Heights University Hospital

All Charges

Charge

Type

Setting

Price

KNEE ARTHROSCOP/SURGERY--RT

Facility

$35,454.57

Service Code	HCPCS 29876
Hospital Charge Code	16000179
Hospital Revenue Code	360
Min. Negotiated Rate	$5,318.19
Max. Negotiated Rate	$5,318.19
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19

KNEE ARTHROSCOP/SURG--RT

Facility

$35,454.57

Service Code	HCPCS 29879
Hospital Charge Code	16000192
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$10,636.37
Rate for Payer: Aetna Better Health Medicaid	$8,649.28
Rate for Payer: Aetna Commercial	$10,636.37
Rate for Payer: Aetna Medicare Advantage	$10,636.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,040.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,040.92
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	$9,040.92
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,609.09
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27
Rate for Payer: Wellpoint Medicaid Managed Care	$8,649.28

KNEE ARTHROSCOP/SURG--RT

Facility

$35,454.57

Service Code	HCPCS 29879
Hospital Charge Code	16000192
Hospital Revenue Code	360
Min. Negotiated Rate	$5,318.19
Max. Negotiated Rate	$5,318.19
Rate for Payer: Qualcare PPO/HMO/WC	$5,318.19

KNEE ARTHROSCOPY KIT

Facility

$461.00

Hospital Charge Code	270338737
Hospital Revenue Code	272
Min. Negotiated Rate	$69.15
Max. Negotiated Rate	$69.15
Rate for Payer: Qualcare PPO/HMO/WC	$69.15

KNEE ARTHROSCOPY KIT

Facility

$461.00

Hospital Charge Code	270338737
Hospital Revenue Code	272
Min. Negotiated Rate	$59.93
Max. Negotiated Rate	$230.50
Rate for Payer: Aetna Commercial	$138.30
Rate for Payer: Aetna Medicare Advantage	$138.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.56
Rate for Payer: Cigna Commercial	$230.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.93
Rate for Payer: Oxford Commercial	$230.50
Rate for Payer: Qualcare PPO/HMO/WC	$69.15
Rate for Payer: UnitedHealthcare Commercial	$230.50

KNEE ARTHROSCOPY W LAT RLS

Facility

$31,016.90

Service Code	HCPCS 29873
Hospital Charge Code	16000380
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,305.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,652.53
Rate for Payer: Aetna Commercial	$9,305.07
Rate for Payer: Aetna Medicare Advantage	$9,305.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,909.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,909.31
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	$7,909.31
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,032.20
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

KNEE ARTHROSCOPY W LAT RLS

Facility

$31,016.90

Service Code	HCPCS 29873
Hospital Charge Code	16000380
Hospital Revenue Code	360
Min. Negotiated Rate	$4,652.53
Max. Negotiated Rate	$4,652.53
Rate for Payer: Qualcare PPO/HMO/WC	$4,652.53

KNEE BLOCK

Facility

$6,250.00

Hospital Charge Code	270667770
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

KNEE BLOCK

Facility

$6,250.00

Hospital Charge Code	270667770
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

KNEE CREATION-SCP FOOT & ANKLE

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686278
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATION-SCP FOOT & ANKLE

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686278
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$4,665.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATION SCP FT & AN 15 3

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686281
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$3,763.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATION SCP FT & AN 15 3

Facility

$15,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270686281
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.50
Max. Negotiated Rate	$7,775.00
Rate for Payer: Aetna Commercial	$4,665.00
Rate for Payer: Aetna Medicare Advantage	$4,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,965.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,965.25
Rate for Payer: Cigna Commercial	$7,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,763.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,332.50

KNEE CREATIONS SCP FOOT ANKLE

Facility

$18,337.50

Service Code	HCPCS C1776
Hospital Charge Code	270680418
Hospital Revenue Code	278
Min. Negotiated Rate	$2,750.62
Max. Negotiated Rate	$9,168.75
Rate for Payer: Aetna Commercial	$5,501.25
Rate for Payer: Aetna Medicare Advantage	$5,501.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,676.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,676.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,676.06
Rate for Payer: Cigna Commercial	$9,168.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,750.62

KNEE CREATIONS SCP FOOT ANKLE

Facility

$18,337.50

Service Code	HCPCS C1776
Hospital Charge Code	270680418
Hospital Revenue Code	278
Min. Negotiated Rate	$2,750.62
Max. Negotiated Rate	$4,437.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,667.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,437.68
Rate for Payer: Qualcare PPO/HMO/WC	$2,750.62

KNEE EXCHANGE TRIAL SET COPAL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690885
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KNEE EXCHANGE TRIAL SET COPAL

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690885
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KNEE FIBERTAK DRILL 2.8MM

Facility

$475.00

Hospital Charge Code	270703164
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

KNEE FIBERTAK DRILL 2.8MM

Facility

$475.00

Hospital Charge Code	270703164
Hospital Revenue Code	272
Min. Negotiated Rate	$61.75
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.75
Rate for Payer: Oxford Commercial	$237.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$237.50

KNEE IMMOBILIZER UNIVERSAL 23

Facility

$67.70

Service Code	HCPCS L1830
Hospital Charge Code	270649884
Hospital Revenue Code	274
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.15

KNEE IMMOBILIZER UNIVERSAL 23

Facility

$67.70

Service Code	HCPCS L1830
Hospital Charge Code	270649884
Hospital Revenue Code	274
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$69.94
Rate for Payer: Aetna Commercial	$20.31
Rate for Payer: Aetna Medicare Advantage	$20.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.26
Rate for Payer: Cigna Commercial	$69.94
Rate for Payer: Cigna Medicare Advantage	$41.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.15

KNEE IMOBILIZER UNIVERSAL 23

Facility

$291.00

Hospital Charge Code	270331551
Hospital Revenue Code	274
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$70.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

KNEE IMOBILIZER UNIVERSAL 23

Facility

$291.00

Hospital Charge Code	270331551
Hospital Revenue Code	274
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$87.30
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

KNEE INJECTION

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84506005
Hospital Revenue Code	361
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

KNEE INJECTION

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84506005
Hospital Revenue Code	361
Min. Negotiated Rate	$141.83
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$327.30
Rate for Payer: Aetna Medicare Advantage	$327.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.20
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	$278.20
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges