Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTERVERTEBRAL BODY FUSION DEV

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704543
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$7,750.00
Rate for Payer: Aetna Commercial	$4,650.00
Rate for Payer: Aetna Medicare Advantage	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,952.50
Rate for Payer: Cigna Commercial	$7,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

INTERVERTEBRAL BODY FUSION DEV

Facility

$15,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704543
Hospital Revenue Code	278
Min. Negotiated Rate	$2,325.00
Max. Negotiated Rate	$3,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,751.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,325.00

INTESTINAL OBSTRUCTION

Facility

$22,781.88

Service Code	APR-DRG 2474
Min. Negotiated Rate	$21,507.47
Max. Negotiated Rate	$22,781.88
Rate for Payer: Aetna Better Health Medicaid	$22,335.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,781.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21,507.47

INTESTINAL OBSTRUCTION

Facility

$6,450.31

Service Code	APR-DRG 2471
Min. Negotiated Rate	$4,615.59
Max. Negotiated Rate	$6,450.31
Rate for Payer: Aetna Better Health Medicaid	$6,323.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,450.31
Rate for Payer: Wellpoint Medicaid Managed Care	$4,615.59

INTESTINAL OBSTRUCTION

Facility

$12,431.60

Service Code	APR-DRG 2473
Min. Negotiated Rate	$9,411.64
Max. Negotiated Rate	$12,431.60
Rate for Payer: Aetna Better Health Medicaid	$12,187.84
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,431.60
Rate for Payer: Wellpoint Medicaid Managed Care	$9,411.64

INTESTINAL OBSTRUCTION

Facility

$8,291.47

Service Code	APR-DRG 2472
Min. Negotiated Rate	$5,936.26
Max. Negotiated Rate	$8,291.47
Rate for Payer: Aetna Better Health Medicaid	$8,128.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,291.47
Rate for Payer: Wellpoint Medicaid Managed Care	$5,936.26

INTL HOSP OR BIRTH CARE E&M NB

Facility

$478.30

Service Code	HCPCS 99460
Hospital Charge Code	93950215
Hospital Revenue Code	510
Min. Negotiated Rate	$62.18
Max. Negotiated Rate	$317.04
Rate for Payer: Aetna Commercial	$143.49
Rate for Payer: Aetna Medicare Advantage	$143.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.97
Rate for Payer: Cigna Commercial	$317.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.18
Rate for Payer: Qualcare PPO/HMO/WC	$71.75

INTL HOSP OR BIRTH CARE E&M NB

Facility

$478.30

Service Code	HCPCS 99460
Hospital Charge Code	93950215
Hospital Revenue Code	510
Min. Negotiated Rate	$71.75
Max. Negotiated Rate	$71.75
Rate for Payer: Qualcare PPO/HMO/WC	$71.75

INTL PREVENTIVE PHYSICAL EXAM

Facility

$500.45

Service Code	HCPCS G0402
Hospital Charge Code	83652529
Hospital Revenue Code	770
Min. Negotiated Rate	$65.06
Max. Negotiated Rate	$317.04
Rate for Payer: Aetna Commercial	$150.13
Rate for Payer: Aetna Medicare Advantage	$150.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.61
Rate for Payer: Cigna Commercial	$317.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.06
Rate for Payer: Oxford Commercial	$250.22
Rate for Payer: Qualcare PPO/HMO/WC	$75.07
Rate for Payer: UnitedHealthcare Commercial	$250.22

INTL PREVENTIVE PHYSICAL EXAM

Facility

$500.45

Service Code	HCPCS G0402
Hospital Charge Code	87502675
Hospital Revenue Code	770
Min. Negotiated Rate	$65.06
Max. Negotiated Rate	$317.04
Rate for Payer: Aetna Commercial	$150.13
Rate for Payer: Aetna Medicare Advantage	$150.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.61
Rate for Payer: Cigna Commercial	$317.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.06
Rate for Payer: Oxford Commercial	$250.22
Rate for Payer: Qualcare PPO/HMO/WC	$75.07
Rate for Payer: UnitedHealthcare Commercial	$250.22

INTL PREVENTIVE PHYSICAL EXAM

Facility

$500.45

Service Code	HCPCS G0402
Hospital Charge Code	87502675
Hospital Revenue Code	770
Min. Negotiated Rate	$75.07
Max. Negotiated Rate	$75.07
Rate for Payer: Qualcare PPO/HMO/WC	$75.07

INTL PREVENTIVE PHYSICAL EXAM

Facility

$500.45

Service Code	HCPCS G0402
Hospital Charge Code	83652529
Hospital Revenue Code	770
Min. Negotiated Rate	$75.07
Max. Negotiated Rate	$75.07
Rate for Payer: Qualcare PPO/HMO/WC	$75.07

INTMD RPR N-HF/GENIT 2.5cm/<

Facility

$1,457.75

Service Code	HCPCS 12041
Hospital Charge Code	16000357
Hospital Revenue Code	360
Min. Negotiated Rate	$189.51
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$437.32
Rate for Payer: Aetna Medicare Advantage	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.73
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	$371.73
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.51
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.66
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

INTMD RPR N-HF/GENIT 2.5cm/<

Facility

$1,457.75

Service Code	HCPCS 12041
Hospital Charge Code	16000357
Hospital Revenue Code	360
Min. Negotiated Rate	$218.66
Max. Negotiated Rate	$218.66
Rate for Payer: Qualcare PPO/HMO/WC	$218.66

INTMD WND REPAIR N-HF/GENIT

Facility

$1,457.75

Service Code	HCPCS 12042
Hospital Charge Code	16000260
Hospital Revenue Code	360
Min. Negotiated Rate	$189.51
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$437.32
Rate for Payer: Aetna Medicare Advantage	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.73
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	$371.73
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.51
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.66
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

INTMD WND REPAIR N-HF/GENIT

Facility

$1,457.75

Service Code	HCPCS 23020
Hospital Charge Code	1600000824
Hospital Revenue Code	360
Min. Negotiated Rate	$189.51
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$437.32
Rate for Payer: Aetna Medicare Advantage	$437.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.73
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	$371.73
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.51
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.66
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INTMD WND REPAIR N-HF/GENIT

Facility

$1,457.75

Service Code	HCPCS 23020
Hospital Charge Code	1600000824
Hospital Revenue Code	360
Min. Negotiated Rate	$218.66
Max. Negotiated Rate	$218.66
Rate for Payer: Qualcare PPO/HMO/WC	$218.66

INTMD WND REPAIR N-HF/GENIT

Facility

$1,457.75

Service Code	HCPCS 12042
Hospital Charge Code	16000260
Hospital Revenue Code	360
Min. Negotiated Rate	$218.66
Max. Negotiated Rate	$218.66
Rate for Payer: Qualcare PPO/HMO/WC	$218.66

INTMD WND REPAIR S/A/T/EXT

Facility

$5,105.84

Service Code	HCPCS 12036
Hospital Charge Code	1600000677
Hospital Revenue Code	360
Min. Negotiated Rate	$765.88
Max. Negotiated Rate	$765.88
Rate for Payer: Qualcare PPO/HMO/WC	$765.88

INTMD WND REPAIR S/A/T/EXT

Facility

$5,105.84

Service Code	HCPCS 12036
Hospital Charge Code	1600000677
Hospital Revenue Code	360
Min. Negotiated Rate	$663.76
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,607.24
Rate for Payer: Aetna Commercial	$1,531.75
Rate for Payer: Aetna Medicare Advantage	$1,531.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,301.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,301.99
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	$1,301.99
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.76
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.88
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,607.24

INTMD WND REPAIR S/A/T/EXT

Facility

$1,497.80

Service Code	HCPCS 12035
Hospital Charge Code	16000406
Hospital Revenue Code	360
Min. Negotiated Rate	$194.71
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$449.34
Rate for Payer: Aetna Medicare Advantage	$449.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.94
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	$381.94
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.71
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$224.67
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

INTMD WND REPAIR S/A/T/EXT

Facility

$2,814.95

Service Code	HCPCS 12032
Hospital Charge Code	1600000417
Hospital Revenue Code	360
Min. Negotiated Rate	$365.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$844.49
Rate for Payer: Aetna Medicare Advantage	$844.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$717.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$717.81
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	$717.81
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$365.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$422.24
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTMD WND REPAIR S/A/T/EXT

Facility

$1,671.20

Service Code	HCPCS 12031
Hospital Charge Code	16000212
Hospital Revenue Code	360
Min. Negotiated Rate	$217.26
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$501.36
Rate for Payer: Aetna Medicare Advantage	$501.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$426.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$426.16
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	$426.16
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.26
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.68
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INTMD WND REPAIR S/A/T/EXT

Facility

$2,814.95

Service Code	HCPCS 12032
Hospital Charge Code	1600000417
Hospital Revenue Code	360
Min. Negotiated Rate	$422.24
Max. Negotiated Rate	$422.24
Rate for Payer: Qualcare PPO/HMO/WC	$422.24

INTMD WND REPAIR S/A/T/EXT

Facility

$1,671.20

Service Code	HCPCS 12031
Hospital Charge Code	16000212
Hospital Revenue Code	360
Min. Negotiated Rate	$250.68
Max. Negotiated Rate	$250.68
Rate for Payer: Qualcare PPO/HMO/WC	$250.68

Know your out-of-pocket cost for care.

All Charges