Heights University Hospital

All Charges

Charge

Type

Setting

Price

MTP CE POST TAPER 7.0MMX13MM

Facility

$2,580.00

Service Code	HCPCS L8641
Hospital Charge Code	270693287
Hospital Revenue Code	278
Min. Negotiated Rate	$387.00
Max. Negotiated Rate	$624.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.36
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

MTP CE POST TAPER 7.0MMX13MM

Facility

$2,580.00

Service Code	HCPCS L8641
Hospital Charge Code	270693287
Hospital Revenue Code	278
Min. Negotiated Rate	$257.13
Max. Negotiated Rate	$774.00
Rate for Payer: Aetna Commercial	$774.00
Rate for Payer: Aetna Medicare Advantage	$774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.90
Rate for Payer: Cigna Commercial	$428.55
Rate for Payer: Cigna Medicare Advantage	$257.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.36
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

MTP DISC 19X15MM

Facility

$13,825.00

Hospital Charge Code	270702446
Hospital Revenue Code	278
Min. Negotiated Rate	$2,073.75
Max. Negotiated Rate	$3,345.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,073.75

MTP DISC 19X15MM

Facility

$13,825.00

Hospital Charge Code	270702446
Hospital Revenue Code	278
Min. Negotiated Rate	$2,073.75
Max. Negotiated Rate	$6,912.50
Rate for Payer: Aetna Commercial	$4,147.50
Rate for Payer: Aetna Medicare Advantage	$4,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,525.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,525.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,525.38
Rate for Payer: Cigna Commercial	$6,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,345.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,073.75

MTP JNT CAPSULOTOMY EA SGL JNT

Facility

$19,998.60

Service Code	HCPCS 28270
Hospital Charge Code	16000202
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

MTP JNT CAPSULOTOMY EA SGL JNT

Facility

$19,998.60

Service Code	HCPCS 28270
Hospital Charge Code	16000202
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

MTP JT 12MM ART COMP 2.0X3.0MM

Facility

$13,070.00

Service Code	HCPCS L8641
Hospital Charge Code	270693288
Hospital Revenue Code	278
Min. Negotiated Rate	$257.13
Max. Negotiated Rate	$3,921.00
Rate for Payer: Aetna Commercial	$3,921.00
Rate for Payer: Aetna Medicare Advantage	$3,921.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,332.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,332.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,614.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,332.85
Rate for Payer: Cigna Commercial	$428.55
Rate for Payer: Cigna Medicare Advantage	$257.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.50

MTP JT 12MM ART COMP 2.0X3.0MM

Facility

$13,070.00

Service Code	HCPCS L8641
Hospital Charge Code	270693288
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.50
Max. Negotiated Rate	$3,162.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,614.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,960.50

MTP PLATE 0 DEG MED RT

Facility

$6,503.75

Hospital Charge Code	270702192
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$1,573.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

MTP PLATE 0 DEG MED RT

Facility

$6,503.75

Hospital Charge Code	270702192
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$3,251.88
Rate for Payer: Aetna Commercial	$1,951.12
Rate for Payer: Aetna Medicare Advantage	$1,951.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,658.46
Rate for Payer: Cigna Commercial	$3,251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

MTP PLATE 5 DEG REV MED LT

Facility

$8,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270702740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,247.25
Max. Negotiated Rate	$4,157.50
Rate for Payer: Aetna Commercial	$2,494.50
Rate for Payer: Aetna Medicare Advantage	$2,494.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,663.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,120.32
Rate for Payer: Cigna Commercial	$4,157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,247.25

MTP PLATE 5 DEG REV MED LT

Facility

$8,315.00

Service Code	HCPCS C1713
Hospital Charge Code	270702740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,247.25
Max. Negotiated Rate	$2,012.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,663.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,247.25

MTP PLATE, 5, LG, LT

Facility

$6,503.75

Hospital Charge Code	270702427
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$3,251.88
Rate for Payer: Aetna Commercial	$1,951.12
Rate for Payer: Aetna Medicare Advantage	$1,951.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,658.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,658.46
Rate for Payer: Cigna Commercial	$3,251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

MTP PLATE, 5, LG, LT

Facility

$6,503.75

Hospital Charge Code	270702427
Hospital Revenue Code	278
Min. Negotiated Rate	$975.56
Max. Negotiated Rate	$1,573.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.91
Rate for Payer: Qualcare PPO/HMO/WC	$975.56

MTP SPIN GRD FML REAMER 19MM

Facility

$1,657.50

Hospital Charge Code	270702428
Hospital Revenue Code	272
Min. Negotiated Rate	$215.47
Max. Negotiated Rate	$828.75
Rate for Payer: Aetna Commercial	$497.25
Rate for Payer: Aetna Medicare Advantage	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.66
Rate for Payer: Cigna Commercial	$828.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.47
Rate for Payer: Oxford Commercial	$828.75
Rate for Payer: Qualcare PPO/HMO/WC	$248.62
Rate for Payer: UnitedHealthcare Commercial	$828.75

MTP SPIN GRD FML REAMER 19MM

Facility

$1,657.50

Hospital Charge Code	270702428
Hospital Revenue Code	272
Min. Negotiated Rate	$248.62
Max. Negotiated Rate	$248.62
Rate for Payer: Qualcare PPO/HMO/WC	$248.62

MTP SPIN GRD MALE REAMER 19MM

Facility

$1,657.50

Hospital Charge Code	270702195
Hospital Revenue Code	272
Min. Negotiated Rate	$248.62
Max. Negotiated Rate	$248.62
Rate for Payer: Qualcare PPO/HMO/WC	$248.62

MTP SPIN GRD MALE REAMER 19MM

Facility

$1,657.50

Hospital Charge Code	270702195
Hospital Revenue Code	272
Min. Negotiated Rate	$215.47
Max. Negotiated Rate	$828.75
Rate for Payer: Aetna Commercial	$497.25
Rate for Payer: Aetna Medicare Advantage	$497.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.66
Rate for Payer: Cigna Commercial	$828.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.47
Rate for Payer: Oxford Commercial	$828.75
Rate for Payer: Qualcare PPO/HMO/WC	$248.62
Rate for Payer: UnitedHealthcare Commercial	$828.75

MT SHORTEN,1ST MT W ALLOGR LT

Facility

$19,998.60

Service Code	HCPCS 28307
Hospital Charge Code	16000907
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

MT SHORTEN,1ST MT W ALLOGR LT

Facility

$19,998.60

Service Code	HCPCS 28307
Hospital Charge Code	16000907
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

MT TO SHORTEN 1ST MT

Facility

$21,064.69

Service Code	HCPCS 28306
Hospital Charge Code	16000515
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$6,319.41
Rate for Payer: Aetna Medicare Advantage	$6,319.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,371.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,371.50
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	$5,371.50
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.41
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.70
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

MT TO SHORTEN 1ST MT

Facility

$21,064.69

Service Code	HCPCS 28306
Hospital Charge Code	16000515
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.70
Max. Negotiated Rate	$3,159.70
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.70

MT TO SHORTEN,1ST MT - RT

Facility

$57,534.50

Hospital Charge Code	16000153
Hospital Revenue Code	360
Min. Negotiated Rate	$8,630.17
Max. Negotiated Rate	$8,630.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,630.17

MT TO SHORTEN,1ST MT - RT

Facility

$57,534.50

Hospital Charge Code	16000153
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$28,767.25
Rate for Payer: Aetna Commercial	$17,260.35
Rate for Payer: Aetna Medicare Advantage	$17,260.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,671.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,671.30
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	$14,671.30
Rate for Payer: Cigna Commercial	$28,767.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,479.48
Rate for Payer: Qualcare PPO/HMO/WC	$8,630.17

M TUBERCULOSIS,PCR/CULTURE I

Facility

$146.00

Service Code	HCPCS 87015
Hospital Charge Code	3038087A
Hospital Revenue Code	309
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

Know your out-of-pocket cost for care.

All Charges