Heights University Hospital

All Charges

Charge

Type

Setting

Price

OTHER PT/OT GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G8991GPCN
Hospital Charge Code	84202065CN
Hospital Revenue Code	420
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER PT/OT GOAL STATUS CN

Facility

$0.01

Service Code	HCPCS G8991GOCN
Hospital Charge Code	74203113CN
Hospital Revenue Code	430
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER PT/OT STATUS

Facility

$0.01

Service Code	HCPCS G8992GP
Hospital Charge Code	84201134
Hospital Revenue Code	429
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

OTHER PT/OT STATUS

Facility

$0.01

Service Code	HCPCS G8992GP
Hospital Charge Code	84201134
Hospital Revenue Code	429
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$18,386.17

Service Code	APR-DRG 1211
Min. Negotiated Rate	$11,712.51
Max. Negotiated Rate	$18,386.17
Rate for Payer: Aetna Better Health Medicaid	$18,025.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,386.17
Rate for Payer: Wellpoint Medicaid Managed Care	$11,712.51

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$36,404.35

Service Code	APR-DRG 1213
Min. Negotiated Rate	$23,841.43
Max. Negotiated Rate	$36,404.35
Rate for Payer: Aetna Better Health Medicaid	$35,690.54
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$36,404.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,841.43

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$62,235.16

Service Code	APR-DRG 1214
Min. Negotiated Rate	$45,566.76
Max. Negotiated Rate	$62,235.16
Rate for Payer: Aetna Better Health Medicaid	$61,014.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$62,235.16
Rate for Payer: Wellpoint Medicaid Managed Care	$45,566.76

OTHER RESPIRATORY AND CHEST PROCEDURES

Facility

$23,804.23

Service Code	APR-DRG 1212
Min. Negotiated Rate	$15,171.50
Max. Negotiated Rate	$23,804.23
Rate for Payer: Aetna Better Health Medicaid	$23,337.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,804.23
Rate for Payer: Wellpoint Medicaid Managed Care	$15,171.50

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$9,709.90

Service Code	APR-DRG 1432
Min. Negotiated Rate	$6,762.00
Max. Negotiated Rate	$9,709.90
Rate for Payer: Aetna Better Health Medicaid	$9,519.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,709.90
Rate for Payer: Wellpoint Medicaid Managed Care	$6,762.00

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$14,366.81

Service Code	APR-DRG 1433
Min. Negotiated Rate	$10,407.44
Max. Negotiated Rate	$14,366.81
Rate for Payer: Aetna Better Health Medicaid	$14,085.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,366.81
Rate for Payer: Wellpoint Medicaid Managed Care	$10,407.44

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$23,055.74

Service Code	APR-DRG 1434
Min. Negotiated Rate	$17,735.59
Max. Negotiated Rate	$23,055.74
Rate for Payer: Aetna Better Health Medicaid	$22,603.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,055.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17,735.59

OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES

Facility

$6,948.89

Service Code	APR-DRG 1431
Min. Negotiated Rate	$4,606.45
Max. Negotiated Rate	$6,948.89
Rate for Payer: Aetna Better Health Medicaid	$6,812.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,948.89
Rate for Payer: Wellpoint Medicaid Managed Care	$4,606.45

OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC

Facility

$64,968.36

Service Code	MSDRG 205
Min. Negotiated Rate	$19,980.94
Max. Negotiated Rate	$64,968.36
Rate for Payer: Aetna Commercial	$61,741.10
Rate for Payer: Aetna Medicare Advantage	$19,980.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,896.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,896.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,656.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,896.27
Rate for Payer: Cigna Commercial	$39,404.95
Rate for Payer: Cigna Medicare Advantage	$21,656.12
Rate for Payer: Clover Medicare Advantage	$20,573.31
Rate for Payer: EmblemHealth Commercial	$64,968.36
Rate for Payer: Humana Medicare Advantage	$22,305.80
Rate for Payer: Oxford Commercial	$24,626.95
Rate for Payer: UnitedHealthcare Commercial	$27,953.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,656.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,955.49
Rate for Payer: Wellcare Medicare Advantage	$21,656.12

OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC

Facility

$39,138.33

Service Code	MSDRG 206
Min. Negotiated Rate	$10,269.83
Max. Negotiated Rate	$39,138.33
Rate for Payer: Aetna Commercial	$31,733.77
Rate for Payer: Aetna Medicare Advantage	$10,269.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,085.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,085.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,046.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,085.97
Rate for Payer: Cigna Commercial	$20,253.41
Rate for Payer: Cigna Medicare Advantage	$13,046.11
Rate for Payer: Clover Medicare Advantage	$12,393.80
Rate for Payer: EmblemHealth Commercial	$39,138.33
Rate for Payer: Humana Medicare Advantage	$13,437.49
Rate for Payer: Oxford Commercial	$12,657.80
Rate for Payer: UnitedHealthcare Commercial	$14,367.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,046.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,828.88
Rate for Payer: Wellcare Medicare Advantage	$13,046.11

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC

Facility

$64,167.24

Service Code	MSDRG 167
Min. Negotiated Rate	$19,679.75
Max. Negotiated Rate	$64,167.24
Rate for Payer: Aetna Commercial	$60,810.43
Rate for Payer: Aetna Medicare Advantage	$19,679.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,171.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,171.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,389.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,171.94
Rate for Payer: Cigna Commercial	$38,810.97
Rate for Payer: Cigna Medicare Advantage	$21,389.08
Rate for Payer: Clover Medicare Advantage	$20,319.63
Rate for Payer: EmblemHealth Commercial	$64,167.24
Rate for Payer: Humana Medicare Advantage	$22,030.75
Rate for Payer: Oxford Commercial	$24,255.73
Rate for Payer: UnitedHealthcare Commercial	$27,532.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,389.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,672.42
Rate for Payer: Wellcare Medicare Advantage	$21,389.08

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC

Facility

$126,034.80

Service Code	MSDRG 166
Min. Negotiated Rate	$38,098.71
Max. Negotiated Rate	$126,034.80
Rate for Payer: Aetna Commercial	$126,034.80
Rate for Payer: Aetna Medicare Advantage	$40,787.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111,922.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111,922.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40,103.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111,922.02
Rate for Payer: Cigna Commercial	$80,439.04
Rate for Payer: Cigna Medicare Advantage	$40,103.91
Rate for Payer: Clover Medicare Advantage	$38,098.71
Rate for Payer: EmblemHealth Commercial	$120,311.73
Rate for Payer: Humana Medicare Advantage	$41,307.03
Rate for Payer: Oxford Commercial	$50,272.07
Rate for Payer: UnitedHealthcare Commercial	$57,063.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$40,103.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$42,510.14
Rate for Payer: Wellcare Medicare Advantage	$40,103.91

OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC

Facility

$51,483.00

Service Code	MSDRG 168
Min. Negotiated Rate	$14,910.95
Max. Negotiated Rate	$51,483.00
Rate for Payer: Aetna Commercial	$46,074.84
Rate for Payer: Aetna Medicare Advantage	$14,910.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,491.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,491.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,491.12
Rate for Payer: Cigna Commercial	$29,406.29
Rate for Payer: Cigna Medicare Advantage	$17,161.00
Rate for Payer: Clover Medicare Advantage	$16,302.95
Rate for Payer: EmblemHealth Commercial	$51,483.00
Rate for Payer: Humana Medicare Advantage	$17,675.83
Rate for Payer: Oxford Commercial	$18,378.08
Rate for Payer: UnitedHealthcare Commercial	$20,860.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,161.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,190.66
Rate for Payer: Wellcare Medicare Advantage	$17,161.00

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$35,113.75

Service Code	APR-DRG 3093
Min. Negotiated Rate	$25,367.98
Max. Negotiated Rate	$35,113.75
Rate for Payer: Aetna Better Health Medicaid	$34,425.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,113.75
Rate for Payer: Wellpoint Medicaid Managed Care	$25,367.98

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$24,960.09

Service Code	APR-DRG 3092
Min. Negotiated Rate	$17,375.87
Max. Negotiated Rate	$24,960.09
Rate for Payer: Aetna Better Health Medicaid	$24,470.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,960.09
Rate for Payer: Wellpoint Medicaid Managed Care	$17,375.87

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$55,053.17

Service Code	APR-DRG 3094
Min. Negotiated Rate	$49,602.17
Max. Negotiated Rate	$55,053.17
Rate for Payer: Aetna Better Health Medicaid	$53,973.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$55,053.17
Rate for Payer: Wellpoint Medicaid Managed Care	$49,602.17

OTHER SIGNIFICANT HIP AND FEMUR SURGERY

Facility

$19,228.78

Service Code	APR-DRG 3091
Min. Negotiated Rate	$12,223.18
Max. Negotiated Rate	$19,228.78
Rate for Payer: Aetna Better Health Medicaid	$18,851.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,228.78
Rate for Payer: Wellpoint Medicaid Managed Care	$12,223.18

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$12,187.23

Service Code	APR-DRG 3853
Min. Negotiated Rate	$8,574.29
Max. Negotiated Rate	$12,187.23
Rate for Payer: Aetna Better Health Medicaid	$11,948.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,187.23
Rate for Payer: Wellpoint Medicaid Managed Care	$8,574.29

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$5,926.47

Service Code	APR-DRG 3851
Min. Negotiated Rate	$4,050.60
Max. Negotiated Rate	$5,926.47
Rate for Payer: Aetna Better Health Medicaid	$5,810.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,926.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4,050.60

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$7,830.82

Service Code	APR-DRG 3852
Min. Negotiated Rate	$5,365.95
Max. Negotiated Rate	$7,830.82
Rate for Payer: Aetna Better Health Medicaid	$7,677.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,830.82
Rate for Payer: Wellpoint Medicaid Managed Care	$5,365.95

OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS

Facility

$21,964.53

Service Code	APR-DRG 3854
Min. Negotiated Rate	$17,604.01
Max. Negotiated Rate	$21,964.53
Rate for Payer: Aetna Better Health Medicaid	$21,533.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,964.53
Rate for Payer: Wellpoint Medicaid Managed Care	$17,604.01

Know your out-of-pocket cost for care.

All Charges