Heights University Hospital

All Charges

Charge

Type

Setting

Price

O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC

Facility

$122,352.60

Service Code	MSDRG 939
Min. Negotiated Rate	$37,095.00
Max. Negotiated Rate	$122,352.60
Rate for Payer: Aetna Commercial	$122,352.60
Rate for Payer: Aetna Medicare Advantage	$39,596.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88,765.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88,765.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$39,047.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88,765.74
Rate for Payer: Cigna Commercial	$78,088.95
Rate for Payer: Cigna Medicare Advantage	$39,047.37
Rate for Payer: Clover Medicare Advantage	$37,095.00
Rate for Payer: EmblemHealth Commercial	$117,142.11
Rate for Payer: Humana Medicare Advantage	$40,218.79
Rate for Payer: Oxford Commercial	$48,803.32
Rate for Payer: UnitedHealthcare Commercial	$55,396.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$39,047.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$41,390.21
Rate for Payer: Wellcare Medicare Advantage	$39,047.37

O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC

Facility

$70,677.72

Service Code	MSDRG 941
Min. Negotiated Rate	$22,127.44
Max. Negotiated Rate	$70,677.72
Rate for Payer: Aetna Commercial	$68,373.79
Rate for Payer: Aetna Medicare Advantage	$22,127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51,274.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51,274.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,559.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51,274.62
Rate for Payer: Cigna Commercial	$43,638.13
Rate for Payer: Cigna Medicare Advantage	$23,559.24
Rate for Payer: Clover Medicare Advantage	$22,381.28
Rate for Payer: EmblemHealth Commercial	$70,677.72
Rate for Payer: Humana Medicare Advantage	$24,266.02
Rate for Payer: Oxford Commercial	$27,272.56
Rate for Payer: UnitedHealthcare Commercial	$30,956.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,559.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24,972.79
Rate for Payer: Wellcare Medicare Advantage	$23,559.24

O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS

Facility

$130,323.96

Service Code	MSDRG 876
Min. Negotiated Rate	$39,267.87
Max. Negotiated Rate	$130,323.96
Rate for Payer: Aetna Commercial	$130,323.96
Rate for Payer: Aetna Medicare Advantage	$42,176.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102,824.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102,824.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41,334.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102,824.91
Rate for Payer: Cigna Commercial	$83,176.51
Rate for Payer: Cigna Medicare Advantage	$41,334.60
Rate for Payer: Clover Medicare Advantage	$39,267.87
Rate for Payer: EmblemHealth Commercial	$124,003.80
Rate for Payer: Humana Medicare Advantage	$42,574.64
Rate for Payer: Oxford Commercial	$51,982.90
Rate for Payer: UnitedHealthcare Commercial	$59,005.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$41,334.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$43,814.68
Rate for Payer: Wellcare Medicare Advantage	$41,334.60

OR THERASKIN - PER SQ CM

Facility

$102.00

Hospital Charge Code	270646669R
Hospital Revenue Code	636
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$24.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

OR THERASKIN - PER SQ CM

Facility

$102.00

Hospital Charge Code	270646669R
Hospital Revenue Code	636
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$51.00
Rate for Payer: Aetna Commercial	$30.60
Rate for Payer: Aetna Medicare Advantage	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.01
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

ORTHOCORD

Facility

$245.00

Hospital Charge Code	270663293
Hospital Revenue Code	272
Min. Negotiated Rate	$31.85
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$73.50
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.85
Rate for Payer: Oxford Commercial	$122.50
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$122.50

ORTHOCORD

Facility

$245.00

Hospital Charge Code	270663293
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

ORTHOCORD #2 SUTURE 223105

Facility

$1,645.00

Hospital Charge Code	270634228
Hospital Revenue Code	272
Min. Negotiated Rate	$246.75
Max. Negotiated Rate	$246.75
Rate for Payer: Qualcare PPO/HMO/WC	$246.75

ORTHOCORD #2 SUTURE 223105

Facility

$1,645.00

Hospital Charge Code	270634228
Hospital Revenue Code	272
Min. Negotiated Rate	$213.85
Max. Negotiated Rate	$822.50
Rate for Payer: Aetna Commercial	$493.50
Rate for Payer: Aetna Medicare Advantage	$493.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$419.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$419.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$419.48
Rate for Payer: Cigna Commercial	$822.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.85
Rate for Payer: Oxford Commercial	$822.50
Rate for Payer: Qualcare PPO/HMO/WC	$246.75
Rate for Payer: UnitedHealthcare Commercial	$822.50

ORTHO-DIENESTROL 0.01%/78

Facility

$122.00

Hospital Charge Code	60633587
Hospital Revenue Code	250
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$36.60
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$61.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$61.00

ORTHO-DIENESTROL 0.01%/78

Facility

$122.00

Hospital Charge Code	60633587
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

ORTHOGLASS 3X15 FOR ARM SPLINT

Facility

$167.25

Hospital Charge Code	8004160
Hospital Revenue Code	272
Min. Negotiated Rate	$21.74
Max. Negotiated Rate	$83.62
Rate for Payer: Aetna Commercial	$50.17
Rate for Payer: Aetna Medicare Advantage	$50.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.65
Rate for Payer: Cigna Commercial	$83.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$83.62
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$83.62

ORTHOGLASS 3X15 FOR ARM SPLINT

Facility

$167.25

Hospital Charge Code	8004160
Hospital Revenue Code	272
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

ORTHOGLASS 3X15 FOR LEG SPLINT

Facility

$220.85

Hospital Charge Code	8004137
Hospital Revenue Code	272
Min. Negotiated Rate	$28.71
Max. Negotiated Rate	$110.42
Rate for Payer: Aetna Commercial	$66.25
Rate for Payer: Aetna Medicare Advantage	$66.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.32
Rate for Payer: Cigna Commercial	$110.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.71
Rate for Payer: Oxford Commercial	$110.42
Rate for Payer: Qualcare PPO/HMO/WC	$33.13
Rate for Payer: UnitedHealthcare Commercial	$110.42

ORTHOGLASS 3X15 FOR LEG SPLINT

Facility

$220.85

Hospital Charge Code	8004137
Hospital Revenue Code	272
Min. Negotiated Rate	$33.13
Max. Negotiated Rate	$33.13
Rate for Payer: Qualcare PPO/HMO/WC	$33.13

ORTHOGLASS 4X15 FOR ARM SPLINT

Facility

$198.45

Hospital Charge Code	8004152
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$99.22
Rate for Payer: Aetna Commercial	$59.53
Rate for Payer: Aetna Medicare Advantage	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.60
Rate for Payer: Cigna Commercial	$99.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.80
Rate for Payer: Oxford Commercial	$99.22
Rate for Payer: Qualcare PPO/HMO/WC	$29.77
Rate for Payer: UnitedHealthcare Commercial	$99.22

ORTHOGLASS 4X15 FOR ARM SPLINT

Facility

$198.45

Hospital Charge Code	8004152
Hospital Revenue Code	272
Min. Negotiated Rate	$29.77
Max. Negotiated Rate	$29.77
Rate for Payer: Qualcare PPO/HMO/WC	$29.77

ORTHOGLASS 4X15 FOR LEG SPLINT

Facility

$264.85

Hospital Charge Code	8004129
Hospital Revenue Code	272
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

ORTHOGLASS 4X15 FOR LEG SPLINT

Facility

$264.85

Hospital Charge Code	8004129
Hospital Revenue Code	272
Min. Negotiated Rate	$34.43
Max. Negotiated Rate	$132.43
Rate for Payer: Aetna Commercial	$79.45
Rate for Payer: Aetna Medicare Advantage	$79.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.54
Rate for Payer: Cigna Commercial	$132.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.43
Rate for Payer: Oxford Commercial	$132.43
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$132.43

ORTHOGLASS 5X15 FOR ARM SPLINT

Facility

$246.45

Hospital Charge Code	8004145
Hospital Revenue Code	272
Min. Negotiated Rate	$36.97
Max. Negotiated Rate	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$36.97

ORTHOGLASS 5X15 FOR ARM SPLINT

Facility

$246.45

Hospital Charge Code	8004145
Hospital Revenue Code	272
Min. Negotiated Rate	$32.04
Max. Negotiated Rate	$123.22
Rate for Payer: Aetna Commercial	$73.94
Rate for Payer: Aetna Medicare Advantage	$73.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.84
Rate for Payer: Cigna Commercial	$123.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.04
Rate for Payer: Oxford Commercial	$123.22
Rate for Payer: Qualcare PPO/HMO/WC	$36.97
Rate for Payer: UnitedHealthcare Commercial	$123.22

ORTHOGLASS 5X15 FOR LEG SPLINT

Facility

$328.85

Hospital Charge Code	8004111
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$164.43
Rate for Payer: Aetna Commercial	$98.66
Rate for Payer: Aetna Medicare Advantage	$98.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.86
Rate for Payer: Cigna Commercial	$164.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.75
Rate for Payer: Oxford Commercial	$164.43
Rate for Payer: Qualcare PPO/HMO/WC	$49.33
Rate for Payer: UnitedHealthcare Commercial	$164.43

ORTHOGLASS 5X15 FOR LEG SPLINT

Facility

$328.85

Hospital Charge Code	8004111
Hospital Revenue Code	272
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$49.33
Rate for Payer: Qualcare PPO/HMO/WC	$49.33

ORTHO GLASS SPLINTING SYSTEM

Facility

$471.25

Hospital Charge Code	270654391
Hospital Revenue Code	272
Min. Negotiated Rate	$61.26
Max. Negotiated Rate	$235.62
Rate for Payer: Aetna Commercial	$141.38
Rate for Payer: Aetna Medicare Advantage	$141.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.17
Rate for Payer: Cigna Commercial	$235.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.26
Rate for Payer: Oxford Commercial	$235.62
Rate for Payer: Qualcare PPO/HMO/WC	$70.69
Rate for Payer: UnitedHealthcare Commercial	$235.62

ORTHO GLASS SPLINTING SYSTEM

Facility

$471.25

Hospital Charge Code	270654391
Hospital Revenue Code	272
Min. Negotiated Rate	$70.69
Max. Negotiated Rate	$70.69
Rate for Payer: Qualcare PPO/HMO/WC	$70.69

Know your out-of-pocket cost for care.

All Charges