Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXTENSION MODULAR 13x10MM

Facility

$2,140.00

Hospital Charge Code	270677208
Hospital Revenue Code	278
Min. Negotiated Rate	$321.00
Max. Negotiated Rate	$517.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$517.88
Rate for Payer: Qualcare PPO/HMO/WC	$321.00

EXTENSION SET ADULT EXPANDABLE

Facility

$20.88

Hospital Charge Code	270640484
Hospital Revenue Code	270
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$10.44
Rate for Payer: Aetna Commercial	$6.26
Rate for Payer: Aetna Medicare Advantage	$6.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.32
Rate for Payer: Cigna Commercial	$10.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.71
Rate for Payer: Oxford Commercial	$10.44
Rate for Payer: Qualcare PPO/HMO/WC	$3.13
Rate for Payer: UnitedHealthcare Commercial	$10.44

EXTENSION SET ADULT EXPANDABLE

Facility

$20.88

Hospital Charge Code	270640484
Hospital Revenue Code	270
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.13

EXTENSION S/J 17G

Facility

$2,710.00

Hospital Charge Code	270642400
Hospital Revenue Code	278
Min. Negotiated Rate	$406.50
Max. Negotiated Rate	$655.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$542.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$655.82
Rate for Payer: Qualcare PPO/HMO/WC	$406.50

EXTENSION S/J 17G

Facility

$2,710.00

Hospital Charge Code	270642400
Hospital Revenue Code	278
Min. Negotiated Rate	$406.50
Max. Negotiated Rate	$1,355.00
Rate for Payer: Aetna Commercial	$813.00
Rate for Payer: Aetna Medicare Advantage	$813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$691.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$691.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$542.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$691.05
Rate for Payer: Cigna Commercial	$1,355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$655.82
Rate for Payer: Qualcare PPO/HMO/WC	$406.50

EXTENSION STEM INSTRUMENT SET

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270689819
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

EXTENSION STEM INSTRUMENT SET

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270689819
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

EXTENSION STEM SET

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688396
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

EXTENSION STEM SET

Facility

$500.00

Service Code	HCPCS C1776
Hospital Charge Code	270688396
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

EXTENSION TUBE FR EPIDURAL INJ

Facility

$182.00

Hospital Charge Code	270325400
Hospital Revenue Code	272
Min. Negotiated Rate	$23.66
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$54.60
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$91.00

EXTENSION TUBE FR EPIDURAL INJ

Facility

$182.00

Hospital Charge Code	270325400
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

EXTENSION TUBING

Facility

$39.75

Hospital Charge Code	270654298
Hospital Revenue Code	272
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.96

EXTENSION TUBING

Facility

$39.75

Hospital Charge Code	270654298
Hospital Revenue Code	272
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$19.88
Rate for Payer: Aetna Commercial	$11.93
Rate for Payer: Aetna Medicare Advantage	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.14
Rate for Payer: Cigna Commercial	$19.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.17
Rate for Payer: Oxford Commercial	$19.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.96
Rate for Payer: UnitedHealthcare Commercial	$19.88

EXTENSION TUBING SET #4429****

Facility

$15.00

Hospital Charge Code	1810076
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

EXTENSION TUBING SET #4429****

Facility

$15.00

Hospital Charge Code	1810076
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

EXTENSION ZIM KNEE 5988-10-15

Facility

$2,426.45

Hospital Charge Code	270625221
Hospital Revenue Code	272
Min. Negotiated Rate	$315.44
Max. Negotiated Rate	$1,213.22
Rate for Payer: Aetna Commercial	$727.93
Rate for Payer: Aetna Medicare Advantage	$727.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.74
Rate for Payer: Cigna Commercial	$1,213.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.44
Rate for Payer: Oxford Commercial	$1,213.22
Rate for Payer: Qualcare PPO/HMO/WC	$363.97
Rate for Payer: UnitedHealthcare Commercial	$1,213.22

EXTENSION ZIM KNEE 5988-10-15

Facility

$2,426.45

Hospital Charge Code	270625221
Hospital Revenue Code	272
Min. Negotiated Rate	$363.97
Max. Negotiated Rate	$363.97
Rate for Payer: Qualcare PPO/HMO/WC	$363.97

EXTENSION ZIM KNEE 5988-10-18

Facility

$2,426.45

Hospital Charge Code	270625222
Hospital Revenue Code	272
Min. Negotiated Rate	$315.44
Max. Negotiated Rate	$1,213.22
Rate for Payer: Aetna Commercial	$727.93
Rate for Payer: Aetna Medicare Advantage	$727.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.74
Rate for Payer: Cigna Commercial	$1,213.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$315.44
Rate for Payer: Oxford Commercial	$1,213.22
Rate for Payer: Qualcare PPO/HMO/WC	$363.97
Rate for Payer: UnitedHealthcare Commercial	$1,213.22

EXTENSION ZIM KNEE 5988-10-18

Facility

$2,426.45

Hospital Charge Code	270625222
Hospital Revenue Code	272
Min. Negotiated Rate	$363.97
Max. Negotiated Rate	$363.97
Rate for Payer: Qualcare PPO/HMO/WC	$363.97

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$81,044.05

Service Code	APR-DRG 9114
Min. Negotiated Rate	$69,675.84
Max. Negotiated Rate	$81,044.05
Rate for Payer: Aetna Better Health Medicaid	$79,454.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$81,044.05
Rate for Payer: Wellpoint Medicaid Managed Care	$69,675.84

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$20,666.87

Service Code	APR-DRG 9111
Min. Negotiated Rate	$16,380.01
Max. Negotiated Rate	$20,666.87
Rate for Payer: Aetna Better Health Medicaid	$20,261.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,666.87
Rate for Payer: Wellpoint Medicaid Managed Care	$16,380.01

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$39,079.68

Service Code	APR-DRG 9113
Min. Negotiated Rate	$29,260.44
Max. Negotiated Rate	$39,079.68
Rate for Payer: Aetna Better Health Medicaid	$38,313.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$39,079.68
Rate for Payer: Wellpoint Medicaid Managed Care	$29,260.44

EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA

Facility

$29,538.37

Service Code	APR-DRG 9112
Min. Negotiated Rate	$21,529.86
Max. Negotiated Rate	$29,538.37
Rate for Payer: Aetna Better Health Medicaid	$28,959.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,538.37
Rate for Payer: Wellpoint Medicaid Managed Care	$21,529.86

EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT

Facility

$131,311.96

Service Code	MSDRG 933
Min. Negotiated Rate	$39,537.19
Max. Negotiated Rate	$131,311.96
Rate for Payer: Aetna Commercial	$131,311.96
Rate for Payer: Aetna Medicare Advantage	$42,495.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83,528.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83,528.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41,618.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83,528.01
Rate for Payer: Cigna Commercial	$82,139.20
Rate for Payer: Cigna Medicare Advantage	$41,618.09
Rate for Payer: Clover Medicare Advantage	$39,537.19
Rate for Payer: EmblemHealth Commercial	$124,854.27
Rate for Payer: Humana Medicare Advantage	$42,866.63
Rate for Payer: Oxford Commercial	$51,334.61
Rate for Payer: UnitedHealthcare Commercial	$58,269.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$41,618.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$44,115.18
Rate for Payer: Wellcare Medicare Advantage	$41,618.09

EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT

Facility

$726,666.12

Service Code	MSDRG 927
Min. Negotiated Rate	$199,986.49
Max. Negotiated Rate	$726,666.12
Rate for Payer: Aetna Commercial	$719,936.32
Rate for Payer: Aetna Medicare Advantage	$232,989.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726,666.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726,666.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210,512.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726,666.12
Rate for Payer: Cigna Commercial	$396,636.33
Rate for Payer: Cigna Medicare Advantage	$210,512.10
Rate for Payer: Clover Medicare Advantage	$199,986.49
Rate for Payer: EmblemHealth Commercial	$631,536.30
Rate for Payer: Humana Medicare Advantage	$216,827.46
Rate for Payer: Oxford Commercial	$247,886.19
Rate for Payer: UnitedHealthcare Commercial	$281,373.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$210,512.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$223,142.83
Rate for Payer: Wellcare Medicare Advantage	$210,512.10

Know your out-of-pocket cost for care.

All Charges