Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROXIMAL TIBIA PLATE

Facility

$9,190.00

Hospital Charge Code	270656543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,378.50
Max. Negotiated Rate	$2,223.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,838.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,223.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,378.50

PROXIMAL TIBIA PLATE

Facility

$9,190.00

Hospital Charge Code	270656543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,378.50
Max. Negotiated Rate	$4,595.00
Rate for Payer: Aetna Commercial	$2,757.00
Rate for Payer: Aetna Medicare Advantage	$2,757.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,838.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.45
Rate for Payer: Cigna Commercial	$4,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,223.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,378.50

PROXIMATE 11 SKIN STAPLER

Facility

$47.00

Hospital Charge Code	270334604
Hospital Revenue Code	272
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$23.50
Rate for Payer: Aetna Commercial	$14.10
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$23.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$23.50

PROXIMATE 11 SKIN STAPLER

Facility

$47.00

Hospital Charge Code	270334604
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

PROXIMATE 11 SKIN STAPLER

Facility

$83.00

Hospital Charge Code	270334612
Hospital Revenue Code	272
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$24.90
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.79
Rate for Payer: Oxford Commercial	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$41.50

PROXIMATE 11 SKIN STAPLER

Facility

$83.00

Hospital Charge Code	270334612
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

PROXIMATE CUTTER RELOAD 75

Facility

$566.00

Hospital Charge Code	270334713
Hospital Revenue Code	272
Min. Negotiated Rate	$73.58
Max. Negotiated Rate	$283.00
Rate for Payer: Aetna Commercial	$169.80
Rate for Payer: Aetna Medicare Advantage	$169.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.33
Rate for Payer: Cigna Commercial	$283.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.58
Rate for Payer: Oxford Commercial	$283.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.90
Rate for Payer: UnitedHealthcare Commercial	$283.00

PROXIMATE CUTTER RELOAD 75

Facility

$566.00

Hospital Charge Code	270334713
Hospital Revenue Code	272
Min. Negotiated Rate	$84.90
Max. Negotiated Rate	$84.90
Rate for Payer: Qualcare PPO/HMO/WC	$84.90

PROXIMATE LINEAR CUTTER 50MM

Facility

$762.00

Hospital Charge Code	270334732
Hospital Revenue Code	272
Min. Negotiated Rate	$99.06
Max. Negotiated Rate	$381.00
Rate for Payer: Aetna Commercial	$228.60
Rate for Payer: Aetna Medicare Advantage	$228.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.31
Rate for Payer: Cigna Commercial	$381.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.06
Rate for Payer: Oxford Commercial	$381.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.30
Rate for Payer: UnitedHealthcare Commercial	$381.00

PROXIMATE LINEAR CUTTER 50MM

Facility

$762.00

Hospital Charge Code	270334732
Hospital Revenue Code	272
Min. Negotiated Rate	$114.30
Max. Negotiated Rate	$114.30
Rate for Payer: Qualcare PPO/HMO/WC	$114.30

PROXIMATE LINEAR STAPLER 30MM

Facility

$548.00

Hospital Charge Code	270334720
Hospital Revenue Code	272
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$82.20
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

PROXIMATE LINEAR STAPLER 30MM

Facility

$548.00

Hospital Charge Code	270334720
Hospital Revenue Code	272
Min. Negotiated Rate	$71.24
Max. Negotiated Rate	$274.00
Rate for Payer: Aetna Commercial	$164.40
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.24
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Commercial	$274.00

PROXIMATE PPH 33MM

Facility

$5,962.95

Hospital Charge Code	270657228
Hospital Revenue Code	278
Min. Negotiated Rate	$894.44
Max. Negotiated Rate	$1,443.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,192.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,443.03
Rate for Payer: Qualcare PPO/HMO/WC	$894.44

PROXIMATE PPH 33MM

Facility

$5,962.95

Hospital Charge Code	270657228
Hospital Revenue Code	278
Min. Negotiated Rate	$894.44
Max. Negotiated Rate	$2,981.47
Rate for Payer: Aetna Commercial	$1,788.88
Rate for Payer: Aetna Medicare Advantage	$1,788.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,520.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,520.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,192.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,520.55
Rate for Payer: Cigna Commercial	$2,981.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,443.03
Rate for Payer: Qualcare PPO/HMO/WC	$894.44

PROXMALHUMERALPLATETS3HOLELEFT

Facility

$10,240.00

Service Code	HCPCS C1713
Hospital Charge Code	270663874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.00
Max. Negotiated Rate	$2,478.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.00

PROXMALHUMERALPLATETS3HOLELEFT

Facility

$10,240.00

Service Code	HCPCS C1713
Hospital Charge Code	270663874
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.00
Max. Negotiated Rate	$5,120.00
Rate for Payer: Aetna Commercial	$3,072.00
Rate for Payer: Aetna Medicare Advantage	$3,072.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,611.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,611.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,048.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,611.20
Rate for Payer: Cigna Commercial	$5,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,478.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,536.00

PROX TIB LOCK PLATE LT 3H STD

Facility

$5,112.00

Service Code	HCPCS C1713
Hospital Charge Code	270683103
Hospital Revenue Code	278
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$1,237.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,022.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.10
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

PROX TIB LOCK PLATE LT 3H STD

Facility

$5,112.00

Service Code	HCPCS C1713
Hospital Charge Code	270683103
Hospital Revenue Code	278
Min. Negotiated Rate	$766.80
Max. Negotiated Rate	$2,556.00
Rate for Payer: Aetna Commercial	$1,533.60
Rate for Payer: Aetna Medicare Advantage	$1,533.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,303.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,303.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,022.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,303.56
Rate for Payer: Cigna Commercial	$2,556.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,237.10
Rate for Payer: Qualcare PPO/HMO/WC	$766.80

PROZAC***

Facility

$28.00

Service Code	HCPCS 80299
Hospital Charge Code	3031770
Hospital Revenue Code	309
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

PROZAC***

Facility

$28.00

Service Code	HCPCS 80299
Hospital Charge Code	3031770
Hospital Revenue Code	309
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

PROZAC/10MG/CAP

Facility

$13.00

Hospital Charge Code	60634882
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

PROZAC/10MG/CAP

Facility

$13.00

Hospital Charge Code	60634882
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

PROZAC/20MG/CAP

Facility

$9.00

Hospital Charge Code	60633780
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

PROZAC/20MG/CAP

Facility

$15.00

Hospital Charge Code	60633779
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

PROZAC/20MG/CAP

Facility

$15.00

Hospital Charge Code	60633779
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

Know your out-of-pocket cost for care.

All Charges