Heights University Hospital

All Charges

Charge

Type

Setting

Price

24 HOUR URINE FOR KIDNEY STONE

Facility

$32.65

Service Code	HCPCS 84392
Hospital Charge Code	3038533E
Hospital Revenue Code	301
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.79
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.12
Rate for Payer: Cigna Commercial	$5.49
Rate for Payer: Cigna Medicare Advantage	$2.75
Rate for Payer: Clover Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$16.47
Rate for Payer: Humana Medicare Advantage	$5.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.49
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.49

24 HOUR URINE FOR KIDNEY STONE

Facility

$338.45

Service Code	HCPCS 82507
Hospital Charge Code	3038533K
Hospital Revenue Code	301
Min. Negotiated Rate	$50.77
Max. Negotiated Rate	$50.77
Rate for Payer: Qualcare PPO/HMO/WC	$50.77

24 HOUR URINE FOR KIDNEY STONE

Facility

$199.90

Service Code	HCPCS 83735
Hospital Charge Code	3038533G
Hospital Revenue Code	301
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$29.98
Rate for Payer: Qualcare PPO/HMO/WC	$29.98

24 HOUR URINE FOR KIDNEY STONE

Facility

$160.85

Service Code	HCPCS 83945
Hospital Charge Code	3038533A
Hospital Revenue Code	301
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.82
Rate for Payer: Aetna Medicare Advantage	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.94
Rate for Payer: Cigna Commercial	$14.45
Rate for Payer: Cigna Medicare Advantage	$7.22
Rate for Payer: Clover Medicare Advantage	$13.73
Rate for Payer: EmblemHealth Commercial	$43.35
Rate for Payer: Humana Medicare Advantage	$14.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.32
Rate for Payer: Wellcare Medicare Advantage	$14.45

24 HOUR URINE FOR KIDNEY STONE

Facility

$268.50

Service Code	HCPCS 81003
Hospital Charge Code	3038533H
Hospital Revenue Code	307
Min. Negotiated Rate	$40.27
Max. Negotiated Rate	$40.27
Rate for Payer: Qualcare PPO/HMO/WC	$40.27

24 HOUR URINE FOR KIDNEY STONE

Facility

$199.90

Service Code	HCPCS 83735
Hospital Charge Code	3038533G
Hospital Revenue Code	301
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.71
Rate for Payer: Aetna Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.55
Rate for Payer: Cigna Commercial	$6.70
Rate for Payer: Cigna Medicare Advantage	$3.35
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.98
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.10
Rate for Payer: Wellcare Medicare Advantage	$6.70

24 HOUR URINE FOR KIDNEY STONE

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	3038533F
Hospital Revenue Code	301
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

24 HOUR URINE FOR KIDNEY STONE

Facility

$152.65

Service Code	HCPCS 82570
Hospital Charge Code	3038533M
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

24 HOUR URINE FOR KIDNEY STONE

Facility

$72.85

Service Code	HCPCS 84300
Hospital Charge Code	3038533D
Hospital Revenue Code	301
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$10.93

24 HOUR URINE FOR KIDNEY STONE

Facility

$152.65

Service Code	HCPCS 82570
Hospital Charge Code	3038533L
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

24 HOUR URINE FOR KIDNEY STONE

Facility

$91.25

Service Code	HCPCS 83935
Hospital Charge Code	3038533O
Hospital Revenue Code	301
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.10
Rate for Payer: Aetna Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$6.82
Rate for Payer: Cigna Medicare Advantage	$3.41
Rate for Payer: Clover Medicare Advantage	$6.48
Rate for Payer: EmblemHealth Commercial	$20.46
Rate for Payer: Humana Medicare Advantage	$7.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.23
Rate for Payer: Wellcare Medicare Advantage	$6.82

24 HOUR URINE FOR KIDNEY STONE

Facility

$160.85

Service Code	HCPCS 83945
Hospital Charge Code	3038533A
Hospital Revenue Code	301
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$24.13
Rate for Payer: Qualcare PPO/HMO/WC	$24.13

24 HOUR URINE FOR KIDNEY STONE

Facility

$153.65

Service Code	HCPCS 82131
Hospital Charge Code	3038533I
Hospital Revenue Code	301
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

24 HOUR URINE FOR KIDNEY STONE

Facility

$52.00

Service Code	HCPCS 82340
Hospital Charge Code	3038533J
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.54
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.09
Rate for Payer: Cigna Commercial	$6.03
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.73
Rate for Payer: EmblemHealth Commercial	$18.09
Rate for Payer: Humana Medicare Advantage	$6.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.39
Rate for Payer: Wellcare Medicare Advantage	$6.03

24 HOUR URINE FOR KIDNEY STONE

Facility

$52.00

Service Code	HCPCS 82340
Hospital Charge Code	3038533J
Hospital Revenue Code	301
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

24 HOUR URINE FOR KIDNEY STONE

Facility

$268.50

Service Code	HCPCS 81003
Hospital Charge Code	3038533H
Hospital Revenue Code	307
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.29
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.24
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: Cigna Medicare Advantage	$1.12
Rate for Payer: Clover Medicare Advantage	$2.14
Rate for Payer: EmblemHealth Commercial	$6.75
Rate for Payer: Humana Medicare Advantage	$2.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.27
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.38
Rate for Payer: Wellcare Medicare Advantage	$2.25

24 HOUR URINE FOR KIDNEY STONE

Facility

$32.65

Service Code	HCPCS 84392
Hospital Charge Code	3038533E
Hospital Revenue Code	301
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$4.90
Rate for Payer: Qualcare PPO/HMO/WC	$4.90

2.4 LOCK VOLAR PLATE LEFT

Facility

$4,194.80

Service Code	HCPCS C1713
Hospital Charge Code	270685572
Hospital Revenue Code	278
Min. Negotiated Rate	$629.22
Max. Negotiated Rate	$2,097.40
Rate for Payer: Aetna Commercial	$1,258.44
Rate for Payer: Aetna Medicare Advantage	$1,258.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,069.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,069.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$838.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,069.67
Rate for Payer: Cigna Commercial	$2,097.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.14
Rate for Payer: Qualcare PPO/HMO/WC	$629.22

2.4 LOCK VOLAR PLATE LEFT

Facility

$4,194.80

Service Code	HCPCS C1713
Hospital Charge Code	270685572
Hospital Revenue Code	278
Min. Negotiated Rate	$629.22
Max. Negotiated Rate	$1,015.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$838.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,015.14
Rate for Payer: Qualcare PPO/HMO/WC	$629.22

2.4MM CAN SCREWSHORT THREAD 18

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270682924
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$257.81
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

2.4MM CAN SCREWSHORT THREAD 18

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270682924
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

2.4MM VA-LCP 2-CLMN PL 7H HD/4

Facility

$4,535.35

Service Code	HCPCS C1713
Hospital Charge Code	270684239
Hospital Revenue Code	278
Min. Negotiated Rate	$680.30
Max. Negotiated Rate	$2,267.68
Rate for Payer: Aetna Commercial	$1,360.61
Rate for Payer: Aetna Medicare Advantage	$1,360.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,156.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,156.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$907.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,156.51
Rate for Payer: Cigna Commercial	$2,267.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,097.55
Rate for Payer: Qualcare PPO/HMO/WC	$680.30

2.4MM VA-LCP 2-CLMN PL 7H HD/4

Facility

$4,535.35

Service Code	HCPCS C1713
Hospital Charge Code	270684239
Hospital Revenue Code	278
Min. Negotiated Rate	$680.30
Max. Negotiated Rate	$1,097.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$907.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,097.55
Rate for Payer: Qualcare PPO/HMO/WC	$680.30

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687787
Hospital Revenue Code	278
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$208.68
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

2.4 MM VA LOCKING SCREWSTARDDR

Facility

$695.60

Service Code	HCPCS C1713
Hospital Charge Code	270687767
Hospital Revenue Code	278
Min. Negotiated Rate	$104.34
Max. Negotiated Rate	$347.80
Rate for Payer: Aetna Commercial	$208.68
Rate for Payer: Aetna Medicare Advantage	$208.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.38
Rate for Payer: Cigna Commercial	$347.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.34
Rate for Payer: Qualcare PPO/HMO/WC	$104.34

Know your out-of-pocket cost for care.

All Charges