Heights University Hospital

All Charges

Charge

Type

Setting

Price

ARTHRODESIS MT OR TME; SGL JOI

Facility

$50,347.74

Service Code	HCPCS 28740
Hospital Charge Code	16000454
Hospital Revenue Code	360
Min. Negotiated Rate	$7,552.16
Max. Negotiated Rate	$7,552.16
Rate for Payer: Qualcare PPO/HMO/WC	$7,552.16

ARTHRODESIS MT OR TME; SGL JOI

Facility

$50,347.74

Service Code	HCPCS 28740
Hospital Charge Code	16000454
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$15,104.32
Rate for Payer: Aetna Medicare Advantage	$15,104.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,838.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,838.67
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	$12,838.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,545.21
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,552.16
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

ARTHRODESIS POST 1LEV LUMBAR

Facility

$47,548.90

Service Code	HCPCS 22612
Hospital Charge Code	16000374
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

ARTHRODESIS POST 1LEV LUMBAR

Facility

$47,548.90

Service Code	HCPCS 22612
Hospital Charge Code	16000374
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

ARTHRODESIS POSTERIOR;EA ADD

Facility

$25,282.63

Service Code	HCPCS 22614
Hospital Charge Code	16000359
Hospital Revenue Code	360
Min. Negotiated Rate	$378.57
Max. Negotiated Rate	$7,584.79
Rate for Payer: Aetna Commercial	$7,584.79
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$378.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,286.74
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ARTHRODESIS POSTERIOR;EA ADD

Facility

$25,282.63

Service Code	HCPCS 22614
Hospital Charge Code	16000359
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

ARTHRODESIS SACROILIAC JOINT

Facility

$124,290.30

Service Code	HCPCS 27279
Hospital Charge Code	16000875
Hospital Revenue Code	360
Min. Negotiated Rate	$18,643.54
Max. Negotiated Rate	$18,643.54
Rate for Payer: Qualcare PPO/HMO/WC	$18,643.54

ARTHRODESIS SACROILIAC JOINT

Facility

$124,290.30

Service Code	HCPCS 27279
Hospital Charge Code	16000875
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$37,287.09
Rate for Payer: Aetna Medicare Advantage	$37,287.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,694.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,694.03
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	$31,694.03
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,157.74
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$18,643.54
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

ARTHRODESIS SACROILIAC JOINT

Facility

$11,748.30

Service Code	HCPCS 27280
Hospital Charge Code	1600000856
Hospital Revenue Code	360
Min. Negotiated Rate	$1,527.28
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$3,524.49
Rate for Payer: Aetna Medicare Advantage	$3,524.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,995.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,995.82
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	$2,995.82
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,527.28
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.24
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

ARTHRODESIS SACROILIAC JOINT

Facility

$11,748.30

Service Code	HCPCS 27280
Hospital Charge Code	1600000856
Hospital Revenue Code	360
Min. Negotiated Rate	$1,762.24
Max. Negotiated Rate	$1,762.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.24

ARTHROD MCP JOINT W/WO FIXATN

Facility

$26,471.80

Service Code	HCPCS 26850
Hospital Charge Code	16000859
Hospital Revenue Code	360
Min. Negotiated Rate	$3,970.77
Max. Negotiated Rate	$3,970.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77

ARTHROD MCP JOINT W/WO FIXATN

Facility

$26,471.80

Service Code	HCPCS 26850
Hospital Charge Code	16000859
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$7,941.54
Rate for Payer: Aetna Medicare Advantage	$7,941.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.31
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	$6,750.31
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,441.33
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000617
Hospital Revenue Code	360
Min. Negotiated Rate	$10,899.73
Max. Negotiated Rate	$10,899.73
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000289
Hospital Revenue Code	360
Min. Negotiated Rate	$10,899.73
Max. Negotiated Rate	$10,899.73
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000617
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$21,799.46
Rate for Payer: Aetna Medicare Advantage	$21,799.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,529.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,529.54
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	$18,529.54
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,446.43
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

ARTHROD MT OR TMT MULTI/TRANSV

Facility

$72,664.88

Service Code	HCPCS 28730
Hospital Charge Code	1600000289
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$21,799.46
Rate for Payer: Aetna Medicare Advantage	$21,799.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,529.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,529.54
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	$18,529.54
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,446.43
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,899.73
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

Arthroereisis Sizer, 9 mm

Facility

$5,475.00

Hospital Charge Code	270684397
Hospital Revenue Code	272
Min. Negotiated Rate	$821.25
Max. Negotiated Rate	$821.25
Rate for Payer: Qualcare PPO/HMO/WC	$821.25

Arthroereisis Sizer, 9 mm

Facility

$5,475.00

Hospital Charge Code	270684397
Hospital Revenue Code	272
Min. Negotiated Rate	$711.75
Max. Negotiated Rate	$2,737.50
Rate for Payer: Aetna Commercial	$1,642.50
Rate for Payer: Aetna Medicare Advantage	$1,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,396.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,396.12
Rate for Payer: Cigna Commercial	$2,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.75
Rate for Payer: Oxford Commercial	$2,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$821.25
Rate for Payer: UnitedHealthcare Commercial	$2,737.50

ARTHROFLEXDECELDERM40X70X1.0MM

Facility

$13,805.00

Service Code	HCPCS Q4125
Hospital Charge Code	270698093
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$4,141.50
Rate for Payer: Aetna Commercial	$4,141.50
Rate for Payer: Aetna Medicare Advantage	$4,141.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,520.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,520.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,761.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,520.28
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,340.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.75

ARTHROFLEXDECELDERM40X70X1.0MM

Facility

$13,805.00

Service Code	HCPCS Q4125
Hospital Charge Code	270698093
Hospital Revenue Code	278
Min. Negotiated Rate	$2,070.75
Max. Negotiated Rate	$3,340.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,761.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,340.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,070.75

ARTHROPLASTY ANKLE,

Facility

$37,086.60

Service Code	HCPCS 27700
Hospital Charge Code	16000566
Hospital Revenue Code	360
Min. Negotiated Rate	$5,562.99
Max. Negotiated Rate	$5,562.99
Rate for Payer: Qualcare PPO/HMO/WC	$5,562.99

ARTHROPLASTY ANKLE,

Facility

$37,086.60

Service Code	HCPCS 27700
Hospital Charge Code	16000566
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,125.98
Rate for Payer: Aetna Medicare Advantage	$11,125.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,457.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,457.08
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	$9,457.08
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,821.26
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,562.99
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

ARTHROPLASTY MCP JOINT,EA JNT

Facility

$37,086.60

Service Code	HCPCS 26530
Hospital Charge Code	16000852
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,125.98
Rate for Payer: Aetna Medicare Advantage	$11,125.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,457.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,457.08
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	$9,457.08
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,821.26
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,562.99
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

ARTHROPLASTY MCP JOINT,EA JNT

Facility

$37,086.60

Service Code	HCPCS 26530
Hospital Charge Code	16000852
Hospital Revenue Code	360
Min. Negotiated Rate	$5,562.99
Max. Negotiated Rate	$5,562.99
Rate for Payer: Qualcare PPO/HMO/WC	$5,562.99

ARTHROPLASTY PATELLA,W PROSTH

Facility

$55,895.68

Service Code	HCPCS 27438
Hospital Charge Code	1600000558
Hospital Revenue Code	360
Min. Negotiated Rate	$8,384.35
Max. Negotiated Rate	$8,384.35
Rate for Payer: Qualcare PPO/HMO/WC	$8,384.35

Know your out-of-pocket cost for care.

All Charges