Heights University Hospital

All Charges

Charge

Type

Setting

Price

MENISCAL ROOT REP PK W ULTRABR

Facility

$4,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270688719
Hospital Revenue Code	278
Min. Negotiated Rate	$738.75
Max. Negotiated Rate	$2,462.50
Rate for Payer: Aetna Commercial	$1,477.50
Rate for Payer: Aetna Medicare Advantage	$1,477.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,255.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,255.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,255.88
Rate for Payer: Cigna Commercial	$2,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.85
Rate for Payer: Qualcare PPO/HMO/WC	$738.75

MENISCAL ROOT REP PK W ULTRABR

Facility

$4,925.00

Service Code	HCPCS C1713
Hospital Charge Code	270688719
Hospital Revenue Code	278
Min. Negotiated Rate	$738.75
Max. Negotiated Rate	$1,191.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,191.85
Rate for Payer: Qualcare PPO/HMO/WC	$738.75

MENISCAL ULTRA SYSTEM FIXATION

Facility

$1,595.00

Hospital Charge Code	270658618
Hospital Revenue Code	272
Min. Negotiated Rate	$207.35
Max. Negotiated Rate	$797.50
Rate for Payer: Aetna Commercial	$478.50
Rate for Payer: Aetna Medicare Advantage	$478.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$406.73
Rate for Payer: Cigna Commercial	$797.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.35
Rate for Payer: Oxford Commercial	$797.50
Rate for Payer: Qualcare PPO/HMO/WC	$239.25
Rate for Payer: UnitedHealthcare Commercial	$797.50

MENISCAL ULTRA SYSTEM FIXATION

Facility

$1,595.00

Hospital Charge Code	270658618
Hospital Revenue Code	272
Min. Negotiated Rate	$239.25
Max. Negotiated Rate	$239.25
Rate for Payer: Qualcare PPO/HMO/WC	$239.25

MENISC REP.SYS.PDSW/STR 228310

Facility

$1,050.00

Hospital Charge Code	270637281
Hospital Revenue Code	272
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

MENISC REP.SYS.PDSW/STR 228310

Facility

$1,050.00

Hospital Charge Code	270637281
Hospital Revenue Code	272
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.50
Rate for Payer: Oxford Commercial	$525.00
Rate for Payer: Qualcare PPO/HMO/WC	$157.50
Rate for Payer: UnitedHealthcare Commercial	$525.00

MENISCUS LAT FF 3.3CM X 3.2CM

Facility

$23,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270676521
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$11,875.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$7,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,056.25
Rate for Payer: Cigna Commercial	$11,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

MENISCUS LAT FF 3.3CM X 3.2CM

Facility

$23,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270676521
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$5,747.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

MENISCUS RT MEDIAL FMNRM

Facility

$23,538.75

Service Code	HCPCS C1762
Hospital Charge Code	270697840
Hospital Revenue Code	278
Min. Negotiated Rate	$3,530.81
Max. Negotiated Rate	$11,769.38
Rate for Payer: Aetna Commercial	$7,061.62
Rate for Payer: Aetna Medicare Advantage	$7,061.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,002.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,002.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,707.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,002.38
Rate for Payer: Cigna Commercial	$11,769.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,696.38
Rate for Payer: Qualcare PPO/HMO/WC	$3,530.81

MENISCUS RT MEDIAL FMNRM

Facility

$23,538.75

Service Code	HCPCS C1762
Hospital Charge Code	270697840
Hospital Revenue Code	278
Min. Negotiated Rate	$3,530.81
Max. Negotiated Rate	$5,696.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,707.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,696.38
Rate for Payer: Qualcare PPO/HMO/WC	$3,530.81

MENISUCUS RIGHT LATERAL 36 MM

Facility

$23,523.75

Service Code	HCPCS C1762
Hospital Charge Code	270684974
Hospital Revenue Code	278
Min. Negotiated Rate	$3,528.56
Max. Negotiated Rate	$5,692.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,704.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,692.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,528.56

MENISUCUS RIGHT LATERAL 36 MM

Facility

$23,523.75

Service Code	HCPCS C1762
Hospital Charge Code	270684974
Hospital Revenue Code	278
Min. Negotiated Rate	$3,528.56
Max. Negotiated Rate	$11,761.88
Rate for Payer: Aetna Commercial	$7,057.12
Rate for Payer: Aetna Medicare Advantage	$7,057.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,998.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,998.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,704.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,998.56
Rate for Payer: Cigna Commercial	$11,761.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,692.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,528.56

MENSICAL KNOT PUSHER & SUTURE

Facility

$200.00

Hospital Charge Code	270339440
Hospital Revenue Code	272
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$100.00

MENSICAL KNOT PUSHER & SUTURE

Facility

$200.00

Hospital Charge Code	270339440
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$7,031.74

Service Code	APR-DRG 5322
Min. Negotiated Rate	$5,081.00
Max. Negotiated Rate	$7,031.74
Rate for Payer: Aetna Better Health Medicaid	$6,893.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,031.74
Rate for Payer: Wellpoint Medicaid Managed Care	$5,081.00

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$10,906.45

Service Code	APR-DRG 5323
Min. Negotiated Rate	$8,352.50
Max. Negotiated Rate	$10,906.45
Rate for Payer: Aetna Better Health Medicaid	$10,692.60
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,906.45
Rate for Payer: Wellpoint Medicaid Managed Care	$8,352.50

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$19,105.17

Service Code	APR-DRG 5324
Min. Negotiated Rate	$17,103.33
Max. Negotiated Rate	$19,105.17
Rate for Payer: Aetna Better Health Medicaid	$18,730.56
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,105.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17,103.33

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS

Facility

$5,573.99

Service Code	APR-DRG 5321
Min. Negotiated Rate	$4,115.51
Max. Negotiated Rate	$5,573.99
Rate for Payer: Aetna Better Health Medicaid	$5,464.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,573.99
Rate for Payer: Wellpoint Medicaid Managed Care	$4,115.51

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC

Facility

$41,065.65

Service Code	MSDRG 760
Min. Negotiated Rate	$10,994.43
Max. Negotiated Rate	$41,065.65
Rate for Payer: Aetna Commercial	$33,972.79
Rate for Payer: Aetna Medicare Advantage	$10,994.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,567.00
Rate for Payer: Cigna Commercial	$21,682.41
Rate for Payer: Cigna Medicare Advantage	$13,688.55
Rate for Payer: Clover Medicare Advantage	$13,004.12
Rate for Payer: EmblemHealth Commercial	$41,065.65
Rate for Payer: Humana Medicare Advantage	$14,099.21
Rate for Payer: Oxford Commercial	$13,550.88
Rate for Payer: UnitedHealthcare Commercial	$15,381.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,688.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,509.86
Rate for Payer: Wellcare Medicare Advantage	$13,688.55

MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC

Facility

$28,381.41

Service Code	MSDRG 761
Min. Negotiated Rate	$6,225.63
Max. Negotiated Rate	$28,381.41
Rate for Payer: Aetna Commercial	$19,237.20
Rate for Payer: Aetna Medicare Advantage	$6,225.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,815.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,815.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,460.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,815.87
Rate for Payer: Cigna Commercial	$12,258.36
Rate for Payer: Cigna Medicare Advantage	$9,460.47
Rate for Payer: Clover Medicare Advantage	$8,987.45
Rate for Payer: EmblemHealth Commercial	$28,381.41
Rate for Payer: Humana Medicare Advantage	$9,744.28
Rate for Payer: Oxford Commercial	$7,661.12
Rate for Payer: UnitedHealthcare Commercial	$8,696.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,460.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,028.10
Rate for Payer: Wellcare Medicare Advantage	$9,460.47

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$19,308.85

Service Code	APR-DRG 7402
Min. Negotiated Rate	$15,242.76
Max. Negotiated Rate	$19,308.85
Rate for Payer: Aetna Better Health Medicaid	$18,930.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,308.85
Rate for Payer: Wellpoint Medicaid Managed Care	$15,242.76

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$12,665.54

Service Code	APR-DRG 7401
Min. Negotiated Rate	$11,945.47
Max. Negotiated Rate	$12,665.54
Rate for Payer: Aetna Better Health Medicaid	$11,945.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,184.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12,665.54

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$68,095.60

Service Code	APR-DRG 7404
Min. Negotiated Rate	$51,348.69
Max. Negotiated Rate	$68,095.60
Rate for Payer: Aetna Better Health Medicaid	$66,760.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$68,095.60
Rate for Payer: Wellpoint Medicaid Managed Care	$51,348.69

MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE

Facility

$33,340.01

Service Code	APR-DRG 7403
Min. Negotiated Rate	$25,550.33
Max. Negotiated Rate	$33,340.01
Rate for Payer: Aetna Better Health Medicaid	$32,686.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$33,340.01
Rate for Payer: Wellpoint Medicaid Managed Care	$25,550.33

MENTHOL CAM EUCALYP OINT 45GM

Facility

$21.15

Hospital Charge Code	6003461
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

Know your out-of-pocket cost for care.

All Charges