Heights University Hospital

All Charges

Charge

Type

Setting

Price

LOWER EXTREMITY VASCULAR PROCEDURES

Facility

$29,230.81

Service Code	APR-DRG 1812
Min. Negotiated Rate	$19,219.79
Max. Negotiated Rate	$29,230.81
Rate for Payer: Aetna Better Health Medicaid	$28,657.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,230.81
Rate for Payer: Wellpoint Medicaid Managed Care	$19,219.79

LOWER EXTREMITY VASCULAR PROCEDURES

Facility

$21,193.55

Service Code	APR-DRG 1811
Min. Negotiated Rate	$14,188.04
Max. Negotiated Rate	$21,193.55
Rate for Payer: Aetna Better Health Medicaid	$20,777.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,193.55
Rate for Payer: Wellpoint Medicaid Managed Care	$14,188.04

LOWER MINOR PROCEDURE KIT

Facility

$146.00

Hospital Charge Code	270338742
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

LOWER MINOR PROCEDURE KIT

Facility

$146.00

Hospital Charge Code	270338742
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

LOW EXT INFANT 2VW-BIL

Facility

$5,100.00

Service Code	HCPCS 7359250
Hospital Charge Code	94061245
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

LOW EXT INFANT 2VW-BIL

Facility

$5,100.00

Service Code	HCPCS 7359250
Hospital Charge Code	94061245
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

LOW EXTR INFANT 2VW-LT

Facility

$250.00

Service Code	HCPCS 73592LT
Hospital Charge Code	94061381
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

LOW EXTR INFANT 2VW-LT

Facility

$250.00

Service Code	HCPCS 73592LT
Hospital Charge Code	94061381
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

LOW EXTR INFANT 2VW-RT

Facility

$5,100.00

Service Code	HCPCS 73592RT
Hospital Charge Code	94061383
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

LOW EXTR INFANT 2VW-RT

Facility

$5,100.00

Service Code	HCPCS 73592RT
Hospital Charge Code	94061383
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

LOW PROFILE NEURO ADAPTION PL

Facility

$1,655.00

Hospital Charge Code	270664778
Hospital Revenue Code	270
Min. Negotiated Rate	$215.15
Max. Negotiated Rate	$827.50
Rate for Payer: Aetna Commercial	$496.50
Rate for Payer: Aetna Medicare Advantage	$496.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.02
Rate for Payer: Cigna Commercial	$827.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.15
Rate for Payer: Oxford Commercial	$827.50
Rate for Payer: Qualcare PPO/HMO/WC	$248.25
Rate for Payer: UnitedHealthcare Commercial	$827.50

LOW PROFILE NEURO ADAPTION PL

Facility

$1,655.00

Hospital Charge Code	270664778
Hospital Revenue Code	270
Min. Negotiated Rate	$248.25
Max. Negotiated Rate	$248.25
Rate for Payer: Qualcare PPO/HMO/WC	$248.25

LOW PROFILE NEURO X PLATE 4 HO

Facility

$1,475.00

Hospital Charge Code	270664779
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

LOW PROFILE NEURO X PLATE 4 HO

Facility

$1,475.00

Hospital Charge Code	270664779
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

LOW PROFILE SCREW 2.0X12MM COR

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270690768
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

LOW PROFILE SCREW 2.0X12MM COR

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270690768
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

LOW PROFILE SCREW 2.0X16MM COR

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270690769
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

LOW PROFILE SCREW 2.0X16MM COR

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270690769
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

LOW PROFILE STNAILH PL 2 HOLE

Facility

$290.00

Hospital Charge Code	270664780
Hospital Revenue Code	270
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

LOW PROFILE STNAILH PL 2 HOLE

Facility

$290.00

Hospital Charge Code	270664780
Hospital Revenue Code	270
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$145.00
Rate for Payer: Aetna Commercial	$87.00
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$145.00

LOWPRO SCRW TI 4.5X65MM CAN PT

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688392
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

LOWPRO SCRW TI 4.5X65MM CAN PT

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270688392
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

LOXAPINE CAP 10MG

Facility

$4.50

Hospital Charge Code	60627808
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

LOXAPINE CAP 10MG

Facility

$4.50

Hospital Charge Code	60627808
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.35
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.25

LOXAPINE CAP 5MG

Facility

$4.50

Hospital Charge Code	60627810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

Know your out-of-pocket cost for care.

All Charges