Heights University Hospital

All Charges

Charge

Type

Setting

Price

AP PARAESOPHAG HERN REPAIR

Facility

$39,439.32

Service Code	HCPCS 43281
Hospital Charge Code	16000744
Hospital Revenue Code	360
Min. Negotiated Rate	$5,915.90
Max. Negotiated Rate	$5,915.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90

AP PARAESOPHAG HERN REPAIR

Facility

$39,439.32

Service Code	HCPCS 43281
Hospital Charge Code	16000744
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$11,831.80
Rate for Payer: Aetna Medicare Advantage	$11,831.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,057.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,057.03
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	$10,057.03
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,127.11
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

APPENDECTOMY,LAPAROSCOPIC

Facility

$43,334.60

Service Code	HCPCS 44970
Hospital Charge Code	16000587
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$13,000.38
Rate for Payer: Aetna Medicare Advantage	$13,000.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,050.32
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	$11,050.32
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,633.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

APPENDECTOMY,LAPAROSCOPIC

Facility

$43,334.60

Service Code	HCPCS 44970
Hospital Charge Code	16000587
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$18,254.11

Service Code	APR-DRG 2332
Min. Negotiated Rate	$17,896.19
Max. Negotiated Rate	$18,254.11
Rate for Payer: Aetna Better Health Medicaid	$17,896.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,254.11

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$40,044.52

Service Code	APR-DRG 2334
Min. Negotiated Rate	$39,259.33
Max. Negotiated Rate	$40,044.52
Rate for Payer: Aetna Better Health Medicaid	$39,259.33
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$40,044.52

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$14,279.75

Service Code	APR-DRG 2331
Min. Negotiated Rate	$13,999.75
Max. Negotiated Rate	$14,279.75
Rate for Payer: Aetna Better Health Medicaid	$13,999.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,279.75

APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS

Facility

$25,663.66

Service Code	APR-DRG 2333
Min. Negotiated Rate	$25,160.45
Max. Negotiated Rate	$25,663.66
Rate for Payer: Aetna Better Health Medicaid	$25,160.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,663.66

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$36,658.56

Service Code	APR-DRG 2344
Min. Negotiated Rate	$35,939.76
Max. Negotiated Rate	$36,658.56
Rate for Payer: Aetna Better Health Medicaid	$35,939.76
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$36,658.56

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$21,267.95

Service Code	APR-DRG 2343
Min. Negotiated Rate	$20,850.93
Max. Negotiated Rate	$21,267.95
Rate for Payer: Aetna Better Health Medicaid	$20,850.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,267.95

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$14,587.31

Service Code	APR-DRG 2342
Min. Negotiated Rate	$14,301.28
Max. Negotiated Rate	$14,587.31
Rate for Payer: Aetna Better Health Medicaid	$14,301.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,587.31

APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS

Facility

$11,468.15

Service Code	APR-DRG 2341
Min. Negotiated Rate	$11,243.28
Max. Negotiated Rate	$11,468.15
Rate for Payer: Aetna Better Health Medicaid	$11,243.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,468.15

APPENDETOMY,OPEN

Facility

$21,811.50

Service Code	HCPCS 44950
Hospital Charge Code	160000215
Hospital Revenue Code	360
Min. Negotiated Rate	$3,271.72
Max. Negotiated Rate	$3,271.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,271.72

APPENDETOMY,OPEN

Facility

$21,811.50

Service Code	HCPCS 44950
Hospital Charge Code	160000215
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$6,543.45
Rate for Payer: Aetna Medicare Advantage	$6,543.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,561.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,561.93
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	$5,561.93
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,835.49
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,271.72
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

APPENDIX PROCEDURES WITH CC

Facility

$55,755.57

Service Code	MSDRG 398
Min. Negotiated Rate	$16,517.29
Max. Negotiated Rate	$55,755.57
Rate for Payer: Aetna Commercial	$51,038.43
Rate for Payer: Aetna Medicare Advantage	$16,517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,585.19
Rate for Payer: Cigna Commercial	$32,574.19
Rate for Payer: Cigna Medicare Advantage	$18,585.19
Rate for Payer: Clover Medicare Advantage	$17,655.93
Rate for Payer: EmblemHealth Commercial	$55,755.57
Rate for Payer: Humana Medicare Advantage	$19,142.75
Rate for Payer: Oxford Commercial	$20,357.92
Rate for Payer: UnitedHealthcare Commercial	$23,108.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,585.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19,700.30
Rate for Payer: Wellcare Medicare Advantage	$18,585.19

APPENDIX PROCEDURES WITH MCC

Facility

$81,335.97

Service Code	MSDRG 397
Min. Negotiated Rate	$25,756.39
Max. Negotiated Rate	$81,335.97
Rate for Payer: Aetna Commercial	$80,755.73
Rate for Payer: Aetna Medicare Advantage	$26,134.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,111.99
Rate for Payer: Cigna Commercial	$51,540.64
Rate for Payer: Cigna Medicare Advantage	$27,111.99
Rate for Payer: Clover Medicare Advantage	$25,756.39
Rate for Payer: EmblemHealth Commercial	$81,335.97
Rate for Payer: Humana Medicare Advantage	$27,925.35
Rate for Payer: Oxford Commercial	$32,211.40
Rate for Payer: UnitedHealthcare Commercial	$36,562.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,111.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28,738.71
Rate for Payer: Wellcare Medicare Advantage	$27,111.99

APPENDIX PROCEDURES WITHOUT CC/MCC

Facility

$45,047.97

Service Code	MSDRG 399
Min. Negotiated Rate	$12,491.63
Max. Negotiated Rate	$45,047.97
Rate for Payer: Aetna Commercial	$38,599.14
Rate for Payer: Aetna Medicare Advantage	$12,491.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,015.99
Rate for Payer: Cigna Commercial	$24,635.09
Rate for Payer: Cigna Medicare Advantage	$15,015.99
Rate for Payer: Clover Medicare Advantage	$14,265.19
Rate for Payer: EmblemHealth Commercial	$45,047.97
Rate for Payer: Humana Medicare Advantage	$15,466.47
Rate for Payer: Oxford Commercial	$15,396.22
Rate for Payer: UnitedHealthcare Commercial	$17,476.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,015.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15,916.95
Rate for Payer: Wellcare Medicare Advantage	$15,015.99

APPILCATOR VISTASEAL 35 CM

Facility

$319.70

Hospital Charge Code	270688804
Hospital Revenue Code	272
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

APPILCATOR VISTASEAL 35 CM

Facility

$319.70

Hospital Charge Code	270688804
Hospital Revenue Code	272
Min. Negotiated Rate	$41.56
Max. Negotiated Rate	$159.85
Rate for Payer: Aetna Commercial	$95.91
Rate for Payer: Aetna Medicare Advantage	$95.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.52
Rate for Payer: Cigna Commercial	$159.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.56
Rate for Payer: Oxford Commercial	$159.85
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Commercial	$159.85

APPLCTOR DISP F/1.5mm RFS-PA15

Facility

$395.00

Hospital Charge Code	270645093
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

APPLCTOR DISP F/1.5mm RFS-PA15

Facility

$395.00

Hospital Charge Code	270645093
Hospital Revenue Code	272
Min. Negotiated Rate	$51.35
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$118.50
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.35
Rate for Payer: Oxford Commercial	$197.50
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$197.50

APPLICATION CYLINDER CAST

Facility

$1,067.95

Service Code	HCPCS 29365
Hospital Charge Code	5780140
Hospital Revenue Code	450
Min. Negotiated Rate	$160.19
Max. Negotiated Rate	$160.19
Rate for Payer: Qualcare PPO/HMO/WC	$160.19

APPLICATION CYLINDER CAST

Facility

$1,067.95

Service Code	HCPCS 29365
Hospital Charge Code	5780140
Hospital Revenue Code	450
Min. Negotiated Rate	$60.95
Max. Negotiated Rate	$666.07
Rate for Payer: Aetna Commercial	$320.38
Rate for Payer: Aetna Medicare Advantage	$320.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.33
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.83
Rate for Payer: Qualcare PPO/HMO/WC	$160.19

APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	412329065
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLICATION LONG ARM CAST

Facility

$1,360.45

Service Code	HCPCS 29065
Hospital Charge Code	412329065
Hospital Revenue Code	361
Min. Negotiated Rate	$176.86
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$408.13
Rate for Payer: Aetna Medicare Advantage	$408.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.91
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	$346.91
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.86
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$204.07
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges