Heights University Hospital

All Charges

Charge

Type

Setting

Price

APPLICATION LONG ARM SPLINT

Facility

$348.85

Service Code	HCPCS 29105
Hospital Charge Code	2500370
Hospital Revenue Code	761
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

APPLICATION LONG ARM SPLINT

Facility

$348.85

Service Code	HCPCS 29105
Hospital Charge Code	2500370
Hospital Revenue Code	761
Min. Negotiated Rate	$43.04
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$104.66
Rate for Payer: Aetna Medicare Advantage	$104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.96
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.35
Rate for Payer: Oxford Commercial	$174.43
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Commercial	$174.43

APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	412329345
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

APPLICATION LONG LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29345
Hospital Charge Code	412329345
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 LEG SPLIT -R

Facility

$1,190.20

Service Code	HCPCS 29505
Hospital Charge Code	1600000472
Hospital Revenue Code	360
Min. Negotiated Rate	$178.53
Max. Negotiated Rate	$178.53
Rate for Payer: Qualcare PPO/HMO/WC	$178.53

APPLICATION LONG LEG SPLIT -R

Facility

$1,190.20

Service Code	HCPCS 29505
Hospital Charge Code	1600000472
Hospital Revenue Code	360
Min. Negotiated Rate	$154.73
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$357.06
Rate for Payer: Aetna Medicare Advantage	$357.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$303.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$303.50
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	$303.50
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.73
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$178.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

APPLICATION OF BODY CAST

Facility

$1,360.45

Service Code	HCPCS 29035
Hospital Charge Code	412329035
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

APPLICATION OF BODY CAST

Facility

$1,360.45

Service Code	HCPCS 29035
Hospital Charge Code	412329035
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLICATION OF FOREARM CAST

Facility

$1,391.15

Service Code	HCPCS 29075
Hospital Charge Code	412329075
Hospital Revenue Code	361
Min. Negotiated Rate	$208.67
Max. Negotiated Rate	$208.67
Rate for Payer: Qualcare PPO/HMO/WC	$208.67

APPLICATION OF FOREARM CAST

Facility

$1,676.25

Service Code	HCPCS 29075
Hospital Charge Code	1600000818
Hospital Revenue Code	360
Min. Negotiated Rate	$251.44
Max. Negotiated Rate	$251.44
Rate for Payer: Qualcare PPO/HMO/WC	$251.44

APPLICATION OF FOREARM CAST

Facility

$1,391.15

Service Code	HCPCS 29075
Hospital Charge Code	412329075
Hospital Revenue Code	361
Min. Negotiated Rate	$180.85
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,443.93
Rate for Payer: Aetna Commercial	$417.35
Rate for Payer: Aetna Medicare Advantage	$417.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$354.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$354.74
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	$354.74
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.85
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$208.67
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,472.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1,443.93

APPLICATION OF FOREARM CAST

Facility

$1,676.25

Service Code	HCPCS 29075
Hospital Charge Code	1600000818
Hospital Revenue Code	360
Min. Negotiated Rate	$217.91
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,443.93
Rate for Payer: Aetna Commercial	$502.88
Rate for Payer: Aetna Medicare Advantage	$502.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.44
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	$427.44
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.91
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$251.44
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,472.81
Rate for Payer: Wellpoint Medicaid Managed Care	$1,443.93

APPLICATION OF HIP CAST

Facility

$1,360.45

Service Code	HCPCS 29305
Hospital Charge Code	412329305
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLICATION OF HIP CAST

Facility

$1,360.45

Service Code	HCPCS 29305
Hospital Charge Code	412329305
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

APPLICATION OF LONG LEG CAST

Facility

$1,563.80

Service Code	HCPCS 29365
Hospital Charge Code	1600000357
Hospital Revenue Code	360
Min. Negotiated Rate	$203.29
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$469.14
Rate for Payer: Aetna Medicare Advantage	$469.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$398.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$398.77
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	$398.77
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.29
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.57
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

APPLICATION OF LONG LEG CAST

Facility

$1,563.80

Service Code	HCPCS 29365
Hospital Charge Code	1600000357
Hospital Revenue Code	360
Min. Negotiated Rate	$234.57
Max. Negotiated Rate	$234.57
Rate for Payer: Qualcare PPO/HMO/WC	$234.57

APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	412329405
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

APPLICATION SHORT LEG CAST

Facility

$1,360.45

Service Code	HCPCS 29405
Hospital Charge Code	412329405
Hospital Revenue Code	361
Min. Negotiated Rate	$204.07
Max. Negotiated Rate	$204.07
Rate for Payer: Qualcare PPO/HMO/WC	$204.07

APPLICATOR COTTON TIP 3

Facility

$420.00

Hospital Charge Code	270300050
Hospital Revenue Code	272
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$63.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

APPLICATOR COTTON TIP 3

Facility

$420.00

Hospital Charge Code	270300050
Hospital Revenue Code	272
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$126.00
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
Rate for Payer: UnitedHealthcare Commercial	$210.00

APPLICATOR COTTON TIP 6 STRL

Facility

$0.10

Hospital Charge Code	270300060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.05
Rate for Payer: Aetna Commercial	$0.03
Rate for Payer: Aetna Medicare Advantage	$0.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.03
Rate for Payer: Cigna Commercial	$0.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.01
Rate for Payer: Oxford Commercial	$0.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.02
Rate for Payer: UnitedHealthcare Commercial	$0.05

APPLICATOR COTTON TIP 6 STRL

Facility

$0.10

Hospital Charge Code	270300060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.02

APPLICATOR ENDOSCOPIC 360

Facility

$3,278.20

Hospital Charge Code	270680888
Hospital Revenue Code	272
Min. Negotiated Rate	$491.73
Max. Negotiated Rate	$491.73
Rate for Payer: Qualcare PPO/HMO/WC	$491.73

APPLICATOR ENDOSCOPIC 360

Facility

$3,278.20

Hospital Charge Code	270680888
Hospital Revenue Code	272
Min. Negotiated Rate	$426.17
Max. Negotiated Rate	$1,639.10
Rate for Payer: Aetna Commercial	$983.46
Rate for Payer: Aetna Medicare Advantage	$983.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.94
Rate for Payer: Cigna Commercial	$1,639.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$426.17
Rate for Payer: Oxford Commercial	$1,639.10
Rate for Payer: Qualcare PPO/HMO/WC	$491.73
Rate for Payer: UnitedHealthcare Commercial	$1,639.10

APPLICATOR ENDOSCOP SUGICEL

Facility

$104.00

Hospital Charge Code	270688737
Hospital Revenue Code	272
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

Know your out-of-pocket cost for care.

All Charges