Heights University Hospital

All Charges

Charge

Type

Setting

Price

OSMOLALITY,URINE

Facility

$102.00

Service Code	HCPCS 83935
Hospital Charge Code	38477023
Hospital Revenue Code	301
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.10
Rate for Payer: Aetna Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$6.82
Rate for Payer: Cigna Medicare Advantage	$3.41
Rate for Payer: Clover Medicare Advantage	$6.48
Rate for Payer: EmblemHealth Commercial	$20.46
Rate for Payer: Humana Medicare Advantage	$7.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.23
Rate for Payer: Wellcare Medicare Advantage	$6.82

OSMOLALITY, URINE

Facility

$156.20

Service Code	HCPCS 83935
Hospital Charge Code	3004918
Hospital Revenue Code	301
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.10
Rate for Payer: Aetna Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$6.82
Rate for Payer: Cigna Medicare Advantage	$3.41
Rate for Payer: Clover Medicare Advantage	$6.48
Rate for Payer: EmblemHealth Commercial	$20.46
Rate for Payer: Humana Medicare Advantage	$7.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.43
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.23
Rate for Payer: Wellcare Medicare Advantage	$6.82

OSMOLALITY, URINE

Facility

$156.20

Service Code	HCPCS 83935
Hospital Charge Code	3004918
Hospital Revenue Code	301
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$23.43
Rate for Payer: Qualcare PPO/HMO/WC	$23.43

OSMOLITE HIGH NITROGEN

Facility

$23.00

Hospital Charge Code	60634855
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

OSMOLITE HIGH NITROGEN

Facility

$23.00

Hospital Charge Code	60634855
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
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	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

OSMOTIC FRAGILITY RBC

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3009987
Hospital Revenue Code	305
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.29
Rate for Payer: Aetna Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.95
Rate for Payer: Cigna Commercial	$13.36
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.16
Rate for Payer: Wellcare Medicare Advantage	$13.36

OSMOTIC FRAGILITY RBC

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3009987
Hospital Revenue Code	305
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

OSRAM MERCURY BURNER

Facility

$780.00

Hospital Charge Code	270665507
Hospital Revenue Code	270
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

OSRAM MERCURY BURNER

Facility

$780.00

Hospital Charge Code	270665507
Hospital Revenue Code	270
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$390.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Commercial	$390.00

OSS 1.5CC

Facility

$4,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270703615
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

OSS 1.5CC

Facility

$4,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270703615
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,312.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

OSS 3CM RESURFACING KIT

Facility

$65,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270681527
Hospital Revenue Code	278
Min. Negotiated Rate	$9,832.50
Max. Negotiated Rate	$15,863.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,863.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,832.50

OSS 3CM RESURFACING KIT

Facility

$65,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270681527
Hospital Revenue Code	278
Min. Negotiated Rate	$9,832.50
Max. Negotiated Rate	$32,775.00
Rate for Payer: Aetna Commercial	$19,665.00
Rate for Payer: Aetna Medicare Advantage	$19,665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,715.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,715.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,715.25
Rate for Payer: Cigna Commercial	$32,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,863.10
Rate for Payer: Qualcare PPO/HMO/WC	$9,832.50

OSS 4CM BONE PIN

Facility

$48,690.00

Service Code	HCPCS C1713
Hospital Charge Code	270691630
Hospital Revenue Code	278
Min. Negotiated Rate	$7,303.50
Max. Negotiated Rate	$24,345.00
Rate for Payer: Aetna Commercial	$14,607.00
Rate for Payer: Aetna Medicare Advantage	$14,607.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,415.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,415.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,738.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,415.95
Rate for Payer: Cigna Commercial	$24,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,782.98
Rate for Payer: Qualcare PPO/HMO/WC	$7,303.50

OSS 4CM BONE PIN

Facility

$48,690.00

Service Code	HCPCS C1713
Hospital Charge Code	270691630
Hospital Revenue Code	278
Min. Negotiated Rate	$7,303.50
Max. Negotiated Rate	$11,782.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,738.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,782.98
Rate for Payer: Qualcare PPO/HMO/WC	$7,303.50

OSS ADAPT FEM DIAPHYSEAL SEG

Facility

$1,915.65

Service Code	HCPCS C1776
Hospital Charge Code	270697109
Hospital Revenue Code	278
Min. Negotiated Rate	$287.35
Max. Negotiated Rate	$463.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.59
Rate for Payer: Qualcare PPO/HMO/WC	$287.35

OSS ADAPT FEM DIAPHYSEAL SEG

Facility

$1,915.65

Service Code	HCPCS C1776
Hospital Charge Code	270697109
Hospital Revenue Code	278
Min. Negotiated Rate	$287.35
Max. Negotiated Rate	$957.83
Rate for Payer: Aetna Commercial	$574.70
Rate for Payer: Aetna Medicare Advantage	$574.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$488.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$488.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$488.49
Rate for Payer: Cigna Commercial	$957.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$463.59
Rate for Payer: Qualcare PPO/HMO/WC	$287.35

OSS AVL TI 63MM MOD BSPLT

Facility

$28,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684635
Hospital Revenue Code	278
Min. Negotiated Rate	$4,275.00
Max. Negotiated Rate	$6,897.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,897.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,275.00

OSS AVL TI 63MM MOD BSPLT

Facility

$28,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684635
Hospital Revenue Code	278
Min. Negotiated Rate	$4,275.00
Max. Negotiated Rate	$14,250.00
Rate for Payer: Aetna Commercial	$8,550.00
Rate for Payer: Aetna Medicare Advantage	$8,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,267.50
Rate for Payer: Cigna Commercial	$14,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,897.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,275.00

OSS AVL TIB BUSHING SET

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684637
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

OSS AVL TIB BUSHING SET

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684637
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

OSS AVL TIBIAL BEARING

Facility

$6,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270684690
Hospital Revenue Code	278
Min. Negotiated Rate	$940.50
Max. Negotiated Rate	$1,517.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,254.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,517.34
Rate for Payer: Qualcare PPO/HMO/WC	$940.50

OSS AVL TIBIAL BEARING

Facility

$6,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270684690
Hospital Revenue Code	278
Min. Negotiated Rate	$940.50
Max. Negotiated Rate	$3,135.00
Rate for Payer: Aetna Commercial	$1,881.00
Rate for Payer: Aetna Medicare Advantage	$1,881.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,598.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,598.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,254.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,598.85
Rate for Payer: Cigna Commercial	$3,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,517.34
Rate for Payer: Qualcare PPO/HMO/WC	$940.50

OSS AVL TI LOCK RING SET

Facility

$2,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270684640
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$720.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

OSS AVL TI LOCK RING SET

Facility

$2,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270684640
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$580.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.80
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

Know your out-of-pocket cost for care.

All Charges