Heights University Hospital

All Charges

Charge

Type

Setting

Price

FRACTIONATED PORPHYRINS IV

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538D
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

FRACTIONATED PORPHYRINS IV

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538D
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

FRACTIONATED PORPHYRINS V

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538E
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

FRACTIONATED PORPHYRINS V

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538E
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

FRACTIONATION

Facility

$215.20

Service Code	HCPCS 83704
Hospital Charge Code	39900525
Hospital Revenue Code	301
Min. Negotiated Rate	$32.28
Max. Negotiated Rate	$32.28
Rate for Payer: Qualcare PPO/HMO/WC	$32.28

FRACTIONATION

Facility

$215.20

Service Code	HCPCS 83704
Hospital Charge Code	39900525
Hospital Revenue Code	301
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$125.27
Rate for Payer: Aetna Commercial	$110.78
Rate for Payer: Aetna Medicare Advantage	$34.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.27
Rate for Payer: Cigna Commercial	$34.19
Rate for Payer: Cigna Medicare Advantage	$17.09
Rate for Payer: Clover Medicare Advantage	$32.48
Rate for Payer: EmblemHealth Commercial	$102.57
Rate for Payer: Humana Medicare Advantage	$35.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.28
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$36.24
Rate for Payer: Wellcare Medicare Advantage	$34.19

FRACTURE ASSESSMENT VIA DXA

Facility

$352.40

Service Code	HCPCS 77086
Hospital Charge Code	85000890
Hospital Revenue Code	409
Min. Negotiated Rate	$52.86
Max. Negotiated Rate	$52.86
Rate for Payer: Qualcare PPO/HMO/WC	$52.86

FRACTURE ASSESSMENT VIA DXA

Facility

$352.40

Service Code	HCPCS 77086
Hospital Charge Code	85000890
Hospital Revenue Code	409
Min. Negotiated Rate	$29.62
Max. Negotiated Rate	$839.00
Rate for Payer: Aetna Commercial	$105.72
Rate for Payer: Aetna Medicare Advantage	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.86
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.81
Rate for Payer: Oxford Commercial	$739.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.86
Rate for Payer: UnitedHealthcare Commercial	$839.00

FRACTURE OF FEMUR

Facility

$6,448.93

Service Code	APR-DRG 3401
Min. Negotiated Rate	$4,535.55
Max. Negotiated Rate	$6,448.93
Rate for Payer: Aetna Better Health Medicaid	$6,322.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,448.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4,535.55

FRACTURE OF FEMUR

Facility

$11,528.56

Service Code	APR-DRG 3403
Min. Negotiated Rate	$8,058.30
Max. Negotiated Rate	$11,528.56
Rate for Payer: Aetna Better Health Medicaid	$11,302.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,528.56
Rate for Payer: Wellpoint Medicaid Managed Care	$8,058.30

FRACTURE OF FEMUR

Facility

$8,131.39

Service Code	APR-DRG 3402
Min. Negotiated Rate	$5,372.54
Max. Negotiated Rate	$8,131.39
Rate for Payer: Aetna Better Health Medicaid	$7,971.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,131.39
Rate for Payer: Wellpoint Medicaid Managed Care	$5,372.54

FRACTURE OF FEMUR

Facility

$18,530.82

Service Code	APR-DRG 3404
Min. Negotiated Rate	$18,167.47
Max. Negotiated Rate	$18,530.82
Rate for Payer: Aetna Better Health Medicaid	$18,167.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,530.82
Rate for Payer: Wellpoint Medicaid Managed Care	$18,518.98

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$11,081.96

Service Code	APR-DRG 3413
Min. Negotiated Rate	$7,464.03
Max. Negotiated Rate	$11,081.96
Rate for Payer: Aetna Better Health Medicaid	$10,864.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,081.96
Rate for Payer: Wellpoint Medicaid Managed Care	$7,464.03

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$6,995.19

Service Code	APR-DRG 3411
Min. Negotiated Rate	$4,598.23
Max. Negotiated Rate	$6,995.19
Rate for Payer: Aetna Better Health Medicaid	$6,858.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,995.19
Rate for Payer: Wellpoint Medicaid Managed Care	$4,598.23

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$8,441.72

Service Code	APR-DRG 3412
Min. Negotiated Rate	$5,577.69
Max. Negotiated Rate	$8,441.72
Rate for Payer: Aetna Better Health Medicaid	$8,276.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,441.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5,577.69

FRACTURE OF PELVIS OR DISLOCATION OF HIP

Facility

$20,311.55

Service Code	APR-DRG 3414
Min. Negotiated Rate	$17,694.88
Max. Negotiated Rate	$20,311.55
Rate for Payer: Aetna Better Health Medicaid	$19,913.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,311.55
Rate for Payer: Wellpoint Medicaid Managed Care	$17,694.88

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$9,249.25

Service Code	APR-DRG 3422
Min. Negotiated Rate	$6,207.78
Max. Negotiated Rate	$9,249.25
Rate for Payer: Aetna Better Health Medicaid	$9,067.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,249.25
Rate for Payer: Wellpoint Medicaid Managed Care	$6,207.78

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$22,762.23

Service Code	APR-DRG 3424
Min. Negotiated Rate	$19,553.20
Max. Negotiated Rate	$22,762.23
Rate for Payer: Aetna Better Health Medicaid	$22,315.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,762.23
Rate for Payer: Wellpoint Medicaid Managed Care	$19,553.20

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$13,173.10

Service Code	APR-DRG 3423
Min. Negotiated Rate	$8,478.22
Max. Negotiated Rate	$13,173.10
Rate for Payer: Aetna Better Health Medicaid	$12,914.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,173.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8,478.22

FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK

Facility

$7,005.01

Service Code	APR-DRG 3421
Min. Negotiated Rate	$4,801.80
Max. Negotiated Rate	$7,005.01
Rate for Payer: Aetna Better Health Medicaid	$6,867.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,005.01
Rate for Payer: Wellpoint Medicaid Managed Care	$4,801.80

FRACTURES OF FEMUR WITH MCC

Facility

$57,325.86

Service Code	MSDRG 533
Min. Negotiated Rate	$17,107.66
Max. Negotiated Rate	$57,325.86
Rate for Payer: Aetna Commercial	$52,862.67
Rate for Payer: Aetna Medicare Advantage	$17,107.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,934.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,934.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,108.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,934.21
Rate for Payer: Cigna Commercial	$33,738.47
Rate for Payer: Cigna Medicare Advantage	$19,108.62
Rate for Payer: Clover Medicare Advantage	$18,153.19
Rate for Payer: EmblemHealth Commercial	$57,325.86
Rate for Payer: Humana Medicare Advantage	$19,681.88
Rate for Payer: Oxford Commercial	$21,085.56
Rate for Payer: UnitedHealthcare Commercial	$23,934.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,108.62
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20,255.14
Rate for Payer: Wellcare Medicare Advantage	$19,108.62

FRACTURES OF FEMUR WITHOUT MCC

Facility

$35,219.88

Service Code	MSDRG 534
Min. Negotiated Rate	$8,796.63
Max. Negotiated Rate	$35,219.88
Rate for Payer: Aetna Commercial	$27,181.59
Rate for Payer: Aetna Medicare Advantage	$8,796.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,329.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,329.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,739.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,329.27
Rate for Payer: Cigna Commercial	$17,348.08
Rate for Payer: Cigna Medicare Advantage	$11,739.96
Rate for Payer: Clover Medicare Advantage	$11,152.96
Rate for Payer: EmblemHealth Commercial	$35,219.88
Rate for Payer: Humana Medicare Advantage	$12,092.16
Rate for Payer: Oxford Commercial	$10,842.05
Rate for Payer: UnitedHealthcare Commercial	$12,306.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,739.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,444.36
Rate for Payer: Wellcare Medicare Advantage	$11,739.96

FRACTURES OF HIP AND PELVIS WITH MCC

Facility

$49,033.23

Service Code	MSDRG 535
Min. Negotiated Rate	$13,989.93
Max. Negotiated Rate	$49,033.23
Rate for Payer: Aetna Commercial	$43,228.88
Rate for Payer: Aetna Medicare Advantage	$13,989.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,837.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,837.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,344.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,837.10
Rate for Payer: Cigna Commercial	$27,589.92
Rate for Payer: Cigna Medicare Advantage	$16,344.41
Rate for Payer: Clover Medicare Advantage	$15,527.19
Rate for Payer: EmblemHealth Commercial	$49,033.23
Rate for Payer: Humana Medicare Advantage	$16,834.74
Rate for Payer: Oxford Commercial	$17,242.90
Rate for Payer: UnitedHealthcare Commercial	$19,572.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,344.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17,325.07
Rate for Payer: Wellcare Medicare Advantage	$16,344.41

FRACTURES OF HIP AND PELVIS WITHOUT MCC

Facility

$35,263.41

Service Code	MSDRG 536
Min. Negotiated Rate	$8,813.00
Max. Negotiated Rate	$35,263.41
Rate for Payer: Aetna Commercial	$27,232.17
Rate for Payer: Aetna Medicare Advantage	$8,813.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,777.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,777.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,754.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,777.93
Rate for Payer: Cigna Commercial	$17,380.36
Rate for Payer: Cigna Medicare Advantage	$11,754.47
Rate for Payer: Clover Medicare Advantage	$11,166.75
Rate for Payer: EmblemHealth Commercial	$35,263.41
Rate for Payer: Humana Medicare Advantage	$12,107.10
Rate for Payer: Oxford Commercial	$10,862.22
Rate for Payer: UnitedHealthcare Commercial	$12,329.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,754.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,459.74
Rate for Payer: Wellcare Medicare Advantage	$11,754.47

FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC

Facility

$53,178.09

Service Code	MSDRG 562
Min. Negotiated Rate	$15,548.25
Max. Negotiated Rate	$53,178.09
Rate for Payer: Aetna Commercial	$48,044.09
Rate for Payer: Aetna Medicare Advantage	$15,548.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41,901.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41,901.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,726.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41,901.84
Rate for Payer: Cigna Commercial	$30,663.12
Rate for Payer: Cigna Medicare Advantage	$17,726.03
Rate for Payer: Clover Medicare Advantage	$16,839.73
Rate for Payer: EmblemHealth Commercial	$53,178.09
Rate for Payer: Humana Medicare Advantage	$18,257.81
Rate for Payer: Oxford Commercial	$19,163.56
Rate for Payer: UnitedHealthcare Commercial	$21,752.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,726.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,789.59
Rate for Payer: Wellcare Medicare Advantage	$17,726.03

Know your out-of-pocket cost for care.

All Charges