Heights University Hospital

All Charges

Charge

Type

Setting

Price

LOAD UNIT TA60-3.5 SINGLE USE

Facility

$203.85

Hospital Charge Code	270630409
Hospital Revenue Code	272
Min. Negotiated Rate	$30.58
Max. Negotiated Rate	$30.58
Rate for Payer: Qualcare PPO/HMO/WC	$30.58

LOAD UNIT TA60-3.5 SINGLE USE

Facility

$203.85

Hospital Charge Code	270630409
Hospital Revenue Code	272
Min. Negotiated Rate	$26.50
Max. Negotiated Rate	$101.92
Rate for Payer: Aetna Commercial	$61.16
Rate for Payer: Aetna Medicare Advantage	$61.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.98
Rate for Payer: Cigna Commercial	$101.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.50
Rate for Payer: Oxford Commercial	$101.92
Rate for Payer: Qualcare PPO/HMO/WC	$30.58
Rate for Payer: UnitedHealthcare Commercial	$101.92

LOANER ARM TRIMANO POSITIONER

Facility

$1,250.00

Hospital Charge Code	270648820
Hospital Revenue Code	271
Min. Negotiated Rate	$162.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$625.00

LOANER ARM TRIMANO POSITIONER

Facility

$1,250.00

Hospital Charge Code	270648820
Hospital Revenue Code	271
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

LOANER FEE ARTHOSCOPY TRAY

Facility

$1,000.00

Hospital Charge Code	270661562
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

LOANER FEE ARTHOSCOPY TRAY

Facility

$1,000.00

Hospital Charge Code	270661562
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

LOANER INSTRUMENT USAGE FEE

Facility

$1,000.00

Hospital Charge Code	270646571
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

LOANER INSTRUMENT USAGE FEE

Facility

$1,000.00

Hospital Charge Code	270646571
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

LOANER PRP

Facility

$750.00

Hospital Charge Code	270659982
Hospital Revenue Code	270
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

LOANER PRP

Facility

$750.00

Hospital Charge Code	270659982
Hospital Revenue Code	270
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

LOBSTER IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003E
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LOBSTER IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003E
Hospital Revenue Code	302
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC

Facility

$64,181.76

Service Code	MSDRG 496
Min. Negotiated Rate	$19,685.21
Max. Negotiated Rate	$64,181.76
Rate for Payer: Aetna Commercial	$60,827.30
Rate for Payer: Aetna Medicare Advantage	$19,685.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,858.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,858.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,393.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,858.33
Rate for Payer: Cigna Commercial	$38,821.73
Rate for Payer: Cigna Medicare Advantage	$21,393.92
Rate for Payer: Clover Medicare Advantage	$20,324.22
Rate for Payer: EmblemHealth Commercial	$64,181.76
Rate for Payer: Humana Medicare Advantage	$22,035.74
Rate for Payer: Oxford Commercial	$24,262.46
Rate for Payer: UnitedHealthcare Commercial	$27,540.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,393.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,677.56
Rate for Payer: Wellcare Medicare Advantage	$21,393.92

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC

Facility

$122,258.17

Service Code	MSDRG 495
Min. Negotiated Rate	$37,069.27
Max. Negotiated Rate	$122,258.17
Rate for Payer: Aetna Commercial	$122,258.17
Rate for Payer: Aetna Medicare Advantage	$39,565.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98,689.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98,689.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$39,020.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98,689.86
Rate for Payer: Cigna Commercial	$78,028.69
Rate for Payer: Cigna Medicare Advantage	$39,020.28
Rate for Payer: Clover Medicare Advantage	$37,069.27
Rate for Payer: EmblemHealth Commercial	$117,060.84
Rate for Payer: Humana Medicare Advantage	$40,190.89
Rate for Payer: Oxford Commercial	$48,765.67
Rate for Payer: UnitedHealthcare Commercial	$55,353.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$39,020.28
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$41,361.50
Rate for Payer: Wellcare Medicare Advantage	$39,020.28

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC

Facility

$46,894.02

Service Code	MSDRG 497
Min. Negotiated Rate	$13,185.67
Max. Negotiated Rate	$46,894.02
Rate for Payer: Aetna Commercial	$40,743.72
Rate for Payer: Aetna Medicare Advantage	$13,185.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,420.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,420.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,631.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,420.81
Rate for Payer: Cigna Commercial	$24,785.74
Rate for Payer: Cigna Medicare Advantage	$15,631.34
Rate for Payer: Clover Medicare Advantage	$14,849.77
Rate for Payer: EmblemHealth Commercial	$46,894.02
Rate for Payer: Humana Medicare Advantage	$16,100.28
Rate for Payer: Oxford Commercial	$15,490.36
Rate for Payer: UnitedHealthcare Commercial	$17,583.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,631.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16,569.22
Rate for Payer: Wellcare Medicare Advantage	$15,631.34

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC

Facility

$101,726.14

Service Code	MSDRG 498
Min. Negotiated Rate	$31,472.57
Max. Negotiated Rate	$101,726.14
Rate for Payer: Aetna Commercial	$101,726.14
Rate for Payer: Aetna Medicare Advantage	$32,921.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71,949.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71,949.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,129.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71,949.87
Rate for Payer: Cigna Commercial	$64,924.55
Rate for Payer: Cigna Medicare Advantage	$33,129.02
Rate for Payer: Clover Medicare Advantage	$31,472.57
Rate for Payer: EmblemHealth Commercial	$99,387.06
Rate for Payer: Humana Medicare Advantage	$34,122.89
Rate for Payer: Oxford Commercial	$40,575.96
Rate for Payer: UnitedHealthcare Commercial	$46,057.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,129.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$35,116.76
Rate for Payer: Wellcare Medicare Advantage	$33,129.02

LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC

Facility

$70,303.29

Service Code	MSDRG 499
Min. Negotiated Rate	$21,986.67
Max. Negotiated Rate	$70,303.29
Rate for Payer: Cigna Commercial	$43,360.51
Rate for Payer: Aetna Commercial	$67,938.81
Rate for Payer: Aetna Medicare Advantage	$21,986.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,561.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,561.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,434.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,561.43
Rate for Payer: Cigna Medicare Advantage	$23,434.43
Rate for Payer: Clover Medicare Advantage	$22,262.71
Rate for Payer: EmblemHealth Commercial	$70,303.29
Rate for Payer: Humana Medicare Advantage	$24,137.46
Rate for Payer: Oxford Commercial	$27,099.06
Rate for Payer: UnitedHealthcare Commercial	$30,759.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,434.43
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24,840.50
Rate for Payer: Wellcare Medicare Advantage	$23,434.43

LOCALIZATION NEEDLE BREAST 7.5

Facility

$180.00

Hospital Charge Code	270665028
Hospital Revenue Code	270
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$90.00

LOCALIZATION NEEDLE BREAST 7.5

Facility

$180.00

Hospital Charge Code	270665028
Hospital Revenue Code	270
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

LOCALIZATION NEEDLE HARDWIRE 2

Facility

$140.00

Service Code	HCPCS A4648
Hospital Charge Code	270665151
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

LOCALIZATION NEEDLE HARDWIRE 2

Facility

$140.00

Service Code	HCPCS A4648
Hospital Charge Code	270665151
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

LOCAL KIT

Facility

$46.00

Hospital Charge Code	270338745
Hospital Revenue Code	272
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

LOCAL KIT

Facility

$46.00

Hospital Charge Code	270338745
Hospital Revenue Code	272
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$13.80
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$23.00

LOCING PLATE

Facility

$3,615.00

Hospital Charge Code	270660696
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$1,807.50
Rate for Payer: Aetna Commercial	$1,084.50
Rate for Payer: Aetna Medicare Advantage	$1,084.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$921.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$921.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$723.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$921.83
Rate for Payer: Cigna Commercial	$1,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$874.83
Rate for Payer: Qualcare PPO/HMO/WC	$542.25

LOCING PLATE

Facility

$3,615.00

Hospital Charge Code	270660696
Hospital Revenue Code	278
Min. Negotiated Rate	$542.25
Max. Negotiated Rate	$874.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$723.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$874.83
Rate for Payer: Qualcare PPO/HMO/WC	$542.25

Know your out-of-pocket cost for care.

All Charges