Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDANCE FOR NDL BRST-TC

Facility

$159.20

Service Code	HCPCS 77032TC
Hospital Charge Code	85000055
Hospital Revenue Code	320
Min. Negotiated Rate	$23.88
Max. Negotiated Rate	$23.88
Rate for Payer: Qualcare PPO/HMO/WC	$23.88

GUIDANCE FOR NDL BRST-TC

Facility

$159.20

Service Code	HCPCS 77032TC
Hospital Charge Code	85000055
Hospital Revenue Code	320
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$47.76
Rate for Payer: Aetna Medicare Advantage	$47.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.60
Rate for Payer: Cigna Commercial	$79.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.88
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

GUIDANCE FOR RADIAJ TX DLVR

Facility

$400.00

Service Code	HCPCS 77387
Hospital Charge Code	85000896
Hospital Revenue Code	333
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$39.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

GUIDANCE FOR RADIAJ TX DLVR

Facility

$400.00

Service Code	HCPCS 77387
Hospital Charge Code	85000896
Hospital Revenue Code	333
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDANCE FOR RADIAJ TX DLVR

Facility

$400.00

Service Code	HCPCS 77387
Hospital Charge Code	2309093
Hospital Revenue Code	333
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$4,435.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$39.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$3,906.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$4,435.00

GUIDANCE FOR RADIAJ TX DLVR

Facility

$400.00

Service Code	HCPCS 77387
Hospital Charge Code	2309093
Hospital Revenue Code	333
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUID CATH MPAI 6F

Facility

$274.75

Hospital Charge Code	2709001203
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$137.38
Rate for Payer: Aetna Commercial	$82.42
Rate for Payer: Aetna Medicare Advantage	$82.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.06
Rate for Payer: Cigna Commercial	$137.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.72
Rate for Payer: Oxford Commercial	$137.38
Rate for Payer: Qualcare PPO/HMO/WC	$41.21
Rate for Payer: UnitedHealthcare Commercial	$137.38

GUID CATH MPAI 6F

Facility

$274.75

Hospital Charge Code	2709001203
Hospital Revenue Code	272
Min. Negotiated Rate	$41.21
Max. Negotiated Rate	$41.21
Rate for Payer: Qualcare PPO/HMO/WC	$41.21

GUID CHCE X/SPPRT 182cm1216101

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	270639577
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

GUID CHCE X/SPPRT 182cm1216101

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	270639577
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

GUIDE 035x180cm ROADRUNN

Facility

$215.00

Service Code	HCPCS C1769
Hospital Charge Code	270679802
Hospital Revenue Code	278
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

GUIDE 035x180cm ROADRUNN

Facility

$215.00

Service Code	HCPCS C1769
Hospital Charge Code	270679802S
Hospital Revenue Code	278
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

GUIDE 035x180cm ROADRUNN

Facility

$215.00

Service Code	HCPCS C1769
Hospital Charge Code	270679802S
Hospital Revenue Code	278
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$64.50
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

GUIDE 035x180cm ROADRUNN

Facility

$239.70

Service Code	HCPCS C1769
Hospital Charge Code	270679802N
Hospital Revenue Code	278
Min. Negotiated Rate	$35.95
Max. Negotiated Rate	$58.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.01
Rate for Payer: Qualcare PPO/HMO/WC	$35.95

GUIDE 035x180cm ROADRUNN

Facility

$239.70

Service Code	HCPCS C1769
Hospital Charge Code	270679802N
Hospital Revenue Code	278
Min. Negotiated Rate	$35.95
Max. Negotiated Rate	$119.85
Rate for Payer: Aetna Commercial	$71.91
Rate for Payer: Aetna Medicare Advantage	$71.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.12
Rate for Payer: Cigna Commercial	$119.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.01
Rate for Payer: Qualcare PPO/HMO/WC	$35.95

GUIDE 035x180cm ROADRUNN

Facility

$215.00

Service Code	HCPCS C1769
Hospital Charge Code	270679802
Hospital Revenue Code	278
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$64.50
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

GUIDE ACCU-CUT AUSTIN/CHEVRON

Facility

$375.00

Hospital Charge Code	270643491
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

GUIDE ACCU-CUT AUSTIN/CHEVRON

Facility

$375.00

Hospital Charge Code	270643491
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDE ACCU-CUT OSTEOTOMY

Facility

$425.00

Hospital Charge Code	270644159
Hospital Revenue Code	272
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$212.50

GUIDE ACCU-CUT OSTEOTOMY

Facility

$425.00

Hospital Charge Code	270644159
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

GUIDE ACCU-CUT YOUNGSWICK 1mm

Facility

$375.00

Hospital Charge Code	270643492
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDE ACCU-CUT YOUNGSWICK 1mm

Facility

$375.00

Hospital Charge Code	270643492
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

GUIDE ACL 7MM

Facility

$4,175.00

Hospital Charge Code	270676467
Hospital Revenue Code	272
Min. Negotiated Rate	$626.25
Max. Negotiated Rate	$626.25
Rate for Payer: Qualcare PPO/HMO/WC	$626.25

GUIDE ACL 7MM

Facility

$4,175.00

Hospital Charge Code	270676467
Hospital Revenue Code	272
Min. Negotiated Rate	$542.75
Max. Negotiated Rate	$2,087.50
Rate for Payer: Aetna Commercial	$1,252.50
Rate for Payer: Aetna Medicare Advantage	$1,252.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,064.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,064.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,064.62
Rate for Payer: Cigna Commercial	$2,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.75
Rate for Payer: Oxford Commercial	$2,087.50
Rate for Payer: Qualcare PPO/HMO/WC	$626.25
Rate for Payer: UnitedHealthcare Commercial	$2,087.50

GUIDE A.I.M ING 1.5MM

Facility

$180.00

Hospital Charge Code	270661782
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$90.00

Know your out-of-pocket cost for care.

All Charges