Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

OPN TXGTR TROCHANTEC FRACT RT

Facility

$8,380.30

Service Code	HCPCS 27248
Hospital Charge Code	1600000598
Hospital Revenue Code	360
Min. Negotiated Rate	$1,257.05
Max. Negotiated Rate	$1,257.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,257.05

OPN TXGTR TROCHANTEC FRACT RT

Facility

$8,380.30

Service Code	HCPCS 27248
Hospital Charge Code	1600000598
Hospital Revenue Code	360
Min. Negotiated Rate	$1,089.44
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$2,514.09
Rate for Payer: Aetna Medicare Advantage	$2,514.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,136.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,136.98
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	$2,136.98
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.44
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,257.05
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

OPN TX RADIAL HEAD/NCK FRCT RT

Facility

$48,992.10

Service Code	HCPCS 24665
Hospital Charge Code	16000685
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 RADIAL HEAD/NCK FRCT RT

Facility

$48,992.10

Service Code	HCPCS 24665
Hospital Charge Code	16000685
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 RDCPL/INTCRPL DISLC1+BN

Facility

$23,899.60

Service Code	HCPCS 25670
Hospital Charge Code	16000695
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 RDCPL/INTCRPL DISLC1+BN

Facility

$23,899.60

Service Code	HCPCS 25670
Hospital Charge Code	16000695
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
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	$17,279.91
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 TIBIAL FX PROXIM,BICOND

Facility

$13,433.90

Service Code	HCPCS 27536
Hospital Charge Code	1600000685
Hospital Revenue Code	360
Min. Negotiated Rate	$1,746.41
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$4,030.17
Rate for Payer: Aetna Medicare Advantage	$4,030.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,425.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,425.64
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	$3,425.64
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,746.41
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.09
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

OPN TX TIBIAL FX PROXIM,BICOND

Facility

$13,433.90

Service Code	HCPCS 27536
Hospital Charge Code	1600000685
Hospital Revenue Code	360
Min. Negotiated Rate	$2,015.09
Max. Negotiated Rate	$2,015.09
Rate for Payer: Qualcare PPO/HMO/WC	$2,015.09

OPN TX TIBL FRACT PRX UNICND

Facility

$14,933.10

Service Code	HCPCS 27535
Hospital Charge Code	16000623
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$4,479.93
Rate for Payer: Aetna Medicare Advantage	$4,479.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,807.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,807.94
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	$3,807.94
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,941.30
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,239.97
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

OPN TX TIBL FRACT PRX UNICND

Facility

$14,933.10

Service Code	HCPCS 27535
Hospital Charge Code	16000623
Hospital Revenue Code	360
Min. Negotiated Rate	$2,239.97
Max. Negotiated Rate	$2,239.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,239.97

OPN TX ULNAR FRAC PROXIMAL END

Facility

$48,992.10

Service Code	HCPCS 24685
Hospital Charge Code	16000377
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 ULNAR FRAC PROXIMAL END

Facility

$48,992.10

Service Code	HCPCS 24685
Hospital Charge Code	16000377
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

OP OFFICE VS CONSULT/TREATMENT

Facility

$91.00

Service Code	HCPCS 99243
Hospital Charge Code	260116
Hospital Revenue Code	510
Min. Negotiated Rate	$11.83
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

OP OFFICE VS CONSULT/TREATMENT

Facility

$91.00

Service Code	HCPCS 99243
Hospital Charge Code	260116
Hospital Revenue Code	510
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

OP OFFICE VS - LEVEL 1 EST PT

Facility

$23.00

Service Code	HCPCS 99211
Hospital Charge Code	260111
Hospital Revenue Code	510
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$8.30
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

OP OFFICE VS - LEVEL 1 EST PT

Facility

$23.00

Service Code	HCPCS 99211
Hospital Charge Code	260111
Hospital Revenue Code	510
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

OP OFFICE VS - LEVEL 1 NEW PT

Facility

$350.00

Service Code	HCPCS 99201
Hospital Charge Code	260101
Hospital Revenue Code	510
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

OP OFFICE VS - LEVEL 1 NEW PT

Facility

$350.00

Service Code	HCPCS 99201
Hospital Charge Code	260101
Hospital Revenue Code	510
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$105.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

OP OFFICE VS - LEVEL 2 EST PT

Facility

$37.00

Service Code	HCPCS 99212
Hospital Charge Code	260112
Hospital Revenue Code	510
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$33.58
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$33.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.81
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

OP OFFICE VS - LEVEL 2 EST PT

Facility

$37.00

Service Code	HCPCS 99212
Hospital Charge Code	260112
Hospital Revenue Code	510
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

OP OFFICE VS - LEVEL 2 NEW PT

Facility

$474.10

Service Code	HCPCS 99202
Hospital Charge Code	260102
Hospital Revenue Code	510
Min. Negotiated Rate	$44.43
Max. Negotiated Rate	$142.23
Rate for Payer: Aetna Commercial	$142.23
Rate for Payer: Aetna Medicare Advantage	$142.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.90
Rate for Payer: Cigna Commercial	$44.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.63
Rate for Payer: Qualcare PPO/HMO/WC	$71.11

OP OFFICE VS - LEVEL 2 NEW PT

Facility

$474.10

Service Code	HCPCS 99202
Hospital Charge Code	260102
Hospital Revenue Code	510
Min. Negotiated Rate	$71.11
Max. Negotiated Rate	$71.11
Rate for Payer: Qualcare PPO/HMO/WC	$71.11

OP OFFICE VS - LEVEL 3 EST PT

Facility

$47.00

Service Code	HCPCS 99213
Hospital Charge Code	260113
Hospital Revenue Code	510
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$62.15
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	$62.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

OP OFFICE VS - LEVEL 3 EST PT

Facility

$47.00

Service Code	HCPCS 99213
Hospital Charge Code	260113
Hospital Revenue Code	510
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

Know your out-of-pocket cost for care.

All Charges