Heights University Hospital

All Charges

Charge

Type

Setting

Price

NERVE CONDUCTION SENSORY

Facility

$5,700.00

Hospital Charge Code	9109090
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

NERVE CONDUCTION SENSORY

Facility

$5,700.00

Hospital Charge Code	9109090
Hospital Revenue Code	922
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.00
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$1,673.00

NERVE COND W/O WAVE STUDY

Facility

$5,700.00

Hospital Charge Code	9109005
Hospital Revenue Code	922
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.00
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$1,673.00

NERVE COND W/O WAVE STUDY

Facility

$5,700.00

Hospital Charge Code	9109005
Hospital Revenue Code	922
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

NERVE CONNECTOR 4X15MM

Facility

$9,990.00

Service Code	HCPCS C1763
Hospital Charge Code	270696285
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.50
Max. Negotiated Rate	$4,995.00
Rate for Payer: Aetna Commercial	$2,997.00
Rate for Payer: Aetna Medicare Advantage	$2,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,547.45
Rate for Payer: Cigna Commercial	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50

NERVE CONNECTOR 4X15MM

Facility

$9,990.00

Service Code	HCPCS C1763
Hospital Charge Code	270696285
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.50
Max. Negotiated Rate	$2,417.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50

NERVE CONNECTOR 5X15MM

Facility

$9,990.00

Service Code	HCPCS C1763
Hospital Charge Code	270696286
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.50
Max. Negotiated Rate	$2,417.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50

NERVE CONNECTOR 5X15MM

Facility

$9,990.00

Service Code	HCPCS C1763
Hospital Charge Code	270696286
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.50
Max. Negotiated Rate	$4,995.00
Rate for Payer: Aetna Commercial	$2,997.00
Rate for Payer: Aetna Medicare Advantage	$2,997.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,547.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,547.45
Rate for Payer: Cigna Commercial	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,417.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.50

NERVE GRAFT (INCLUDES OBTAINING GRAFT), SINGLE STRAND, HAND OR FOOT; UP TO 4 CM LENGTH

Facility

$20,898.76

Service Code	CPT 64890
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$20,898.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Cigna Commercial	$20,898.76
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

NERVE GUIDE 5 mm x 3cm

Facility

$6,482.50

Hospital Charge Code	270683437
Hospital Revenue Code	272
Min. Negotiated Rate	$972.38
Max. Negotiated Rate	$972.38
Rate for Payer: Qualcare PPO/HMO/WC	$972.38

NERVE GUIDE 5 mm x 3cm

Facility

$6,482.50

Hospital Charge Code	270683437
Hospital Revenue Code	272
Min. Negotiated Rate	$842.73
Max. Negotiated Rate	$3,241.25
Rate for Payer: Aetna Commercial	$1,944.75
Rate for Payer: Aetna Medicare Advantage	$1,944.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,653.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,653.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,653.04
Rate for Payer: Cigna Commercial	$3,241.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$842.73
Rate for Payer: Oxford Commercial	$3,241.25
Rate for Payer: Qualcare PPO/HMO/WC	$972.38
Rate for Payer: UnitedHealthcare Commercial	$3,241.25

NERVE GUIDE MM X 3 CM

Facility

$6,482.50

Hospital Charge Code	270683501
Hospital Revenue Code	272
Min. Negotiated Rate	$972.38
Max. Negotiated Rate	$972.38
Rate for Payer: Qualcare PPO/HMO/WC	$972.38

NERVE GUIDE MM X 3 CM

Facility

$6,482.50

Hospital Charge Code	270683501
Hospital Revenue Code	272
Min. Negotiated Rate	$842.73
Max. Negotiated Rate	$3,241.25
Rate for Payer: Aetna Commercial	$1,944.75
Rate for Payer: Aetna Medicare Advantage	$1,944.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,653.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,653.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,653.04
Rate for Payer: Cigna Commercial	$3,241.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$842.73
Rate for Payer: Oxford Commercial	$3,241.25
Rate for Payer: Qualcare PPO/HMO/WC	$972.38
Rate for Payer: UnitedHealthcare Commercial	$3,241.25

NERVE KIT STIMULATOR 20G 6

Facility

$58.50

Hospital Charge Code	270676805
Hospital Revenue Code	272
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$29.25
Rate for Payer: Aetna Commercial	$17.55
Rate for Payer: Aetna Medicare Advantage	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.92
Rate for Payer: Cigna Commercial	$29.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.61
Rate for Payer: Oxford Commercial	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.78
Rate for Payer: UnitedHealthcare Commercial	$29.25

NERVE KIT STIMULATOR 20G 6

Facility

$58.50

Hospital Charge Code	270676805
Hospital Revenue Code	272
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$8.78
Rate for Payer: Qualcare PPO/HMO/WC	$8.78

NERVE OR MUSCLE BIOPSY

Facility

$412.85

Service Code	HCPCS 88331
Hospital Charge Code	3005279
Hospital Revenue Code	310
Min. Negotiated Rate	$61.93
Max. Negotiated Rate	$61.93
Rate for Payer: Qualcare PPO/HMO/WC	$61.93

NERVE OR MUSCLE BIOPSY

Facility

$412.85

Service Code	HCPCS 88331
Hospital Charge Code	3005279
Hospital Revenue Code	310
Min. Negotiated Rate	$53.67
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$123.86
Rate for Payer: Aetna Medicare Advantage	$123.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.28
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$54.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.93
Rate for Payer: UnitedHealthcare Commercial	$114.00

NERVE PROTECTOR 7x20MM

Facility

$8,125.00

Hospital Charge Code	270673262
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,966.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

NERVE PROTECTOR 7x20MM

Facility

$8,125.00

Hospital Charge Code	270673262
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$2,437.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

NERVE PROTECTOR 7X40MM

Facility

$14,175.00

Service Code	HCPCS C1763
Hospital Charge Code	270696287
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$7,087.50
Rate for Payer: Aetna Commercial	$4,252.50
Rate for Payer: Aetna Medicare Advantage	$4,252.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,614.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,614.62
Rate for Payer: Cigna Commercial	$7,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

NERVE PROTECTOR 7X40MM

Facility

$14,175.00

Service Code	HCPCS C1763
Hospital Charge Code	270696287
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$3,430.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,430.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,126.25

NERVE PROTECTOR/WRAP

Facility

$9,875.00

Hospital Charge Code	270664248
Hospital Revenue Code	270
Min. Negotiated Rate	$1,283.75
Max. Negotiated Rate	$4,937.50
Rate for Payer: Aetna Commercial	$2,962.50
Rate for Payer: Aetna Medicare Advantage	$2,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,518.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,518.12
Rate for Payer: Cigna Commercial	$4,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,283.75
Rate for Payer: Oxford Commercial	$4,937.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25
Rate for Payer: UnitedHealthcare Commercial	$4,937.50

NERVE PROTECTOR/WRAP

Facility

$9,875.00

Hospital Charge Code	270664248
Hospital Revenue Code	270
Min. Negotiated Rate	$1,481.25
Max. Negotiated Rate	$1,481.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,481.25

NERVE SET STIMUPLEX 21GAx4

Facility

$67.17

Hospital Charge Code	270656035
Hospital Revenue Code	272
Min. Negotiated Rate	$10.08
Max. Negotiated Rate	$10.08
Rate for Payer: Qualcare PPO/HMO/WC	$10.08

NERVE SET STIMUPLEX 21GAx4

Facility

$67.17

Hospital Charge Code	270656035
Hospital Revenue Code	272
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$33.59
Rate for Payer: Aetna Commercial	$20.15
Rate for Payer: Aetna Medicare Advantage	$20.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.13
Rate for Payer: Cigna Commercial	$33.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.73
Rate for Payer: Oxford Commercial	$33.59
Rate for Payer: Qualcare PPO/HMO/WC	$10.08
Rate for Payer: UnitedHealthcare Commercial	$33.59

Know your out-of-pocket cost for care.

All Charges