Heights University Hospital

All Charges

Charge

Type

Setting

Price

OF,ANKLE FRACTURE

Facility

$48,992.10

Service Code	HCPCS 27766
Hospital Charge Code	16000399
Hospital Revenue Code	360
Min. Negotiated Rate	$7,348.81
Max. Negotiated Rate	$7,348.81
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81

OF,ANKLE FRACTURE

Facility

$48,992.10

Service Code	HCPCS 27766
Hospital Charge Code	16000399
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$14,697.63
Rate for Payer: Aetna Medicare Advantage	$14,697.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,492.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,492.99
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	$12,492.99
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,368.97
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

OF CLAVICLE FRACTURE

Facility

$63,943.60

Service Code	HCPCS 23515
Hospital Charge Code	16000390
Hospital Revenue Code	360
Min. Negotiated Rate	$9,591.54
Max. Negotiated Rate	$9,591.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54

OF CLAVICLE FRACTURE

Facility

$63,943.60

Service Code	HCPCS 23515
Hospital Charge Code	16000390
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,183.08
Rate for Payer: Aetna Commercial	$19,183.08
Rate for Payer: Aetna Medicare Advantage	$19,183.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,305.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,305.62
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	$16,305.62
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,312.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	74308335
Hospital Revenue Code	514
Min. Negotiated Rate	$150.88
Max. Negotiated Rate	$580.30
Rate for Payer: Aetna Commercial	$348.18
Rate for Payer: Aetna Medicare Advantage	$348.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.95
Rate for Payer: Cigna Commercial	$580.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.88
Rate for Payer: Qualcare PPO/HMO/WC	$174.09

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	83653210
Hospital Revenue Code	514
Min. Negotiated Rate	$150.88
Max. Negotiated Rate	$580.30
Rate for Payer: Aetna Commercial	$348.18
Rate for Payer: Aetna Medicare Advantage	$348.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.95
Rate for Payer: Cigna Commercial	$580.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.88
Rate for Payer: Qualcare PPO/HMO/WC	$174.09

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	83653210
Hospital Revenue Code	514
Min. Negotiated Rate	$174.09
Max. Negotiated Rate	$174.09
Rate for Payer: Qualcare PPO/HMO/WC	$174.09

OFFICE CONSULT COMPREHENSIVE

Facility

$1,160.60

Service Code	HCPCS 99244
Hospital Charge Code	74308335
Hospital Revenue Code	514
Min. Negotiated Rate	$174.09
Max. Negotiated Rate	$174.09
Rate for Payer: Qualcare PPO/HMO/WC	$174.09

OFFICE CONSULT DETAILED

Facility

$245.50

Service Code	HCPCS 99243
Hospital Charge Code	412399243
Hospital Revenue Code	510
Min. Negotiated Rate	$36.83
Max. Negotiated Rate	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$36.83

OFFICE CONSULT DETAILED

Facility

$245.50

Service Code	HCPCS 99243
Hospital Charge Code	412399243
Hospital Revenue Code	510
Min. Negotiated Rate	$31.91
Max. Negotiated Rate	$122.75
Rate for Payer: Aetna Commercial	$73.65
Rate for Payer: Aetna Medicare Advantage	$73.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.60
Rate for Payer: Cigna Commercial	$122.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.91
Rate for Payer: Qualcare PPO/HMO/WC	$36.83

OFFICE CONSULT EXPANDED

Facility

$225.20

Service Code	HCPCS 99242
Hospital Charge Code	412399242
Hospital Revenue Code	510
Min. Negotiated Rate	$29.28
Max. Negotiated Rate	$112.60
Rate for Payer: Aetna Commercial	$67.56
Rate for Payer: Aetna Medicare Advantage	$67.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$112.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.28
Rate for Payer: Qualcare PPO/HMO/WC	$33.78

OFFICE CONSULT EXPANDED

Facility

$566.00

Service Code	HCPCS 99242
Hospital Charge Code	83653205
Hospital Revenue Code	514
Min. Negotiated Rate	$73.58
Max. Negotiated Rate	$283.00
Rate for Payer: Aetna Commercial	$169.80
Rate for Payer: Aetna Medicare Advantage	$169.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.33
Rate for Payer: Cigna Commercial	$283.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.58
Rate for Payer: Qualcare PPO/HMO/WC	$84.90

OFFICE CONSULT EXPANDED

Facility

$225.20

Service Code	HCPCS 99242
Hospital Charge Code	412399242
Hospital Revenue Code	510
Min. Negotiated Rate	$33.78
Max. Negotiated Rate	$33.78
Rate for Payer: Qualcare PPO/HMO/WC	$33.78

OFFICE CONSULT EXPANDED

Facility

$566.00

Service Code	HCPCS 99242
Hospital Charge Code	83653205
Hospital Revenue Code	514
Min. Negotiated Rate	$84.90
Max. Negotiated Rate	$84.90
Rate for Payer: Qualcare PPO/HMO/WC	$84.90

OFFICE CONSULT FOCUSED

Facility

$453.00

Service Code	HCPCS 99241
Hospital Charge Code	83653200
Hospital Revenue Code	761
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

OFFICE CONSULT FOCUSED

Facility

$453.00

Service Code	HCPCS 99241
Hospital Charge Code	83653200
Hospital Revenue Code	761
Min. Negotiated Rate	$58.89
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$135.90
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.89
Rate for Payer: Oxford Commercial	$226.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.95
Rate for Payer: UnitedHealthcare Commercial	$226.50

OFFICE CONSULT MINOR

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	412399241
Hospital Revenue Code	510
Min. Negotiated Rate	$26.18
Max. Negotiated Rate	$26.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

OFFICE CONSULT MINOR

Facility

$174.55

Service Code	HCPCS 99241
Hospital Charge Code	412399241
Hospital Revenue Code	510
Min. Negotiated Rate	$22.69
Max. Negotiated Rate	$87.28
Rate for Payer: Aetna Commercial	$52.37
Rate for Payer: Aetna Medicare Advantage	$52.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.51
Rate for Payer: Cigna Commercial	$87.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.18

OFFICE OP VISIT EST - I

Facility

$368.18

Service Code	HCPCS 99211
Hospital Charge Code	85000845
Hospital Revenue Code	510
Min. Negotiated Rate	$55.23
Max. Negotiated Rate	$55.23
Rate for Payer: Qualcare PPO/HMO/WC	$55.23

OFFICE OP VISIT EST - I

Facility

$368.18

Service Code	HCPCS 99211
Hospital Charge Code	85000845
Hospital Revenue Code	510
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$110.45
Rate for Payer: Aetna Commercial	$110.45
Rate for Payer: Aetna Medicare Advantage	$110.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.89
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.86
Rate for Payer: Qualcare PPO/HMO/WC	$55.23

OFFICE OP VISIT EST - V

Facility

$833.26

Service Code	HCPCS 99215
Hospital Charge Code	85000865
Hospital Revenue Code	510
Min. Negotiated Rate	$124.99
Max. Negotiated Rate	$124.99
Rate for Payer: Qualcare PPO/HMO/WC	$124.99

OFFICE OP VISIT EST - V

Facility

$833.26

Service Code	HCPCS 99215
Hospital Charge Code	85000865
Hospital Revenue Code	510
Min. Negotiated Rate	$108.32
Max. Negotiated Rate	$249.98
Rate for Payer: Aetna Commercial	$249.98
Rate for Payer: Aetna Medicare Advantage	$249.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.48
Rate for Payer: Cigna Commercial	$135.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.99

OFFICE OP VISIT NEW - I

Facility

$368.18

Service Code	HCPCS 99201
Hospital Charge Code	85000820
Hospital Revenue Code	510
Min. Negotiated Rate	$55.23
Max. Negotiated Rate	$55.23
Rate for Payer: Qualcare PPO/HMO/WC	$55.23

OFFICE OP VISIT NEW - I

Facility

$368.18

Service Code	HCPCS 99201
Hospital Charge Code	85000820
Hospital Revenue Code	510
Min. Negotiated Rate	$47.86
Max. Negotiated Rate	$184.09
Rate for Payer: Aetna Commercial	$110.45
Rate for Payer: Aetna Medicare Advantage	$110.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.89
Rate for Payer: Cigna Commercial	$184.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.86
Rate for Payer: Qualcare PPO/HMO/WC	$55.23

OFFICE OP VISIT NEW - II

Facility

$477.85

Service Code	HCPCS 99202
Hospital Charge Code	85000825
Hospital Revenue Code	510
Min. Negotiated Rate	$44.43
Max. Negotiated Rate	$143.35
Rate for Payer: Aetna Commercial	$143.35
Rate for Payer: Aetna Medicare Advantage	$143.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.85
Rate for Payer: Cigna Commercial	$44.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.12
Rate for Payer: Qualcare PPO/HMO/WC	$71.68

Know your out-of-pocket cost for care.

All Charges