Heights University Hospital

All Charges

Charge

Type

Setting

Price

PRQ TCAT PLMT NTRAC ST 2+LES

Facility

$35,998.44

Service Code	HCPCS 92930
Hospital Charge Code	403492930
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,179.60
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ TCAT PLMT NTRAC ST 2+LES

Facility

$35,998.44

Service Code	HCPCS 92930
Hospital Charge Code	403492930
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ TCAT PLMT NTRAC ST 2+LES

Facility

$35,998.44

Service Code	HCPCS 92930
Hospital Charge Code	404692930
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$10,799.53
Rate for Payer: Aetna Medicare Advantage	$10,799.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,179.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,179.60
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRQ TCAT PLMT NTRAC ST 2+LES

Facility

$35,998.44

Service Code	HCPCS 92930
Hospital Charge Code	404692930
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.77
Max. Negotiated Rate	$5,399.77
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77

PRSHEATH INTRO4FR 11CM .035X50

Facility

$9.30

Service Code	HCPCS C1766
Hospital Charge Code	270658188N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

PRSHEATH INTRO4FR 11CM .035X50

Facility

$46.50

Service Code	HCPCS C1766
Hospital Charge Code	270658188
Hospital Revenue Code	278
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$23.25
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.86
Rate for Payer: Cigna Commercial	$23.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

PRSHEATH INTRO4FR 11CM .035X50

Facility

$46.50

Service Code	HCPCS C1766
Hospital Charge Code	270658188
Hospital Revenue Code	278
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

PRSHEATH INTRO4FR 11CM .035X50

Facility

$9.30

Service Code	HCPCS C1766
Hospital Charge Code	270658188N
Hospital Revenue Code	278
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$4.65
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.37
Rate for Payer: Cigna Commercial	$4.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

PRSHEATH INTRO4FR 11CM .035X50

Facility

$46.50

Service Code	HCPCS C1766
Hospital Charge Code	270658188S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$23.25
Rate for Payer: Aetna Commercial	$13.95
Rate for Payer: Aetna Medicare Advantage	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.86
Rate for Payer: Cigna Commercial	$23.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

PRSHEATH INTRO4FR 11CM .035X50

Facility

$46.50

Service Code	HCPCS C1766
Hospital Charge Code	270658188S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

PRTL REM FT BONE,MTRSL HD1-5EA

Facility

$9,331.45

Service Code	HCPCS 28288
Hospital Charge Code	16000327
Hospital Revenue Code	360
Min. Negotiated Rate	$1,399.72
Max. Negotiated Rate	$1,399.72
Rate for Payer: Qualcare PPO/HMO/WC	$1,399.72

PRTL REM FT BONE,MTRSL HD1-5EA

Facility

$9,331.45

Service Code	HCPCS 28288
Hospital Charge Code	16000327
Hospital Revenue Code	360
Min. Negotiated Rate	$1,213.09
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$2,799.43
Rate for Payer: Aetna Medicare Advantage	$2,799.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,379.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,379.52
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	$2,379.52
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,213.09
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,399.72
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PRX HUM LO PLT 2H 73MM

Facility

$6,957.50

Service Code	HCPCS C1776
Hospital Charge Code	270680682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,043.62
Max. Negotiated Rate	$1,683.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,391.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,043.62

PRX HUM LO PLT 2H 73MM

Facility

$6,957.50

Service Code	HCPCS C1776
Hospital Charge Code	270680682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,043.62
Max. Negotiated Rate	$3,478.75
Rate for Payer: Aetna Commercial	$2,087.25
Rate for Payer: Aetna Medicare Advantage	$2,087.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,774.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,774.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,774.16
Rate for Payer: Cigna Commercial	$3,478.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,683.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,043.62

PRX HUM LO PLT LT 11H 190MM

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270680847
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$2,076.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

PRX HUM LO PLT LT 11H 190MM

Facility

$8,580.00

Service Code	HCPCS C1713
Hospital Charge Code	270680847
Hospital Revenue Code	278
Min. Negotiated Rate	$1,287.00
Max. Negotiated Rate	$4,290.00
Rate for Payer: Aetna Commercial	$2,574.00
Rate for Payer: Aetna Medicare Advantage	$2,574.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,187.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,716.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,187.90
Rate for Payer: Cigna Commercial	$4,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,076.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,287.00

PRXMALHUMERLNAILT2LONGRT240MM

Facility

$13,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270663838
Hospital Revenue Code	278
Min. Negotiated Rate	$2,098.50
Max. Negotiated Rate	$6,995.00
Rate for Payer: Aetna Commercial	$4,197.00
Rate for Payer: Aetna Medicare Advantage	$4,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,567.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,567.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,567.45
Rate for Payer: Cigna Commercial	$6,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,385.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,098.50

PRXMALHUMERLNAILT2LONGRT240MM

Facility

$13,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270663838
Hospital Revenue Code	278
Min. Negotiated Rate	$2,098.50
Max. Negotiated Rate	$3,385.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,385.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,098.50

PR Z1 ST/OSS LH CP/XL AA DM LN

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704914
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

PR Z1 ST/OSS LH CP/XL AA DM LN

Facility

$32,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704914
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$9,750.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

PSA DISPOSABLE CABLE

Facility

$303.75

Hospital Charge Code	270666011
Hospital Revenue Code	272
Min. Negotiated Rate	$39.49
Max. Negotiated Rate	$151.88
Rate for Payer: Aetna Commercial	$91.12
Rate for Payer: Aetna Medicare Advantage	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.46
Rate for Payer: Cigna Commercial	$151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.49
Rate for Payer: Oxford Commercial	$151.88
Rate for Payer: Qualcare PPO/HMO/WC	$45.56
Rate for Payer: UnitedHealthcare Commercial	$151.88

PSA DISPOSABLE CABLE

Facility

$303.75

Hospital Charge Code	270666011
Hospital Revenue Code	272
Min. Negotiated Rate	$45.56
Max. Negotiated Rate	$45.56
Rate for Payer: Qualcare PPO/HMO/WC	$45.56

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011S
Hospital Revenue Code	272
Min. Negotiated Rate	$39.49
Max. Negotiated Rate	$151.88
Rate for Payer: Aetna Commercial	$91.12
Rate for Payer: Aetna Medicare Advantage	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.46
Rate for Payer: Cigna Commercial	$151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.49
Rate for Payer: Oxford Commercial	$151.88
Rate for Payer: Qualcare PPO/HMO/WC	$45.56
Rate for Payer: UnitedHealthcare Commercial	$151.88

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011N
Hospital Revenue Code	272
Min. Negotiated Rate	$39.49
Max. Negotiated Rate	$151.88
Rate for Payer: Aetna Commercial	$91.12
Rate for Payer: Aetna Medicare Advantage	$91.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.46
Rate for Payer: Cigna Commercial	$151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.49
Rate for Payer: Oxford Commercial	$151.88
Rate for Payer: Qualcare PPO/HMO/WC	$45.56
Rate for Payer: UnitedHealthcare Commercial	$151.88

PSA Disposible Cable

Facility

$303.75

Hospital Charge Code	270666011S
Hospital Revenue Code	272
Min. Negotiated Rate	$45.56
Max. Negotiated Rate	$45.56
Rate for Payer: Qualcare PPO/HMO/WC	$45.56

Know your out-of-pocket cost for care.

All Charges