge Code	5790105
Hospital Revenue Code	450
Min. Negotiated Rate	$501.40
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$2,146.80
Rate for Payer: Aetna Medicare Advantage	$2,146.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,824.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,824.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,824.78
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.40

ER-REPLACE TUNNEL CV CATH

Facility

$7,156.00

Service Code	HCPCS 36578
Hospital Charge Code	5790105
Hospital Revenue Code	450
Min. Negotiated Rate	$1,073.40
Max. Negotiated Rate	$1,073.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,073.40

ER REP LAC FLR MTH TNG TO 2.5

Facility

$796.25

Service Code	HCPCS 41250
Hospital Charge Code	5700646
Hospital Revenue Code	450
Min. Negotiated Rate	$57.96
Max. Negotiated Rate	$1,063.82
Rate for Payer: Aetna Commercial	$238.88
Rate for Payer: Aetna Medicare Advantage	$238.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.04
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.51
Rate for Payer: Qualcare PPO/HMO/WC	$119.44

ER REP LAC FLR MTH TNG TO 2.5

Facility

$796.25

Service Code	HCPCS 41250
Hospital Charge Code	5700646
Hospital Revenue Code	450
Min. Negotiated Rate	$119.44
Max. Negotiated Rate	$119.44
Rate for Payer: Qualcare PPO/HMO/WC	$119.44

ER REP LIP FULL THK, VERMILION

Facility

$2,371.25

Service Code	HCPCS 40650
Hospital Charge Code	5700645
Hospital Revenue Code	450
Min. Negotiated Rate	$156.17
Max. Negotiated Rate	$1,284.36
Rate for Payer: Aetna Commercial	$711.38
Rate for Payer: Aetna Medicare Advantage	$711.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.67
Rate for Payer: Cigna Commercial	$1,284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.26
Rate for Payer: Qualcare PPO/HMO/WC	$355.69

ER REP LIP FULL THK, VERMILION

Facility

$2,371.25

Service Code	HCPCS 40650
Hospital Charge Code	5700645
Hospital Revenue Code	450
Min. Negotiated Rate	$355.69
Max. Negotiated Rate	$355.69
Rate for Payer: Qualcare PPO/HMO/WC	$355.69

ER REP SCA/AR/LEG EA ADDI TO 5

Facility

$670.00

Service Code	HCPCS 13122
Hospital Charge Code	5700456
Hospital Revenue Code	450
Min. Negotiated Rate	$46.00
Max. Negotiated Rate	$201.00
Rate for Payer: Aetna Commercial	$201.00
Rate for Payer: Aetna Medicare Advantage	$201.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.85
Rate for Payer: Cigna Commercial	$73.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.10
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

ER REP SCA/AR/LEG EA ADDI TO 5

Facility

$670.00

Service Code	HCPCS 13122
Hospital Charge Code	5700456
Hospital Revenue Code	450
Min. Negotiated Rate	$100.50
Max. Negotiated Rate	$100.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.50

ER REP SIM NCK TO TRUN7.6-12.5

Facility

$438.75

Service Code	HCPCS 12004
Hospital Charge Code	5700516
Hospital Revenue Code	450
Min. Negotiated Rate	$57.04
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$131.62
Rate for Payer: Aetna Medicare Advantage	$131.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.88
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.04
Rate for Payer: Qualcare PPO/HMO/WC	$65.81

ER REP SIM NCK TO TRUN7.6-12.5

Facility

$438.75

Service Code	HCPCS 12004
Hospital Charge Code	5700516
Hospital Revenue Code	450
Min. Negotiated Rate	$65.81
Max. Negotiated Rate	$65.81
Rate for Payer: Qualcare PPO/HMO/WC	$65.81

ER REP SIM NECK TO TRU 2.6-7.5

Facility

$876.31

Service Code	HCPCS 12002
Hospital Charge Code	5700515
Hospital Revenue Code	450
Min. Negotiated Rate	$131.45
Max. Negotiated Rate	$131.45
Rate for Payer: Qualcare PPO/HMO/WC	$131.45

ER REP SIM NECK TO TRU 2.6-7.5

Facility

$876.31

Service Code	HCPCS 12002
Hospital Charge Code	5700515
Hospital Revenue Code	450
Min. Negotiated Rate	$57.96
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$262.89
Rate for Payer: Aetna Medicare Advantage	$262.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.46
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.92
Rate for Payer: Qualcare PPO/HMO/WC	$131.45

ER REP TDN/MSC WRIST PRIM EACH

Facility

$15,986.80

Service Code	HCPCS 25260
Hospital Charge Code	5700660
Hospital Revenue Code	450
Min. Negotiated Rate	$292.21
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Better Health Medicaid	$649.28
Rate for Payer: Aetna Commercial	$4,796.04
Rate for Payer: Aetna Medicare Advantage	$4,796.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,076.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,076.63
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	$4,076.63
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,078.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,398.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$662.27

ER REP TDN/MSC WRIST PRIM EACH

Facility

$15,986.80

Service Code	HCPCS 25260
Hospital Charge Code	5700660
Hospital Revenue Code	450
Min. Negotiated Rate	$2,398.02
Max. Negotiated Rate	$2,398.02
Rate for Payer: Qualcare PPO/HMO/WC	$2,398.02

ER-RHYTHM EKG MONITORING

Facility

$123.00

Service Code	HCPCS 93041
Hospital Charge Code	5790235
Hospital Revenue Code	730
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$603.00

ER-RHYTHM EKG MONITORING

Facility

$123.00

Service Code	HCPCS 93041
Hospital Charge Code	5790235
Hospital Revenue Code	730
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

ER-RIB EACH FRACTURE-BILA

Facility

$612.00

Hospital Charge Code	5790320
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-RIB EACH FRACTURE-BILA

Facility

$612.00

Hospital Charge Code	5790320
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

ERROR

Facility

$8,625.00

Hospital Charge Code	270632237C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.75
Max. Negotiated Rate	$4,312.50
Rate for Payer: Aetna Commercial	$2,587.50
Rate for Payer: Aetna Medicare Advantage	$2,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,199.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,199.38
Rate for Payer: Cigna Commercial	$4,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,087.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,293.75

ERROR

Facility

$1,100.00

Hospital Charge Code	270642232
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

ERROR

Facility

$485.90

Hospital Charge Code	27065737
Hospital Revenue Code	271
Min. Negotiated Rate	$63.17
Max. Negotiated Rate	$242.95
Rate for Payer: Aetna Commercial	$145.77
Rate for Payer: Aetna Medicare Advantage	$145.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.90
Rate for Payer: Cigna Commercial	$242.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.17
Rate for Payer: Oxford Commercial	$242.95
Rate for Payer: Qualcare PPO/HMO/WC	$72.89
Rate for Payer: UnitedHealthcare Commercial	$242.95

Know your out-of-pocket cost for care.

All Charges