Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR-INJ ANKLE ARTHRO-RT

Facility

$578.00

Service Code	HCPCS 27648RT
Hospital Charge Code	7411878
Hospital Revenue Code	361
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
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	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-RT

Facility

$578.00

Service Code	HCPCS 27648RT
Hospital Charge Code	7411878
Hospital Revenue Code	361
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

IR-INJ ANKLE ARTHRO-RT

Facility

$578.00

Service Code	HCPCS 27648RT
Hospital Charge Code	2690995
Hospital Revenue Code	361
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$1,864.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.70
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
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	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14

IR INJ CHOL THROUGH EXIST CATH

Facility

$414.45

Hospital Charge Code	2004741
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR INJ CHOL THROUGH EXIST CATH

Facility

$414.45

Hospital Charge Code	2004741
Hospital Revenue Code	361
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR-INJECT KNEE ARTHRO-BIL

Facility

$719.00

Service Code	HCPCS 2737050
Hospital Charge Code	7411778
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$359.50
Rate for Payer: Aetna Commercial	$215.70
Rate for Payer: Aetna Medicare Advantage	$215.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.34
Rate for Payer: Cigna Commercial	$359.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.47
Rate for Payer: Oxford Commercial	$359.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.85
Rate for Payer: UnitedHealthcare Commercial	$359.50

IR-INJECT KNEE ARTHRO-BIL

Facility

$719.00

Service Code	HCPCS 2737050
Hospital Charge Code	2690350
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$359.50
Rate for Payer: Aetna Commercial	$215.70
Rate for Payer: Aetna Medicare Advantage	$215.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.34
Rate for Payer: Cigna Commercial	$359.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.47
Rate for Payer: Oxford Commercial	$359.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.85
Rate for Payer: UnitedHealthcare Commercial	$359.50

IR-INJECT KNEE ARTHRO-BIL

Facility

$719.00

Service Code	HCPCS 2737050
Hospital Charge Code	2690350
Hospital Revenue Code	761
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.85

IR-INJECT KNEE ARTHRO-BIL

Facility

$719.00

Service Code	HCPCS 2737050
Hospital Charge Code	7411778
Hospital Revenue Code	761
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.85

IR-INJECT KNEE ARTHRO-LT

Facility

$719.00

Service Code	HCPCS 27370LT
Hospital Charge Code	7411875
Hospital Revenue Code	761
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.85

IR-INJECT KNEE ARTHRO-LT

Facility

$719.00

Service Code	HCPCS 27370LT
Hospital Charge Code	2690980
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$359.50
Rate for Payer: Aetna Commercial	$215.70
Rate for Payer: Aetna Medicare Advantage	$215.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.34
Rate for Payer: Cigna Commercial	$359.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.47
Rate for Payer: Oxford Commercial	$359.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.85
Rate for Payer: UnitedHealthcare Commercial	$359.50

IR-INJECT KNEE ARTHRO-LT

Facility

$719.00

Service Code	HCPCS 27370LT
Hospital Charge Code	7411875
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$359.50
Rate for Payer: Aetna Commercial	$215.70
Rate for Payer: Aetna Medicare Advantage	$215.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.34
Rate for Payer: Cigna Commercial	$359.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.47
Rate for Payer: Oxford Commercial	$359.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.85
Rate for Payer: UnitedHealthcare Commercial	$359.50

IR-INJECT KNEE ARTHRO-LT

Facility

$719.00

Service Code	HCPCS 27370LT
Hospital Charge Code	2690980
Hospital Revenue Code	761
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.85

IR-INJECT KNEE ARTHRO-RT

Facility

$719.00

Service Code	HCPCS 27370RT
Hospital Charge Code	7411876
Hospital Revenue Code	761
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.85

IR-INJECT KNEE ARTHRO-RT

Facility

$719.00

Service Code	HCPCS 27370RT
Hospital Charge Code	7411876
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$359.50
Rate for Payer: Aetna Commercial	$215.70
Rate for Payer: Aetna Medicare Advantage	$215.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.34
Rate for Payer: Cigna Commercial	$359.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.47
Rate for Payer: Oxford Commercial	$359.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.85
Rate for Payer: UnitedHealthcare Commercial	$359.50

IR-INJECT KNEE ARTHRO-RT

Facility

$719.00

Service Code	HCPCS 27370RT
Hospital Charge Code	2690985
Hospital Revenue Code	761
Min. Negotiated Rate	$107.85
Max. Negotiated Rate	$107.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.85

IR-INJECT KNEE ARTHRO-RT

Facility

$719.00

Service Code	HCPCS 27370RT
Hospital Charge Code	2690985
Hospital Revenue Code	761
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$359.50
Rate for Payer: Aetna Commercial	$215.70
Rate for Payer: Aetna Medicare Advantage	$215.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.34
Rate for Payer: Cigna Commercial	$359.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.47
Rate for Payer: Oxford Commercial	$359.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.85
Rate for Payer: UnitedHealthcare Commercial	$359.50

IR-INJECT WRIST ARTHRO-BI

Facility

$638.00

Service Code	HCPCS 2524650
Hospital Charge Code	2690335
Hospital Revenue Code	361
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-BI

Facility

$638.00

Service Code	HCPCS 2524650
Hospital Charge Code	2690335
Hospital Revenue Code	361
Min. Negotiated Rate	$82.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$191.40
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.94
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-BI

Facility

$638.00

Service Code	HCPCS 2524650
Hospital Charge Code	7411775
Hospital Revenue Code	361
Min. Negotiated Rate	$82.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$191.40
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.94
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-BI

Facility

$638.00

Service Code	HCPCS 2524650
Hospital Charge Code	7411775
Hospital Revenue Code	361
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	2690950
Hospital Revenue Code	361
Min. Negotiated Rate	$82.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$191.40
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.94
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	321025246L
Hospital Revenue Code	361
Min. Negotiated Rate	$82.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$191.40
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.94
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	7411869
Hospital Revenue Code	361
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

IR-INJECT WRIST ARTHRO-LT

Facility

$638.00

Service Code	HCPCS 25246LT
Hospital Charge Code	7411869
Hospital Revenue Code	361
Min. Negotiated Rate	$82.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$191.40
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
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	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.94
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

Know your out-of-pocket cost for care.

All Charges