Heights University Hospital

All Charges

Charge

Type

Setting

Price

HIP BI W/WO PELVIS =/> 5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 73523
Hospital Charge Code	94061482
Hospital Revenue Code	320
Min. Negotiated Rate	$169.66
Max. Negotiated Rate	$169.66
Rate for Payer: Qualcare PPO/HMO/WC	$169.66

HIP BI W/WO PELVIS =/> 5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 73523
Hospital Charge Code	75190637
Hospital Revenue Code	320
Min. Negotiated Rate	$169.66
Max. Negotiated Rate	$169.66
Rate for Payer: Qualcare PPO/HMO/WC	$169.66

HIP BI W/WO PELVIS =/> 5 VIEWS

Facility

$1,131.07

Service Code	HCPCS 73523
Hospital Charge Code	94061482
Hospital Revenue Code	320
Min. Negotiated Rate	$58.81
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$339.32
Rate for Payer: Aetna Medicare Advantage	$339.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.42
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$169.66
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HIP COMPLETE-LT

Facility

$250.00

Hospital Charge Code	94061357
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

HIP COMPLETE-LT

Facility

$250.00

Hospital Charge Code	94061357
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HIP COMPLETE-RT

Facility

$250.00

Hospital Charge Code	94061359
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

HIP COMPLETE-RT

Facility

$250.00

Hospital Charge Code	94061359
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HIP FIBER TAK SUTURE ANCH DL

Facility

$2,008.50

Service Code	HCPCS C1713
Hospital Charge Code	270704866
Hospital Revenue Code	278
Min. Negotiated Rate	$301.27
Max. Negotiated Rate	$1,004.25
Rate for Payer: Aetna Commercial	$602.55
Rate for Payer: Aetna Medicare Advantage	$602.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$512.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$512.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$512.17
Rate for Payer: Cigna Commercial	$1,004.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.06
Rate for Payer: Qualcare PPO/HMO/WC	$301.27

HIP FIBER TAK SUTURE ANCH DL

Facility

$2,008.50

Service Code	HCPCS C1713
Hospital Charge Code	270704866
Hospital Revenue Code	278
Min. Negotiated Rate	$301.27
Max. Negotiated Rate	$486.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$486.06
Rate for Payer: Qualcare PPO/HMO/WC	$301.27

HIP FRACTURE NAIL LAG SCREW

Facility

$2,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270683106
Hospital Revenue Code	278
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$1,320.00
Rate for Payer: Aetna Commercial	$792.00
Rate for Payer: Aetna Medicare Advantage	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$673.20
Rate for Payer: Cigna Commercial	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

HIP FRACTURE NAIL LAG SCREW

Facility

$2,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270683106
Hospital Revenue Code	278
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$638.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$528.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

HIP FRACTURE NAIL LEFT 11X380M

Facility

$29,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705821
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$7,018.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

HIP FRACTURE NAIL LEFT 11X380M

Facility

$29,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705821
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$14,500.00
Rate for Payer: Aetna Commercial	$8,700.00
Rate for Payer: Aetna Medicare Advantage	$8,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,395.00
Rate for Payer: Cigna Commercial	$14,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

HIP FRACTURE NAIL RIGHT 11X360

Facility

$29,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705819
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$7,018.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

HIP FRACTURE NAIL RIGHT 11X360

Facility

$29,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705819
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$14,500.00
Rate for Payer: Aetna Commercial	$8,700.00
Rate for Payer: Aetna Medicare Advantage	$8,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,395.00
Rate for Payer: Cigna Commercial	$14,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

HIP INSTRUMENTATION SYSTEM

Facility

$2,500.00

Hospital Charge Code	270670489
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
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) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

HIP INSTRUMENTATION SYSTEM

Facility

$2,500.00

Hospital Charge Code	270670489
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

HIP INSTRUMENT USAGE FEE

Facility

$6,450.00

Hospital Charge Code	270698191
Hospital Revenue Code	279
Min. Negotiated Rate	$838.50
Max. Negotiated Rate	$3,225.00
Rate for Payer: Aetna Commercial	$1,935.00
Rate for Payer: Aetna Medicare Advantage	$1,935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.75
Rate for Payer: Cigna Commercial	$3,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$838.50
Rate for Payer: Oxford Commercial	$3,225.00
Rate for Payer: Qualcare PPO/HMO/WC	$967.50
Rate for Payer: UnitedHealthcare Commercial	$3,225.00

HIP INSTRUMENT USAGE FEE

Facility

$6,450.00

Hospital Charge Code	270698191
Hospital Revenue Code	279
Min. Negotiated Rate	$967.50
Max. Negotiated Rate	$967.50
Rate for Payer: Qualcare PPO/HMO/WC	$967.50

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	2011550
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	94061485
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HIP I VIEW W/WO PELVIS 1V LT

Facility

$358.23

Service Code	HCPCS 73501LT
Hospital Charge Code	94270265
Hospital Revenue Code	320
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$53.73
Rate for Payer: Qualcare PPO/HMO/WC	$53.73

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	94061485
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP I VIEW W/WO PELVIS 1V LT

Facility

$5,100.00

Service Code	HCPCS 73501LT
Hospital Charge Code	2011550
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HIP I VIEW W/WO PELVIS 1V LT

Facility

$358.23

Service Code	HCPCS 73501LT
Hospital Charge Code	94270265
Hospital Revenue Code	320
Min. Negotiated Rate	$46.57
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$107.47
Rate for Payer: Aetna Medicare Advantage	$107.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.35
Rate for Payer: Cigna Commercial	$179.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.73
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges