Heights University Hospital

All Charges

Charge

Type

Setting

Price

OPIUM TINC DEOD LIQ 100MG/ML

Facility

$320.00

Hospital Charge Code	6004022
Hospital Revenue Code	251
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

OPIUM TINC DEOD LIQ 100MG/ML

Facility

$320.00

Hospital Charge Code	6004022
Hospital Revenue Code	251
Min. Negotiated Rate	$41.60
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$96.00
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.60
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.00
Rate for Payer: UnitedHealthcare Commercial	$160.00

OPN BX/EXC LN,AXILLARY NODE

Facility

$24,074.90

Service Code	HCPCS 38525
Hospital Charge Code	16000206
Hospital Revenue Code	360
Min. Negotiated Rate	$3,611.24
Max. Negotiated Rate	$3,611.24
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24

OPN BX/EXC LN,AXILLARY NODE

Facility

$24,074.90

Service Code	HCPCS 38525
Hospital Charge Code	16000206
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,324.19
Rate for Payer: Aetna Commercial	$7,222.47
Rate for Payer: Aetna Medicare Advantage	$7,222.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,139.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,139.10
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	$6,139.10
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.74
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

OPN BX/EXC LN,DEEPCERV NODE(S)

Facility

$24,074.90

Service Code	HCPCS 38510
Hospital Charge Code	16000297
Hospital Revenue Code	360
Min. Negotiated Rate	$3,611.24
Max. Negotiated Rate	$3,611.24
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24

OPN BX/EXC LN,DEEPCERV NODE(S)

Facility

$24,074.90

Service Code	HCPCS 38510
Hospital Charge Code	16000297
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,324.19
Rate for Payer: Aetna Commercial	$7,222.47
Rate for Payer: Aetna Medicare Advantage	$7,222.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,139.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,139.10
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	$6,139.10
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.74
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

OPN RDL SHFT FX CLSD R/U JT

Facility

$48,992.10

Service Code	HCPCS 25525
Hospital Charge Code	16000691
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

OPN RDL SHFT FX CLSD R/U JT

Facility

$48,992.10

Service Code	HCPCS 25525
Hospital Charge Code	16000691
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

OPN TX ACUTE SHOULDER DISLOCAT

Facility

$48,992.10

Service Code	HCPCS 23660
Hospital Charge Code	16000818
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

OPN TX ACUTE SHOULDER DISLOCAT

Facility

$48,992.10

Service Code	HCPCS 23660
Hospital Charge Code	16000818
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

OPN TX ARTCL FRACT MCP/IP JNT

Facility

$23,899.60

Service Code	HCPCS 26746
Hospital Charge Code	16000424
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

OPN TX ARTCL FRACT MCP/IP JNT

Facility

$23,899.60

Service Code	HCPCS 26746
Hospital Charge Code	16000424
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$7,169.88
Rate for Payer: Aetna Medicare Advantage	$7,169.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,094.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,094.40
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	$6,094.40
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,106.95
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

OPN TX BIMALLEOLAR ANKLE FRACT

Facility

$48,992.10

Service Code	HCPCS 27814
Hospital Charge Code	16000305
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

OPN TX BIMALLEOLAR ANKLE FRACT

Facility

$48,992.10

Service Code	HCPCS 27814
Hospital Charge Code	16000305
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

OPN TX CRPL BN FRACT O/T SCPD

Facility

$22,174.50

Service Code	HCPCS 25645
Hospital Charge Code	16000619
Hospital Revenue Code	360
Min. Negotiated Rate	$3,326.18
Max. Negotiated Rate	$3,326.18
Rate for Payer: Qualcare PPO/HMO/WC	$3,326.18

OPN TX CRPL BN FRACT O/T SCPD

Facility

$22,174.50

Service Code	HCPCS 25645
Hospital Charge Code	16000619
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,851.00
Rate for Payer: Aetna Commercial	$6,652.35
Rate for Payer: Aetna Medicare Advantage	$6,652.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,654.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,654.50
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	$5,654.50
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,882.68
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,326.18
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

OPN TXCRPL SCPD NAVICULAR FRAC

Facility

$48,992.10

Service Code	HCPCS 25628
Hospital Charge Code	16000553
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

OPN TXCRPL SCPD NAVICULAR FRAC

Facility

$48,992.10

Service Code	HCPCS 25628
Hospital Charge Code	16000553
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Oxford Commercial	$8,679.00
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: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

OPN TX DISTL PHLNG FRACT EA

Facility

$25,094.58

Service Code	HCPCS 26765
Hospital Charge Code	1600000425
Hospital Revenue Code	360
Min. Negotiated Rate	$3,764.19
Max. Negotiated Rate	$3,764.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,764.19

OPN TX DISTL PHLNG FRACT EA

Facility

$25,094.58

Service Code	HCPCS 26765
Hospital Charge Code	1600000425
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$7,528.37
Rate for Payer: Aetna Medicare Advantage	$7,528.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,399.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,399.12
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	$6,399.12
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,262.30
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,764.19
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

OPN TX DSTL FBLR FX LAT MALS

Facility

$48,992.10

Service Code	HCPCS 27792
Hospital Charge Code	16000221
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

OPN TX DSTL FBLR FX LAT MALS

Facility

$48,992.10

Service Code	HCPCS 27792
Hospital Charge Code	16000221
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$77,080.57
Rate for Payer: Aetna Better Health Medicaid	$75,569.19
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$77,080.57
Rate for Payer: Wellpoint Medicaid Managed Care	$75,569.19

OPN TX FMRL FRAC DSTL M/L CNDY

Facility

$15,278.28

Service Code	HCPCS 27514
Hospital Charge Code	16000708
Hospital Revenue Code	360
Min. Negotiated Rate	$2,291.74
Max. Negotiated Rate	$2,291.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,291.74

OPN TX FMRL FRAC DSTL M/L CNDY

Facility

$15,278.28

Service Code	HCPCS 27514
Hospital Charge Code	16000708
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$4,583.48
Rate for Payer: Aetna Medicare Advantage	$4,583.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,895.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,895.96
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	$3,895.96
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,986.18
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,291.74
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

OPN TX GRTER HMRL TUBER FRAC

Facility

$63,943.60

Service Code	HCPCS 23630
Hospital Charge Code	16000679
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

Know your out-of-pocket cost for care.

All Charges