Heights University Hospital

All Charges

Charge

Type

Setting

Price

NON-IONIC CONTRAST-PER ML

Facility

$8.00

Hospital Charge Code	94061441
Hospital Revenue Code	255
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

NON LOCKING SCREW 2.9 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270684920
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

NON LOCKING SCREW 2.9 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270684920
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$258.00
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

NON LOCKING SCREW 2.9 8MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270684921
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$408.00
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

NON LOCKING SCREW 2.9 8MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270684921
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

NON LOCKING SCREW 3.0X22MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270661003
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$294.00
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

NON LOCKING SCREW 3.0X22MM

Facility

$980.00

Service Code	HCPCS C1713
Hospital Charge Code	270661003
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

NON-LOCKING SCREW 3.5X12mm

Facility

$950.00

Hospital Charge Code	270669411
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

NON-LOCKING SCREW 3.5X12mm

Facility

$950.00

Hospital Charge Code	270669411
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

NON-LOCKING SCREW 3.5 X14MM

Facility

$1,385.00

Hospital Charge Code	270669412
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$415.50
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

NON-LOCKING SCREW 3.5 X14MM

Facility

$1,385.00

Hospital Charge Code	270669412
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$335.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

NON-LOCKING SCREW 3X14mm

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270669410
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

NON-LOCKING SCREW 3X14mm

Facility

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	270669410
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility

$42,055.44

Service Code	MSDRG 600
Min. Negotiated Rate	$11,366.55
Max. Negotiated Rate	$42,055.44
Rate for Payer: Aetna Commercial	$35,122.64
Rate for Payer: Aetna Medicare Advantage	$11,366.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,394.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,394.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,018.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,394.01
Rate for Payer: Cigna Commercial	$22,416.27
Rate for Payer: Cigna Medicare Advantage	$14,018.48
Rate for Payer: Clover Medicare Advantage	$13,317.56
Rate for Payer: EmblemHealth Commercial	$42,055.44
Rate for Payer: Humana Medicare Advantage	$14,439.03
Rate for Payer: Oxford Commercial	$14,009.52
Rate for Payer: UnitedHealthcare Commercial	$15,902.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,018.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,859.59
Rate for Payer: Wellcare Medicare Advantage	$14,018.48

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$29,382.78

Service Code	MSDRG 601
Min. Negotiated Rate	$6,602.11
Max. Negotiated Rate	$29,382.78
Rate for Payer: Aetna Commercial	$20,400.52
Rate for Payer: Aetna Medicare Advantage	$6,602.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,367.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,367.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,794.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,367.21
Rate for Payer: Cigna Commercial	$13,020.20
Rate for Payer: Cigna Medicare Advantage	$9,794.26
Rate for Payer: Clover Medicare Advantage	$9,304.55
Rate for Payer: EmblemHealth Commercial	$29,382.78
Rate for Payer: Humana Medicare Advantage	$10,088.09
Rate for Payer: Oxford Commercial	$8,137.25
Rate for Payer: UnitedHealthcare Commercial	$9,236.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,794.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,381.92
Rate for Payer: Wellcare Medicare Advantage	$9,794.26

NONOPASS REACH CRESCENT

Facility

$1,429.70

Hospital Charge Code	270670490
Hospital Revenue Code	272
Min. Negotiated Rate	$185.86
Max. Negotiated Rate	$714.85
Rate for Payer: Aetna Commercial	$428.91
Rate for Payer: Aetna Medicare Advantage	$428.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.57
Rate for Payer: Cigna Commercial	$714.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.86
Rate for Payer: Oxford Commercial	$714.85
Rate for Payer: Qualcare PPO/HMO/WC	$214.46
Rate for Payer: UnitedHealthcare Commercial	$714.85

NONOPASS REACH CRESCENT

Facility

$1,429.70

Hospital Charge Code	270670490
Hospital Revenue Code	272
Min. Negotiated Rate	$214.46
Max. Negotiated Rate	$214.46
Rate for Payer: Qualcare PPO/HMO/WC	$214.46

NON. PVC/ 22 FILTER EXT SET

Facility

$35.00

Hospital Charge Code	270650262
Hospital Revenue Code	270
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$10.50
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$17.50

NON. PVC/ 22 FILTER EXT SET

Facility

$35.00

Hospital Charge Code	270650262
Hospital Revenue Code	270
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

NON-ROUTINE BL DRAW 3/> YRS

Facility

$40.76

Service Code	HCPCS 36410
Hospital Charge Code	16000342
Hospital Revenue Code	360
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$12.23
Rate for Payer: Aetna Medicare Advantage	$12.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.39
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	$10.39
Rate for Payer: Cigna Commercial	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.11

NON-ROUTINE BL DRAW 3/> YRS

Facility

$40.76

Service Code	HCPCS 36410
Hospital Charge Code	16000342
Hospital Revenue Code	360
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$6.11
Rate for Payer: Qualcare PPO/HMO/WC	$6.11

NON ROUTINE BLOOD DRAW > 3YRS

Facility

$46.15

Service Code	HCPCS 36410
Hospital Charge Code	5100088
Hospital Revenue Code	361
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

NON ROUTINE BLOOD DRAW > 3YRS

Facility

$46.15

Service Code	HCPCS 36410
Hospital Charge Code	5100088
Hospital Revenue Code	361
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$13.85
Rate for Payer: Aetna Medicare Advantage	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.77
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	$11.77
Rate for Payer: Cigna Commercial	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC

Facility

$41,602.62

Service Code	MSDRG 071
Min. Negotiated Rate	$11,196.31
Max. Negotiated Rate	$41,602.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,221.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,221.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,221.02

NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC

Facility

$60,144.27

Service Code	MSDRG 070
Min. Negotiated Rate	$18,167.27
Max. Negotiated Rate	$60,144.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,344.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,344.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,344.93

Know your out-of-pocket cost for care.

All Charges