Heights University Hospital

All Charges

Charge

Type

Setting

Price

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	1600000291
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,176.62
Rate for Payer: Aetna Commercial	$8,403.73
Rate for Payer: Aetna Medicare Advantage	$8,403.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,143.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,143.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,143.17
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,641.62
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IMPLANT NEUROELECTRODES

Facility

$28,012.45

Service Code	HCPCS 64581
Hospital Charge Code	16001043
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,176.62
Rate for Payer: Aetna Commercial	$8,403.74
Rate for Payer: Aetna Medicare Advantage	$8,403.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,143.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,143.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,143.17
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,641.62
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

IMPLANT NEUROELECTRODES

Facility

$28,012.45

Service Code	HCPCS 64581
Hospital Charge Code	16001043
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	160000227
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,176.62
Rate for Payer: Aetna Commercial	$8,403.73
Rate for Payer: Aetna Medicare Advantage	$8,403.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,143.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,143.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,143.17
Rate for Payer: Cigna Commercial	$15,176.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,641.62
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	160000227
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$28,012.44

Service Code	HCPCS 64561
Hospital Charge Code	1600000291
Hospital Revenue Code	360
Min. Negotiated Rate	$4,201.87
Max. Negotiated Rate	$4,201.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,201.87

IMPLANT NEUROELECTRODES

Facility

$39,614.51

Service Code	HCPCS 63650
Hospital Charge Code	321563650
Hospital Revenue Code	361
Min. Negotiated Rate	$5,942.18
Max. Negotiated Rate	$5,942.18
Rate for Payer: Qualcare PPO/HMO/WC	$5,942.18

IMPLANTOFBRAININTRACHEMOANGENT

Facility

$150,015.70

Service Code	HCPCS 61517
Hospital Charge Code	270663209
Hospital Revenue Code	360
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$45,004.71
Rate for Payer: Aetna Commercial	$45,004.71
Rate for Payer: Aetna Medicare Advantage	$45,004.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,254.00
Rate for Payer: Cigna Commercial	$86.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,502.04
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$22,502.35
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

IMPLANTOFBRAININTRACHEMOANGENT

Facility

$150,015.70

Service Code	HCPCS 61517
Hospital Charge Code	270663209
Hospital Revenue Code	360
Min. Negotiated Rate	$22,502.35
Max. Negotiated Rate	$22,502.35
Rate for Payer: Qualcare PPO/HMO/WC	$22,502.35

IMPLANT ON 10 90 1197-090-10

Facility

$15,624.00

Hospital Charge Code	270635996
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.60
Max. Negotiated Rate	$3,781.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.60

IMPLANT ON 10 90 1197-090-10

Facility

$15,624.00

Hospital Charge Code	270635996
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.60
Max. Negotiated Rate	$7,812.00
Rate for Payer: Aetna Commercial	$4,687.20
Rate for Payer: Aetna Medicare Advantage	$4,687.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,984.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,984.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,124.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,984.12
Rate for Payer: Cigna Commercial	$7,812.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.60

IMPLANT OSSEOTITE 4 15 OSS415

Facility

$1,288.00

Hospital Charge Code	270620301
Hospital Revenue Code	278
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$644.00
Rate for Payer: Aetna Commercial	$386.40
Rate for Payer: Aetna Medicare Advantage	$386.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.44
Rate for Payer: Cigna Commercial	$644.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.70
Rate for Payer: Qualcare PPO/HMO/WC	$193.20

IMPLANT OSSEOTITE 4 15 OSS415

Facility

$1,288.00

Hospital Charge Code	270620301
Hospital Revenue Code	278
Min. Negotiated Rate	$193.20
Max. Negotiated Rate	$311.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$257.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$311.70
Rate for Payer: Qualcare PPO/HMO/WC	$193.20

IMPLANT PAT-ACTIVE HT RECODER

Facility

$34,718.90

Service Code	HCPCS 33282
Hospital Charge Code	5100815
Hospital Revenue Code	480
Min. Negotiated Rate	$5,207.84
Max. Negotiated Rate	$5,207.84
Rate for Payer: Qualcare PPO/HMO/WC	$5,207.84

IMPLANT PAT-ACTIVE HT RECODER

Facility

$34,718.90

Service Code	HCPCS 33282
Hospital Charge Code	5100815
Hospital Revenue Code	480
Min. Negotiated Rate	$1,580.00
Max. Negotiated Rate	$17,359.45
Rate for Payer: Aetna Commercial	$10,415.67
Rate for Payer: Aetna Medicare Advantage	$10,415.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,853.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,853.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,853.32
Rate for Payer: Cigna Commercial	$17,359.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,513.46
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,207.84
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

IMPLANT PEEK MED CONTOUR

Facility

$42,000.00

Hospital Charge Code	270677110
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$21,000.00
Rate for Payer: Aetna Commercial	$12,600.00
Rate for Payer: Aetna Medicare Advantage	$12,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,710.00
Rate for Payer: Cigna Commercial	$21,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

IMPLANT PEEK MED CONTOUR

Facility

$42,000.00

Hospital Charge Code	270677110
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$10,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

IMPLANT PRODISC-C VIVO MED 5MM

Facility

$42,500.00

Service Code	HCPCS L8699
Hospital Charge Code	270698936
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$21,250.00
Rate for Payer: Aetna Commercial	$12,750.00
Rate for Payer: Aetna Medicare Advantage	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,837.50
Rate for Payer: Cigna Commercial	$21,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

IMPLANT PRODISC-C VIVO MED 5MM

Facility

$42,500.00

Service Code	HCPCS L8699
Hospital Charge Code	270698936
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	87502595
Hospital Revenue Code	761
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

IMPLANT REMOVAL

Facility

$2,081.00

Service Code	HCPCS 11976
Hospital Charge Code	87502595
Hospital Revenue Code	761
Min. Negotiated Rate	$270.53
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$624.30
Rate for Payer: Aetna Medicare Advantage	$624.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.65
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.53
Rate for Payer: Oxford Commercial	$1,040.50
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$1,040.50

IMPLANT REMVL W REINSERTION

Facility

$2,081.00

Hospital Charge Code	83652067
Hospital Revenue Code	360
Min. Negotiated Rate	$270.53
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$624.30
Rate for Payer: Aetna Medicare Advantage	$624.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.65
Rate for Payer: Cigna Commercial	$1,040.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.53
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

IMPLANT REMVL W REINSERTION

Facility

$2,081.00

Hospital Charge Code	83652067
Hospital Revenue Code	360
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

IMPLANT REPAIR DEVICE MENISCAL

Facility

$3,037.50

Service Code	HCPCS C1776
Hospital Charge Code	270663297
Hospital Revenue Code	278
Min. Negotiated Rate	$455.62
Max. Negotiated Rate	$735.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.08
Rate for Payer: Qualcare PPO/HMO/WC	$455.62

IMPLANT REPAIR DEVICE MENISCAL

Facility

$3,037.50

Service Code	HCPCS C1776
Hospital Charge Code	270663297
Hospital Revenue Code	278
Min. Negotiated Rate	$455.62
Max. Negotiated Rate	$1,518.75
Rate for Payer: Aetna Commercial	$911.25
Rate for Payer: Aetna Medicare Advantage	$911.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$774.56
Rate for Payer: Cigna Commercial	$1,518.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$735.08
Rate for Payer: Qualcare PPO/HMO/WC	$455.62

Know your out-of-pocket cost for care.

All Charges