Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATELETS IRRADIATED

Facility

$904.31

Hospital Charge Code	3101510
Hospital Revenue Code	390
Min. Negotiated Rate	$135.65
Max. Negotiated Rate	$135.65
Rate for Payer: Qualcare PPO/HMO/WC	$135.65

PLATELETS IRRADIATED

Facility

$904.31

Hospital Charge Code	3101510
Hospital Revenue Code	390
Min. Negotiated Rate	$117.56
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$271.29
Rate for Payer: Aetna Medicare Advantage	$271.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.60
Rate for Payer: Cigna Commercial	$452.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.56
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.65
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELETS, IRRADIATED EA UNIT

Facility

$488.00

Hospital Charge Code	38471096
Hospital Revenue Code	384
Min. Negotiated Rate	$63.44
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$146.40
Rate for Payer: Aetna Medicare Advantage	$146.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.44
Rate for Payer: Cigna Commercial	$244.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.44
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.20
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELETS, IRRADIATED EA UNIT

Facility

$488.00

Hospital Charge Code	38471096
Hospital Revenue Code	384
Min. Negotiated Rate	$73.20
Max. Negotiated Rate	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$73.20

PLATELETS PHERESIS EACH UNIT

Facility

$2,577.63

Hospital Charge Code	3101512
Hospital Revenue Code	390
Min. Negotiated Rate	$335.09
Max. Negotiated Rate	$1,288.82
Rate for Payer: Aetna Commercial	$773.29
Rate for Payer: Aetna Medicare Advantage	$773.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.30
Rate for Payer: Cigna Commercial	$1,288.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.09
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$386.64
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELETS PHERESIS EACH UNIT

Facility

$2,577.63

Hospital Charge Code	3101512
Hospital Revenue Code	390
Min. Negotiated Rate	$386.64
Max. Negotiated Rate	$386.64
Rate for Payer: Qualcare PPO/HMO/WC	$386.64

PLATELETS PHERESIS LEUKORED

Facility

$3,198.72

Hospital Charge Code	38471204
Hospital Revenue Code	390
Min. Negotiated Rate	$415.83
Max. Negotiated Rate	$1,599.36
Rate for Payer: Aetna Commercial	$959.62
Rate for Payer: Aetna Medicare Advantage	$959.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$815.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$815.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$815.67
Rate for Payer: Cigna Commercial	$1,599.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$415.83
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$479.81
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELETS PHERESIS LEUKORED

Facility

$3,198.72

Hospital Charge Code	38471204
Hospital Revenue Code	390
Min. Negotiated Rate	$479.81
Max. Negotiated Rate	$479.81
Rate for Payer: Qualcare PPO/HMO/WC	$479.81

PLATELETS PHER IRRAD LEUKORED

Facility

$4,106.63

Hospital Charge Code	38471205
Hospital Revenue Code	390
Min. Negotiated Rate	$533.86
Max. Negotiated Rate	$2,053.32
Rate for Payer: Aetna Commercial	$1,231.99
Rate for Payer: Aetna Medicare Advantage	$1,231.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,047.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,047.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,047.19
Rate for Payer: Cigna Commercial	$2,053.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$533.86
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$615.99
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELETS PHER IRRAD LEUKORED

Facility

$4,106.63

Hospital Charge Code	38471205
Hospital Revenue Code	390
Min. Negotiated Rate	$615.99
Max. Negotiated Rate	$615.99
Rate for Payer: Qualcare PPO/HMO/WC	$615.99

PLATELETS PHER LEUKO CMV NEG

Facility

$2,638.00

Hospital Charge Code	38471212
Hospital Revenue Code	390
Min. Negotiated Rate	$342.94
Max. Negotiated Rate	$1,319.00
Rate for Payer: Aetna Commercial	$791.40
Rate for Payer: Aetna Medicare Advantage	$791.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$672.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$672.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$672.69
Rate for Payer: Cigna Commercial	$1,319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.94
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$395.70
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELETS PHER LEUKO CMV NEG

Facility

$2,638.00

Hospital Charge Code	38471212
Hospital Revenue Code	390
Min. Negotiated Rate	$395.70
Max. Negotiated Rate	$395.70
Rate for Payer: Qualcare PPO/HMO/WC	$395.70

PLATE LEVEL 1 26 MM PYRENEES

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270689798
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE LEVEL 1 26 MM PYRENEES

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270689798
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$1,956.00
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE LEVEL 1 32MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270692337
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$1,956.00
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE LEVEL 1 32MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270692337
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

PLATE L-FUSION 2.4/2.7MM SH RT

Facility

$3,828.00

Service Code	HCPCS C1713
Hospital Charge Code	270675598
Hospital Revenue Code	278
Min. Negotiated Rate	$574.20
Max. Negotiated Rate	$1,914.00
Rate for Payer: Aetna Commercial	$1,148.40
Rate for Payer: Aetna Medicare Advantage	$1,148.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$976.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$976.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$976.14
Rate for Payer: Cigna Commercial	$1,914.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$926.38
Rate for Payer: Qualcare PPO/HMO/WC	$574.20

PLATE L-FUSION 2.4/2.7MM SH RT

Facility

$3,828.00

Service Code	HCPCS C1713
Hospital Charge Code	270675598
Hospital Revenue Code	278
Min. Negotiated Rate	$574.20
Max. Negotiated Rate	$926.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$926.38
Rate for Payer: Qualcare PPO/HMO/WC	$574.20

PLATE LG ANTER TIBIA 2DI SYS

Facility

$5,611.50

Service Code	HCPCS C1713
Hospital Charge Code	270704105
Hospital Revenue Code	278
Min. Negotiated Rate	$841.73
Max. Negotiated Rate	$1,357.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.98
Rate for Payer: Qualcare PPO/HMO/WC	$841.73

PLATE LG ANTER TIBIA 2DI SYS

Facility

$5,611.50

Service Code	HCPCS C1713
Hospital Charge Code	270704105
Hospital Revenue Code	278
Min. Negotiated Rate	$841.73
Max. Negotiated Rate	$2,805.75
Rate for Payer: Aetna Commercial	$1,683.45
Rate for Payer: Aetna Medicare Advantage	$1,683.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,430.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,430.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,122.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,430.93
Rate for Payer: Cigna Commercial	$2,805.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,357.98
Rate for Payer: Qualcare PPO/HMO/WC	$841.73

PLATE LG FRAGMENT 4HOLE 143614

Facility

$947.45

Hospital Charge Code	270633175
Hospital Revenue Code	278
Min. Negotiated Rate	$142.12
Max. Negotiated Rate	$229.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.28
Rate for Payer: Qualcare PPO/HMO/WC	$142.12

PLATE LG FRAGMENT 4HOLE 143614

Facility

$947.45

Hospital Charge Code	270633175
Hospital Revenue Code	278
Min. Negotiated Rate	$142.12
Max. Negotiated Rate	$473.73
Rate for Payer: Aetna Commercial	$284.24
Rate for Payer: Aetna Medicare Advantage	$284.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.60
Rate for Payer: Cigna Commercial	$473.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.28
Rate for Payer: Qualcare PPO/HMO/WC	$142.12

PLATE LG FRAGMENT 6HOLE 143616

Facility

$1,076.40

Hospital Charge Code	270633167
Hospital Revenue Code	278
Min. Negotiated Rate	$161.46
Max. Negotiated Rate	$538.20
Rate for Payer: Aetna Commercial	$322.92
Rate for Payer: Aetna Medicare Advantage	$322.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.48
Rate for Payer: Cigna Commercial	$538.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.49
Rate for Payer: Qualcare PPO/HMO/WC	$161.46

PLATE LG FRAGMENT 6HOLE 143616

Facility

$1,076.40

Hospital Charge Code	270633167
Hospital Revenue Code	278
Min. Negotiated Rate	$161.46
Max. Negotiated Rate	$260.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.49
Rate for Payer: Qualcare PPO/HMO/WC	$161.46

PLATE LISFRANC MEDIUM

Facility

$10,015.00

Hospital Charge Code	270669553
Hospital Revenue Code	278
Min. Negotiated Rate	$1,502.25
Max. Negotiated Rate	$5,007.50
Rate for Payer: Aetna Commercial	$3,004.50
Rate for Payer: Aetna Medicare Advantage	$3,004.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,553.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,003.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,553.82
Rate for Payer: Cigna Commercial	$5,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,423.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,502.25

Know your out-of-pocket cost for care.

All Charges