Heights University Hospital

All Charges

Charge

Type

Setting

Price

OVERDRILL FOR 3.5 SCREW AO FIT

Facility

$930.00

Hospital Charge Code	270660365
Hospital Revenue Code	272
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$465.00

OVERDRILL FOR 3.5 SCREW AO FIT

Facility

$930.00

Hospital Charge Code	270660365
Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

OVERDRILL TC 2.0/2.5

Facility

$880.00

Hospital Charge Code	270669820
Hospital Revenue Code	272
Min. Negotiated Rate	$114.40
Max. Negotiated Rate	$440.00
Rate for Payer: Aetna Commercial	$264.00
Rate for Payer: Aetna Medicare Advantage	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.40
Rate for Payer: Cigna Commercial	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.40
Rate for Payer: Oxford Commercial	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00
Rate for Payer: UnitedHealthcare Commercial	$440.00

OVERDRILL TC 2.0/2.5

Facility

$880.00

Hospital Charge Code	270669820
Hospital Revenue Code	272
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.00

OVERTIME PER HOUR ATS300

Facility

$304.00

Hospital Charge Code	270605798
Hospital Revenue Code	270
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$45.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

OVERTIME PER HOUR ATS300

Facility

$304.00

Hospital Charge Code	270605798
Hospital Revenue Code	270
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$152.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$91.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.52
Rate for Payer: Cigna Commercial	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.52
Rate for Payer: Oxford Commercial	$152.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.60
Rate for Payer: UnitedHealthcare Commercial	$152.00

OVERTUBE GUARDUS 10.0x11.7mm

Facility

$775.00

Hospital Charge Code	270640965
Hospital Revenue Code	272
Min. Negotiated Rate	$100.75
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$232.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.75
Rate for Payer: Oxford Commercial	$387.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$387.50

OVERTUBE GUARDUS 10.0x11.7mm

Facility

$775.00

Hospital Charge Code	270640965
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

OVERTUBE GUARDUS 50CM

Facility

$930.00

Hospital Charge Code	270678796
Hospital Revenue Code	272
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

OVERTUBE GUARDUS 50CM

Facility

$930.00

Hospital Charge Code	270678796
Hospital Revenue Code	272
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$139.50
Rate for Payer: UnitedHealthcare Commercial	$465.00

OVERTUBE GUARDUS 8.6x10mm

Facility

$525.00

Hospital Charge Code	270636439
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

OVERTUBE GUARDUS 8.6x10mm

Facility

$525.00

Hospital Charge Code	270636439
Hospital Revenue Code	272
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.25
Rate for Payer: Oxford Commercial	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$78.75
Rate for Payer: UnitedHealthcare Commercial	$262.50

OVERTUBE GUARDUS 8.6x10mm

Facility

$975.00

Hospital Charge Code	270642702
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

OVERTUBE GUARDUS 8.6x10mm

Facility

$975.00

Hospital Charge Code	270642702
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

OVERTUBE GUARDUS 8.6X10MM

Facility

$219.95

Hospital Charge Code	2706427002
Hospital Revenue Code	272
Min. Negotiated Rate	$28.59
Max. Negotiated Rate	$109.97
Rate for Payer: Aetna Commercial	$65.98
Rate for Payer: Aetna Medicare Advantage	$65.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.09
Rate for Payer: Cigna Commercial	$109.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.59
Rate for Payer: Oxford Commercial	$109.97
Rate for Payer: Qualcare PPO/HMO/WC	$32.99
Rate for Payer: UnitedHealthcare Commercial	$109.97

OVERTUBE GUARDUS 8.6X10MM

Facility

$219.95

Hospital Charge Code	2706427002
Hospital Revenue Code	272
Min. Negotiated Rate	$32.99
Max. Negotiated Rate	$32.99
Rate for Payer: Qualcare PPO/HMO/WC	$32.99

OV-ESTABLISHED-BRIEF

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	83653180
Hospital Revenue Code	514
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

OV-ESTABLISHED-BRIEF

Facility

$319.65

Service Code	HCPCS 99211
Hospital Charge Code	83653180
Hospital Revenue Code	514
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$95.89
Rate for Payer: Aetna Commercial	$95.89
Rate for Payer: Aetna Medicare Advantage	$95.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.51
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

OV-ESTABLISHED-COMPREHENSIVE

Facility

$1,213.80

Service Code	HCPCS 99215
Hospital Charge Code	83653220
Hospital Revenue Code	514
Min. Negotiated Rate	$182.07
Max. Negotiated Rate	$182.07
Rate for Payer: Qualcare PPO/HMO/WC	$182.07

OV-ESTABLISHED-COMPREHENSIVE

Facility

$1,213.80

Service Code	HCPCS 99215
Hospital Charge Code	83653220
Hospital Revenue Code	514
Min. Negotiated Rate	$135.96
Max. Negotiated Rate	$364.14
Rate for Payer: Aetna Commercial	$364.14
Rate for Payer: Aetna Medicare Advantage	$364.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.52
Rate for Payer: Cigna Commercial	$135.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.79
Rate for Payer: Qualcare PPO/HMO/WC	$182.07

OV-ESTABLISHED-EXTENDED

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	83653195
Hospital Revenue Code	514
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

OV-ESTABLISHED-EXTENDED

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	83653195
Hospital Revenue Code	514
Min. Negotiated Rate	$91.37
Max. Negotiated Rate	$248.64
Rate for Payer: Aetna Commercial	$248.64
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$91.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.74
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

OV-ESTABLISHED-INTERMEDIATE

Facility

$655.20

Service Code	HCPCS 99213
Hospital Charge Code	83653190
Hospital Revenue Code	514
Min. Negotiated Rate	$62.15
Max. Negotiated Rate	$196.56
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$196.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.08
Rate for Payer: Cigna Commercial	$62.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.18
Rate for Payer: Qualcare PPO/HMO/WC	$98.28

OV-ESTABLISHED-INTERMEDIATE

Facility

$655.20

Service Code	HCPCS 99213
Hospital Charge Code	74308305
Hospital Revenue Code	514
Min. Negotiated Rate	$62.15
Max. Negotiated Rate	$196.56
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$196.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.08
Rate for Payer: Cigna Commercial	$62.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.18
Rate for Payer: Qualcare PPO/HMO/WC	$98.28

OV-ESTABLISHED-INTERMEDIATE

Facility

$655.20

Service Code	HCPCS 99213
Hospital Charge Code	83653190
Hospital Revenue Code	514
Min. Negotiated Rate	$98.28
Max. Negotiated Rate	$98.28
Rate for Payer: Qualcare PPO/HMO/WC	$98.28

Know your out-of-pocket cost for care.

All Charges