Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXPL/REM FB IPH JOINT EA

Facility

$14,318.80

Service Code	HCPCS 26080
Hospital Charge Code	16000841
Hospital Revenue Code	360
Min. Negotiated Rate	$1,861.44
Max. Negotiated Rate	$4,295.64
Rate for Payer: Aetna Commercial	$4,295.64
Rate for Payer: Aetna Medicare Advantage	$4,295.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,651.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,651.29
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	$3,651.29
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,861.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,147.82
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXPL/REM FB MCP JOINT

Facility

$14,854.00

Service Code	HCPCS 26075
Hospital Charge Code	1600000463
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,456.20
Rate for Payer: Aetna Medicare Advantage	$4,456.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,787.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,787.77
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	$3,787.77
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,931.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXPL/REM FB MCP JOINT

Facility

$14,854.00

Service Code	HCPCS 26075
Hospital Charge Code	1600000463
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

EXPL W DRAIN/REM FB - IT/MT FO

Facility

$20,545.30

Service Code	HCPCS 28020
Hospital Charge Code	16000716
Hospital Revenue Code	360
Min. Negotiated Rate	$3,081.80
Max. Negotiated Rate	$3,081.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,081.80

EXPL W DRAIN/REM FB - IT/MT FO

Facility

$20,545.30

Service Code	HCPCS 28020
Hospital Charge Code	16000716
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,163.59
Rate for Payer: Aetna Medicare Advantage	$6,163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,239.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,239.05
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	$5,239.05
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,670.89
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,081.80
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXPL W DR/REM FB - IP FOOT JNT

Facility

$17,164.20

Service Code	HCPCS 28024
Hospital Charge Code	16000568
Hospital Revenue Code	360
Min. Negotiated Rate	$2,574.63
Max. Negotiated Rate	$2,574.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,574.63

EXPL W DR/REM FB - IP FOOT JNT

Facility

$17,164.20

Service Code	HCPCS 28024
Hospital Charge Code	16000568
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$5,149.26
Rate for Payer: Aetna Medicare Advantage	$5,149.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,376.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,376.87
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	$4,376.87
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,231.35
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,574.63
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXPL W DR/REM FB-MTP FOOT JNT

Facility

$19,998.60

Service Code	HCPCS 28022
Hospital Charge Code	16000717
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

EXPL W DR/REM FB-MTP FOOT JNT

Facility

$19,998.60

Service Code	HCPCS 28022
Hospital Charge Code	16000717
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXPOSRE SET

Facility

$7,476.50

Hospital Charge Code	270687446
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.47
Max. Negotiated Rate	$1,121.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.47

EXPOSRE SET

Facility

$7,476.50

Hospital Charge Code	270687446
Hospital Revenue Code	272
Min. Negotiated Rate	$971.95
Max. Negotiated Rate	$3,738.25
Rate for Payer: Aetna Commercial	$2,242.95
Rate for Payer: Aetna Medicare Advantage	$2,242.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.51
Rate for Payer: Cigna Commercial	$3,738.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.95
Rate for Payer: Oxford Commercial	$3,738.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.47
Rate for Payer: UnitedHealthcare Commercial	$3,738.25

EXPO STANDARD FR4

Facility

$142.50

Hospital Charge Code	270684318
Hospital Revenue Code	272
Min. Negotiated Rate	$21.38
Max. Negotiated Rate	$21.38
Rate for Payer: Qualcare PPO/HMO/WC	$21.38

EXPO STANDARD FR4

Facility

$142.50

Hospital Charge Code	270684318N
Hospital Revenue Code	272
Min. Negotiated Rate	$18.52
Max. Negotiated Rate	$71.25
Rate for Payer: Aetna Commercial	$42.75
Rate for Payer: Aetna Medicare Advantage	$42.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.34
Rate for Payer: Cigna Commercial	$71.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.52
Rate for Payer: Oxford Commercial	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.38
Rate for Payer: UnitedHealthcare Commercial	$71.25

EXPO STANDARD FR4

Facility

$142.50

Hospital Charge Code	270684318
Hospital Revenue Code	272
Min. Negotiated Rate	$18.52
Max. Negotiated Rate	$71.25
Rate for Payer: Aetna Commercial	$42.75
Rate for Payer: Aetna Medicare Advantage	$42.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.34
Rate for Payer: Cigna Commercial	$71.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.52
Rate for Payer: Oxford Commercial	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.38
Rate for Payer: UnitedHealthcare Commercial	$71.25

EXPO STANDARD FR4

Facility

$142.50

Hospital Charge Code	270684318N
Hospital Revenue Code	272
Min. Negotiated Rate	$21.38
Max. Negotiated Rate	$21.38
Rate for Payer: Qualcare PPO/HMO/WC	$21.38

EXP SPACER 10X28X10-16MM 15D

Facility

$35,000.00

Hospital Charge Code	270703475
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$8,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

EXP SPACER 10X28X10-16MM 15D

Facility

$35,000.00

Hospital Charge Code	270703475
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$17,500.00
Rate for Payer: Aetna Commercial	$10,500.00
Rate for Payer: Aetna Medicare Advantage	$10,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,925.00
Rate for Payer: Cigna Commercial	$17,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,470.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,250.00

EXSTENSIVE PROSTATE SURGERY

Facility

$22,051.00

Service Code	HCPCS 55840
Hospital Charge Code	1600000443
Hospital Revenue Code	360
Min. Negotiated Rate	$1,136.49
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$6,615.30
Rate for Payer: Aetna Medicare Advantage	$6,615.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,623.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,623.01
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	$5,623.01
Rate for Payer: Cigna Commercial	$1,136.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,866.63
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,307.65
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXSTENSIVE PROSTATE SURGERY

Facility

$22,051.00

Service Code	HCPCS 55840
Hospital Charge Code	1600000443
Hospital Revenue Code	360
Min. Negotiated Rate	$3,307.65
Max. Negotiated Rate	$3,307.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,307.65

EX TAB 5.5X40MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705051
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

EX TAB 5.5X40MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705051
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

EX TAB 56.5X40MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705052
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

EX TAB 56.5X40MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705052
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

EX TAB 6.5X35MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705053
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

EX TAB 6.5X35MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705053
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

Know your out-of-pocket cost for care.

All Charges