Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXC LEG/ANKLE TUM DEEP<5 CM RT

Facility

$13,615.50

Service Code	HCPCS 27619
Hospital Charge Code	16000624
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC LEG/ANKLE TUM DEEP<5 CM RT

Facility

$13,615.50

Service Code	HCPCS 27619
Hospital Charge Code	16000624
Hospital Revenue Code	360
Min. Negotiated Rate	$1,770.02
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$4,084.65
Rate for Payer: Aetna Medicare Advantage	$4,084.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,471.95
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC LEG/ANKLE TUM DEP 5 CM/>

Facility

$10,870.60

Service Code	HCPCS 27634
Hospital Charge Code	16000711
Hospital Revenue Code	360
Min. Negotiated Rate	$1,630.59
Max. Negotiated Rate	$1,630.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,630.59

EXC LEG/ANKLE TUM DEP 5 CM/>

Facility

$10,870.60

Service Code	HCPCS 27634
Hospital Charge Code	16000711
Hospital Revenue Code	360
Min. Negotiated Rate	$1,413.18
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$3,261.18
Rate for Payer: Aetna Medicare Advantage	$3,261.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,772.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,772.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,772.00
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,413.18
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,630.59
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC LESION MENISCUS/CAPSULE

Facility

$19,467.90

Service Code	HCPCS 27347
Hospital Charge Code	16000881
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

EXC LESION MENISCUS/CAPSULE

Facility

$19,467.90

Service Code	HCPCS 27347
Hospital Charge Code	16000881
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,840.37
Rate for Payer: Aetna Medicare Advantage	$5,840.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,964.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,964.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,964.31
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,530.83
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXCLUDER CONTRA LEG 12X10

Facility

$19,325.00

Hospital Charge Code	270639871
Hospital Revenue Code	278
Min. Negotiated Rate	$2,898.75
Max. Negotiated Rate	$9,662.50
Rate for Payer: Aetna Commercial	$5,797.50
Rate for Payer: Aetna Medicare Advantage	$5,797.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,927.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,927.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,927.88
Rate for Payer: Cigna Commercial	$9,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,676.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,898.75

EXCLUDER CONTRA LEG 12X10

Facility

$19,325.00

Hospital Charge Code	270639871
Hospital Revenue Code	278
Min. Negotiated Rate	$2,898.75
Max. Negotiated Rate	$4,676.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,865.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,676.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,898.75

EXCLUDER CONTRA LEG 14X14

Facility

$19,900.00

Hospital Charge Code	270645825
Hospital Revenue Code	278
Min. Negotiated Rate	$2,985.00
Max. Negotiated Rate	$4,815.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,815.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,985.00

EXCLUDER CONTRA LEG 14X14

Facility

$19,900.00

Hospital Charge Code	270645825
Hospital Revenue Code	278
Min. Negotiated Rate	$2,985.00
Max. Negotiated Rate	$9,950.00
Rate for Payer: Aetna Commercial	$5,970.00
Rate for Payer: Aetna Medicare Advantage	$5,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,074.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,074.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,074.50
Rate for Payer: Cigna Commercial	$9,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,815.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,985.00

EXCLUDER CONTRA LEG 18X14

Facility

$17,955.00

Hospital Charge Code	270639670
Hospital Revenue Code	278
Min. Negotiated Rate	$2,693.25
Max. Negotiated Rate	$4,345.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,591.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,345.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.25

EXCLUDER CONTRA LEG 18X14

Facility

$17,955.00

Hospital Charge Code	270639670
Hospital Revenue Code	278
Min. Negotiated Rate	$2,693.25
Max. Negotiated Rate	$8,977.50
Rate for Payer: Aetna Commercial	$5,386.50
Rate for Payer: Aetna Medicare Advantage	$5,386.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,578.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,578.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,591.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,578.52
Rate for Payer: Cigna Commercial	$8,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,345.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.25

EXCLUDER CONTRA LEG 20X12

Facility

$18,850.00

Hospital Charge Code	270641853
Hospital Revenue Code	278
Min. Negotiated Rate	$2,827.50
Max. Negotiated Rate	$4,561.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,561.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,827.50

EXCLUDER CONTRA LEG 20X12

Facility

$18,850.00

Hospital Charge Code	270641853
Hospital Revenue Code	278
Min. Negotiated Rate	$2,827.50
Max. Negotiated Rate	$9,425.00
Rate for Payer: Aetna Commercial	$5,655.00
Rate for Payer: Aetna Medicare Advantage	$5,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,806.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,806.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,806.75
Rate for Payer: Cigna Commercial	$9,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,561.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,827.50

EXCLUDER ENDOP 12x12 PXC121200

Facility

$19,325.00

Hospital Charge Code	270638294V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,898.75
Max. Negotiated Rate	$4,676.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,865.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,676.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,898.75

EXCLUDER ENDOP 12x12 PXC121200

Facility

$19,325.00

Hospital Charge Code	270638294V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,898.75
Max. Negotiated Rate	$9,662.50
Rate for Payer: Aetna Commercial	$5,797.50
Rate for Payer: Aetna Medicare Advantage	$5,797.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,927.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,927.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,927.88
Rate for Payer: Cigna Commercial	$9,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,676.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,898.75

EXCLUDER MAIN BODY

Facility

$38,895.00

Hospital Charge Code	270640223
Hospital Revenue Code	278
Min. Negotiated Rate	$5,834.25
Max. Negotiated Rate	$9,412.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,779.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,412.59
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25

EXCLUDER MAIN BODY

Facility

$38,895.00

Hospital Charge Code	270640223
Hospital Revenue Code	278
Min. Negotiated Rate	$5,834.25
Max. Negotiated Rate	$19,447.50
Rate for Payer: Aetna Commercial	$11,668.50
Rate for Payer: Aetna Medicare Advantage	$11,668.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,918.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,918.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,779.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,918.23
Rate for Payer: Cigna Commercial	$19,447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,412.59
Rate for Payer: Qualcare PPO/HMO/WC	$5,834.25

EXCLUDER MAIN BODY 26X14X18

Facility

$40,825.00

Hospital Charge Code	270641852
Hospital Revenue Code	278
Min. Negotiated Rate	$6,123.75
Max. Negotiated Rate	$20,412.50
Rate for Payer: Aetna Commercial	$12,247.50
Rate for Payer: Aetna Medicare Advantage	$12,247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,410.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,410.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,410.38
Rate for Payer: Cigna Commercial	$20,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,879.65
Rate for Payer: Qualcare PPO/HMO/WC	$6,123.75

EXCLUDER MAIN BODY 26X14X18

Facility

$40,825.00

Hospital Charge Code	270641852
Hospital Revenue Code	278
Min. Negotiated Rate	$6,123.75
Max. Negotiated Rate	$9,879.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,879.65
Rate for Payer: Qualcare PPO/HMO/WC	$6,123.75

EXCLUDER MAIN BODY 28X12X18

Facility

$41,850.00

Hospital Charge Code	270644343
Hospital Revenue Code	278
Min. Negotiated Rate	$6,277.50
Max. Negotiated Rate	$20,925.00
Rate for Payer: Aetna Commercial	$12,555.00
Rate for Payer: Aetna Medicare Advantage	$12,555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,671.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,671.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,671.75
Rate for Payer: Cigna Commercial	$20,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,127.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,277.50

EXCLUDER MAIN BODY 28X12X18

Facility

$41,850.00

Hospital Charge Code	270644343
Hospital Revenue Code	278
Min. Negotiated Rate	$6,277.50
Max. Negotiated Rate	$10,127.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,127.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,277.50

EXCLUDER MAIN BODY 28X14X14

Facility

$41,850.00

Hospital Charge Code	270644344
Hospital Revenue Code	278
Min. Negotiated Rate	$6,277.50
Max. Negotiated Rate	$10,127.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,127.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,277.50

EXCLUDER MAIN BODY 28X14X14

Facility

$41,850.00

Hospital Charge Code	270644344
Hospital Revenue Code	278
Min. Negotiated Rate	$6,277.50
Max. Negotiated Rate	$20,925.00
Rate for Payer: Aetna Commercial	$12,555.00
Rate for Payer: Aetna Medicare Advantage	$12,555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,671.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,671.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,671.75
Rate for Payer: Cigna Commercial	$20,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,127.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,277.50

EXC NECK LES SC < 3 CM

Facility

$13,615.50

Service Code	HCPCS 21555
Hospital Charge Code	16000323
Hospital Revenue Code	360
Min. Negotiated Rate	$1,770.02
Max. Negotiated Rate	$4,084.65
Rate for Payer: Aetna Commercial	$4,084.65
Rate for Payer: Aetna Medicare Advantage	$4,084.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,471.95
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Know your out-of-pocket cost for care.

All Charges