Heights University Hospital

All Charges

Charge

Type

Setting

Price

2CC INFLUX SPARC

Facility

$4,675.00

Service Code	HCPCS C1765
Hospital Charge Code	270705824
Hospital Revenue Code	278
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$2,337.50
Rate for Payer: Aetna Commercial	$1,402.50
Rate for Payer: Aetna Medicare Advantage	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,192.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,192.12
Rate for Payer: Cigna Commercial	$2,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: Qualcare PPO/HMO/WC	$701.25

2CC INFLUX SPARC

Facility

$4,675.00

Service Code	HCPCS C1765
Hospital Charge Code	270705824
Hospital Revenue Code	278
Min. Negotiated Rate	$701.25
Max. Negotiated Rate	$1,131.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,131.35
Rate for Payer: Qualcare PPO/HMO/WC	$701.25

2 DOSE SM-153 QUADRAMED

Facility

$14,130.00

Hospital Charge Code	270619807
Hospital Revenue Code	250
Min. Negotiated Rate	$1,836.90
Max. Negotiated Rate	$7,065.00
Rate for Payer: Aetna Commercial	$4,239.00
Rate for Payer: Aetna Medicare Advantage	$4,239.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,603.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,603.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,603.15
Rate for Payer: Cigna Commercial	$7,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,836.90
Rate for Payer: Oxford Commercial	$7,065.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,119.50
Rate for Payer: UnitedHealthcare Commercial	$7,065.00

2 DOSE SM-153 QUADRAMED

Facility

$14,130.00

Hospital Charge Code	270619807
Hospital Revenue Code	250
Min. Negotiated Rate	$2,119.50
Max. Negotiated Rate	$2,119.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,119.50

2D TTE W OR W/O FOL W/CON,FU

Facility

$6,070.00

Service Code	HCPCS C8924
Hospital Charge Code	365438924
Hospital Revenue Code	480
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

2D TTE W OR W/O FOL W/CON,FU

Facility

$6,070.00

Service Code	HCPCS C8924
Hospital Charge Code	365438924
Hospital Revenue Code	480
Min. Negotiated Rate	$789.10
Max. Negotiated Rate	$1,821.00
Rate for Payer: Aetna Commercial	$1,821.00
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,547.85
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.10
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

2IN THICK ARMBOARDS PADS

Facility

$313.75

Hospital Charge Code	270656093
Hospital Revenue Code	271
Min. Negotiated Rate	$40.79
Max. Negotiated Rate	$156.88
Rate for Payer: Aetna Commercial	$94.12
Rate for Payer: Aetna Medicare Advantage	$94.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.01
Rate for Payer: Cigna Commercial	$156.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.79
Rate for Payer: Oxford Commercial	$156.88
Rate for Payer: Qualcare PPO/HMO/WC	$47.06
Rate for Payer: UnitedHealthcare Commercial	$156.88

2IN THICK ARMBOARDS PADS

Facility

$313.75

Hospital Charge Code	270656093
Hospital Revenue Code	271
Min. Negotiated Rate	$47.06
Max. Negotiated Rate	$47.06
Rate for Payer: Qualcare PPO/HMO/WC	$47.06

2MM POST

Facility

$195.00

Hospital Charge Code	270339446
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

2MM POST

Facility

$195.00

Hospital Charge Code	270339446
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$58.50
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.19
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

2MM REAMER

Facility

$370.00

Hospital Charge Code	270339444
Hospital Revenue Code	272
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$111.00
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.10
Rate for Payer: Oxford Commercial	$185.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$185.00

2MM REAMER

Facility

$370.00

Hospital Charge Code	270339444
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

2MM STRAIGHT PLATE 8 HOLE REIN

Facility

$4,094.25

Service Code	HCPCS C1713
Hospital Charge Code	270703767
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$2,047.12
Rate for Payer: Aetna Commercial	$1,228.28
Rate for Payer: Aetna Medicare Advantage	$1,228.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,044.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,044.03
Rate for Payer: Cigna Commercial	$2,047.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

2MM STRAIGHT PLATE 8 HOLE REIN

Facility

$4,094.25

Service Code	HCPCS C1713
Hospital Charge Code	270703767
Hospital Revenue Code	278
Min. Negotiated Rate	$614.14
Max. Negotiated Rate	$990.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$818.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$990.81
Rate for Payer: Qualcare PPO/HMO/WC	$614.14

2MMX4 KWIRE STERILE

Facility

$440.00

Service Code	HCPCS C1713
Hospital Charge Code	270694260
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

2MMX4 KWIRE STERILE

Facility

$440.00

Service Code	HCPCS C1713
Hospital Charge Code	270694260
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

2ND AMPL PT NUCL ACID MULT

Facility

$47.00

Service Code	HCPCS 83900
Hospital Charge Code	3035161
Hospital Revenue Code	301
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.10
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

2ND AMPL PT NUCL ACID MULT

Facility

$47.00

Service Code	HCPCS 83900
Hospital Charge Code	3035161
Hospital Revenue Code	301
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

2'REPR FT FLEXOR TEND W FR GRF

Facility

$21,066.25

Service Code	HCPCS 28202
Hospital Charge Code	16000633
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$6,319.88
Rate for Payer: Aetna Medicare Advantage	$6,319.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,371.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,371.89
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	$5,371.89
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.61
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

2'REPR FT FLEXOR TEND W FR GRF

Facility

$21,066.25

Service Code	HCPCS 28202
Hospital Charge Code	16000633
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.94
Max. Negotiated Rate	$3,159.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.94

2' REPR/SUTR LEG FLEXOR TENDON

Facility

$19,467.90

Service Code	HCPCS 27659
Hospital Charge Code	16000894
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$5,840.37
Rate for Payer: Aetna Medicare Advantage	$5,840.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,964.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,964.31
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	$4,964.31
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,530.83
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

2' REPR/SUTR LEG FLEXOR TENDON

Facility

$19,467.90

Service Code	HCPCS 27659
Hospital Charge Code	16000894
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

2' REPR TORN COLLAT ANKL LIGAM

Facility

$30,595.00

Service Code	HCPCS 27698
Hospital Charge Code	16000316
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Better Health Medicaid	$15,569.19
Rate for Payer: Aetna Commercial	$9,178.50
Rate for Payer: Aetna Medicare Advantage	$9,178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,801.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,801.73
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	$7,801.73
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,977.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$15,569.19

2' REPR TORN COLLAT ANKL LIGAM

Facility

$30,595.00

Service Code	HCPCS 27698
Hospital Charge Code	16000316
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

2'SUTURE ABD WALL FR EVISCRATN

Facility

$9,107.40

Service Code	HCPCS 49900
Hospital Charge Code	16000755
Hospital Revenue Code	360
Min. Negotiated Rate	$1,366.11
Max. Negotiated Rate	$1,366.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,366.11

Know your out-of-pocket cost for care.

All Charges