Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSIGNIA PLATE 20MM

Facility

$5,237.45

Service Code	HCPCS C1889
Hospital Charge Code	270703882
Hospital Revenue Code	278
Min. Negotiated Rate	$785.62
Max. Negotiated Rate	$1,267.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,047.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,267.46
Rate for Payer: Qualcare PPO/HMO/WC	$785.62

INSIGNIA PLATE 20MM

Facility

$5,237.45

Service Code	HCPCS C1889
Hospital Charge Code	270703882
Hospital Revenue Code	278
Min. Negotiated Rate	$785.62
Max. Negotiated Rate	$2,618.72
Rate for Payer: Aetna Commercial	$1,571.23
Rate for Payer: Aetna Medicare Advantage	$1,571.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,335.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,335.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,047.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,335.55
Rate for Payer: Cigna Commercial	$2,618.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,267.46
Rate for Payer: Qualcare PPO/HMO/WC	$785.62

INSITU HYBRIDIZATION EA PROBE

Facility

$342.65

Service Code	HCPCS 88365
Hospital Charge Code	38477206
Hospital Revenue Code	312
Min. Negotiated Rate	$44.54
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$102.80
Rate for Payer: Aetna Medicare Advantage	$102.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.38
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$96.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

INSITU HYBRIDIZATION EA PROBE

Facility

$342.65

Service Code	HCPCS 88365
Hospital Charge Code	38477206
Hospital Revenue Code	312
Min. Negotiated Rate	$51.40
Max. Negotiated Rate	$51.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.40

INSJ BIOMECHANICAL DEVICE

Facility

$23,774.45

Service Code	HCPCS 22853
Hospital Charge Code	162002
Hospital Revenue Code	360
Min. Negotiated Rate	$247.90
Max. Negotiated Rate	$7,132.34
Rate for Payer: Aetna Commercial	$7,132.34
Rate for Payer: Aetna Medicare Advantage	$7,132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,062.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,062.48
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	$6,062.48
Rate for Payer: Cigna Commercial	$247.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,090.68
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSJ BIOMECHANICAL DEVICE

Facility

$23,774.45

Service Code	HCPCS 22853
Hospital Charge Code	162002
Hospital Revenue Code	360
Min. Negotiated Rate	$3,566.17
Max. Negotiated Rate	$3,566.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,566.17

INSJ BIOMECHANICAL DEVICE

Facility

$13,677.00

Service Code	HCPCS 22859
Hospital Charge Code	1600000726
Hospital Revenue Code	360
Min. Negotiated Rate	$325.36
Max. Negotiated Rate	$4,103.10
Rate for Payer: Aetna Commercial	$4,103.10
Rate for Payer: Aetna Medicare Advantage	$4,103.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,487.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,487.64
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	$3,487.64
Rate for Payer: Cigna Commercial	$325.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,778.01
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,051.55
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSJ BIOMECHANICAL DEVICE

Facility

$25,282.63

Service Code	HCPCS 22854
Hospital Charge Code	160000192
Hospital Revenue Code	360
Min. Negotiated Rate	$325.69
Max. Negotiated Rate	$7,584.79
Rate for Payer: Aetna Commercial	$7,584.79
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$325.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,286.74
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSJ BIOMECHANICAL DEVICE

Facility

$13,677.00

Service Code	HCPCS 22859
Hospital Charge Code	1600000726
Hospital Revenue Code	360
Min. Negotiated Rate	$2,051.55
Max. Negotiated Rate	$2,051.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,051.55

INSJ BIOMECHANICAL DEVICE

Facility

$25,282.63

Service Code	HCPCS 22854
Hospital Charge Code	160000192
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSJ PICC RS&I 5 YR+

Facility

$6,925.84

Service Code	HCPCS 36573
Hospital Charge Code	16000302
Hospital Revenue Code	360
Min. Negotiated Rate	$900.36
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$2,077.75
Rate for Payer: Aetna Medicare Advantage	$2,077.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,766.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,766.09
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	$1,766.09
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.36
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,038.88
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

INSJ PICC RS&I 5 YR+

Facility

$6,925.84

Service Code	HCPCS 36573
Hospital Charge Code	16000302
Hospital Revenue Code	360
Min. Negotiated Rate	$1,038.88
Max. Negotiated Rate	$1,038.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,038.88

INSJ/RPLCMT PERQ ELTRD RA SPI

Facility

$66,189.10

Service Code	HCPCS 0784T
Hospital Charge Code	160000853
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$26,535.15
Rate for Payer: Aetna Commercial	$19,856.73
Rate for Payer: Aetna Medicare Advantage	$19,856.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,878.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,878.22
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	$16,878.22
Rate for Payer: Cigna Commercial	$26,535.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,604.58
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,928.36
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

INSJ/RPLCMT PERQ ELTRD RA SPI

Facility

$66,189.10

Service Code	HCPCS 0784T
Hospital Charge Code	160000853
Hospital Revenue Code	360
Min. Negotiated Rate	$9,928.36
Max. Negotiated Rate	$9,928.36
Rate for Payer: Qualcare PPO/HMO/WC	$9,928.36

INS PICC AGE YR/>5

Facility

$10,596.92

Service Code	HCPCS 36569
Hospital Charge Code	1600000659
Hospital Revenue Code	360
Min. Negotiated Rate	$1,377.60
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$3,179.08
Rate for Payer: Aetna Medicare Advantage	$3,179.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,702.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,702.21
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	$2,702.21
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,377.60
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,589.54
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

INS PICC AGE YR/>5

Facility

$10,596.92

Service Code	HCPCS 36569
Hospital Charge Code	1600000659
Hospital Revenue Code	360
Min. Negotiated Rate	$1,589.54
Max. Negotiated Rate	$1,589.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,589.54

INS PICC DEVICE W PORT 5 YRS/>

Facility

$22,851.90

Service Code	HCPCS 36571
Hospital Charge Code	16000736
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$6,855.57
Rate for Payer: Aetna Medicare Advantage	$6,855.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,827.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,827.23
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	$5,827.23
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,970.75
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,427.78
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INS PICC DEVICE W PORT 5 YRS/>

Facility

$22,851.90

Service Code	HCPCS 36571
Hospital Charge Code	16000736
Hospital Revenue Code	360
Min. Negotiated Rate	$3,427.78
Max. Negotiated Rate	$3,427.78
Rate for Payer: Qualcare PPO/HMO/WC	$3,427.78

INSPRA 25MG TAB

Facility

$19.00

Hospital Charge Code	60635556
Hospital Revenue Code	250
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

INSPRA 25MG TAB

Facility

$19.00

Hospital Charge Code	60635556
Hospital Revenue Code	250
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$9.50

INS/RPLC SPI NPG/RCVR POCKET

Facility

$179,437.65

Service Code	HCPCS 63685
Hospital Charge Code	1600000514
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$73,484.37
Rate for Payer: Aetna Commercial	$53,831.29
Rate for Payer: Aetna Medicare Advantage	$53,831.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,756.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,756.60
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	$45,756.60
Rate for Payer: Cigna Commercial	$73,484.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,326.89
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$26,915.65
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

INS/RPLC SPI NPG/RCVR POCKET

Facility

$179,437.65

Service Code	HCPCS 63685
Hospital Charge Code	1600000514
Hospital Revenue Code	360
Min. Negotiated Rate	$26,915.65
Max. Negotiated Rate	$26,915.65
Rate for Payer: Qualcare PPO/HMO/WC	$26,915.65

INS/RPL PRHP SAC/GASTR NPG/R

Facility

$38,477.00

Service Code	HCPCS 64590
Hospital Charge Code	160000228
Hospital Revenue Code	360
Min. Negotiated Rate	$5,771.55
Max. Negotiated Rate	$5,771.55
Rate for Payer: Qualcare PPO/HMO/WC	$5,771.55

INS/RPL PRHP SAC/GASTR NPG/R

Facility

$38,477.00

Service Code	HCPCS 64590
Hospital Charge Code	160000228
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$46,199.32
Rate for Payer: Aetna Commercial	$11,543.10
Rate for Payer: Aetna Medicare Advantage	$11,543.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,811.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,811.64
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	$9,811.64
Rate for Payer: Cigna Commercial	$46,199.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,002.01
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,771.55
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

INSRT MDM LINER 22.2/38MM 38D

Facility

$4,465.10

Service Code	HCPCS C1776
Hospital Charge Code	270681299
Hospital Revenue Code	278
Min. Negotiated Rate	$669.76
Max. Negotiated Rate	$2,232.55
Rate for Payer: Aetna Commercial	$1,339.53
Rate for Payer: Aetna Medicare Advantage	$1,339.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.60
Rate for Payer: Cigna Commercial	$2,232.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.55
Rate for Payer: Qualcare PPO/HMO/WC	$669.76

Know your out-of-pocket cost for care.

All Charges