Heights University Hospital

All Charges

Charge

Type

Setting

Price

PRCTSPY W/BCP ELCTRCAUT****

Facility

$283.00

Service Code	HCPCS 99999
Hospital Charge Code	2300432
Hospital Revenue Code	361
Min. Negotiated Rate	$42.45
Max. Negotiated Rate	$42.45
Rate for Payer: Qualcare PPO/HMO/WC	$42.45

PRCTSPY W/BCP ELCTRCAUT****

Facility

$283.00

Service Code	HCPCS 99999
Hospital Charge Code	2300432
Hospital Revenue Code	361
Min. Negotiated Rate	$36.79
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$84.90
Rate for Payer: Aetna Medicare Advantage	$84.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.17
Rate for Payer: Cigna Commercial	$141.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.79
Rate for Payer: Qualcare PPO/HMO/WC	$42.45

PRDI THERAPEUTIC PHR SET****

Facility

$213.00

Hospital Charge Code	8002529
Hospital Revenue Code	279
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$31.95
Rate for Payer: Qualcare PPO/HMO/WC	$31.95

PRDI THERAPEUTIC PHR SET****

Facility

$213.00

Hospital Charge Code	8002529
Hospital Revenue Code	279
Min. Negotiated Rate	$27.69
Max. Negotiated Rate	$106.50
Rate for Payer: Aetna Commercial	$63.90
Rate for Payer: Aetna Medicare Advantage	$63.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.31
Rate for Payer: Cigna Commercial	$106.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.69
Rate for Payer: Oxford Commercial	$106.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.95
Rate for Payer: UnitedHealthcare Commercial	$106.50

Pre-albumin

Facility

$390.00

Service Code	HCPCS 84134
Hospital Charge Code	39888031
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Pre-albumin

Facility

$390.00

Service Code	HCPCS 84134
Hospital Charge Code	39888031
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.27
Rate for Payer: Aetna Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.46
Rate for Payer: Cigna Commercial	$14.59
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.47
Rate for Payer: Wellcare Medicare Advantage	$14.59

PREALBUMIN

Facility

$100.25

Service Code	HCPCS 84134
Hospital Charge Code	39900428
Hospital Revenue Code	301
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$15.04
Rate for Payer: Qualcare PPO/HMO/WC	$15.04

PREALBUMIN

Facility

$96.25

Service Code	HCPCS 84134
Hospital Charge Code	3002842
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.27
Rate for Payer: Aetna Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.46
Rate for Payer: Cigna Commercial	$14.59
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.44
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.47
Rate for Payer: Wellcare Medicare Advantage	$14.59

PREALBUMIN

Facility

$100.25

Service Code	HCPCS 84134
Hospital Charge Code	39900428
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.27
Rate for Payer: Aetna Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.46
Rate for Payer: Cigna Commercial	$14.59
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.04
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.47
Rate for Payer: Wellcare Medicare Advantage	$14.59

PREALBUMIN

Facility

$96.25

Service Code	HCPCS 84134
Hospital Charge Code	3002842
Hospital Revenue Code	301
Min. Negotiated Rate	$14.44
Max. Negotiated Rate	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$14.44

PREALBUMIN SERUM

Facility

$103.00

Service Code	HCPCS 84134
Hospital Charge Code	38478093
Hospital Revenue Code	301
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

PREALBUMIN SERUM

Facility

$103.00

Service Code	HCPCS 84134
Hospital Charge Code	38478093
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.27
Rate for Payer: Aetna Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.46
Rate for Payer: Cigna Commercial	$14.59
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.47
Rate for Payer: Wellcare Medicare Advantage	$14.59

PRE-BENT ROD 5.5X45MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706193
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PRE-BENT ROD 5.5X45MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706193
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PRE-BENT ROD 5.5X60MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270702847
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PRE-BENT ROD 5.5X60MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270702847
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PREBENT ROD 5.5X60MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706171
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PREBENT ROD 5.5X60MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706171
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PRE-BENT ROD 5.5X70MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270703104
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PRE-BENT ROD 5.5X70MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270703104
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PRECEPT SCREW 6.5x40MM POLYAXI

Facility

$10,285.00

Hospital Charge Code	270665929
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,085.50
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

PRECEPT SCREW 6.5x40MM POLYAXI

Facility

$10,285.00

Hospital Charge Code	270665929
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$2,488.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

PRECEPT SCREW 6.5x50MM POLYAXI

Facility

$10,285.00

Hospital Charge Code	270665928
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$2,488.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

PRECEPT SCREW 6.5x50MM POLYAXI

Facility

$10,285.00

Hospital Charge Code	270665928
Hospital Revenue Code	278
Min. Negotiated Rate	$1,542.75
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,085.50
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75

PRECEPT SCREW SHANK, 6.5x50MM

Facility

$4,865.00

Hospital Charge Code	270665930
Hospital Revenue Code	278
Min. Negotiated Rate	$729.75
Max. Negotiated Rate	$1,177.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$973.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,177.33
Rate for Payer: Qualcare PPO/HMO/WC	$729.75

Know your out-of-pocket cost for care.

All Charges