Heights University Hospital

All Charges

Charge

Type

Setting

Price

PT WEDGE CAST CLUBFOOT

Facility

$1,485.20

Service Code	HCPCS 29750GP
Hospital Charge Code	422529750
Hospital Revenue Code	420
Min. Negotiated Rate	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT WEDGE CAST CLUBFOOT

Facility

$1,485.20

Service Code	HCPCS 29750GP
Hospital Charge Code	422529750
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$742.60
Rate for Payer: Aetna Commercial	$445.56
Rate for Payer: Aetna Medicare Advantage	$445.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.73
Rate for Payer: Cigna Commercial	$742.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.08
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.78
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WEDGE CAST EXCPT CLUBFT CST

Facility

$1,485.20

Service Code	HCPCS 29740GP
Hospital Charge Code	422529740
Hospital Revenue Code	420
Min. Negotiated Rate	$222.78
Max. Negotiated Rate	$222.78
Rate for Payer: Qualcare PPO/HMO/WC	$222.78

PT WEDGE CAST EXCPT CLUBFT CST

Facility

$1,485.20

Service Code	HCPCS 29740GP
Hospital Charge Code	422529740
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$742.60
Rate for Payer: Aetna Commercial	$445.56
Rate for Payer: Aetna Medicare Advantage	$445.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.73
Rate for Payer: Cigna Commercial	$742.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.08
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.78
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WHEELCHAIR MANAGE EA 15 MIN

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	422597542
Hospital Revenue Code	420
Min. Negotiated Rate	$21.39
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$49.35
Rate for Payer: Aetna Medicare Advantage	$49.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.95
Rate for Payer: Cigna Commercial	$82.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.39
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.68
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WHEELCHAIR MANAGE EA 15 MIN

Facility

$164.50

Service Code	HCPCS 97542GP
Hospital Charge Code	422597542
Hospital Revenue Code	420
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$24.68
Rate for Payer: Qualcare PPO/HMO/WC	$24.68

PT WHEELCHR MGT TRAING EA 15M

Facility

$73.00

Service Code	HCPCS 97542GP
Hospital Charge Code	9100135
Hospital Revenue Code	420
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$21.90
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.49
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WHEELCHR MGT TRAING EA 15M

Facility

$73.00

Service Code	HCPCS 97542GP
Hospital Charge Code	9100135
Hospital Revenue Code	420
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

PT WHIRLPOOL

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	422597022
Hospital Revenue Code	420
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

PT WHIRLPOOL

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	422597022
Hospital Revenue Code	420
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$55.50
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WINDOWING OF CAST

Facility

$869.79

Service Code	HCPCS 29730GP
Hospital Charge Code	422529730
Hospital Revenue Code	420
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$260.94
Rate for Payer: Aetna Medicare Advantage	$260.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$221.80
Rate for Payer: Cigna Commercial	$434.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.07
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.47
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WINDOWING OF CAST

Facility

$869.79

Service Code	HCPCS 29730GP
Hospital Charge Code	422529730
Hospital Revenue Code	420
Min. Negotiated Rate	$130.47
Max. Negotiated Rate	$130.47
Rate for Payer: Qualcare PPO/HMO/WC	$130.47

PT-WORK HARD/COND ADD HR

Facility

$170.00

Hospital Charge Code	9109040
Hospital Revenue Code	420
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT-WORK HARD/COND ADD HR

Facility

$170.00

Hospital Charge Code	9109040
Hospital Revenue Code	420
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

PT-WORK HARD/CONDITIO 2HR

Facility

$601.00

Hospital Charge Code	9109035
Hospital Revenue Code	420
Min. Negotiated Rate	$90.15
Max. Negotiated Rate	$90.15
Rate for Payer: Qualcare PPO/HMO/WC	$90.15

PT-WORK HARD/CONDITIO 2HR

Facility

$601.00

Hospital Charge Code	9109035
Hospital Revenue Code	420
Min. Negotiated Rate	$78.13
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$180.30
Rate for Payer: Aetna Medicare Advantage	$180.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.25
Rate for Payer: Cigna Commercial	$300.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.13
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WORK HARDENING 1ST 2 HRS

Facility

$601.00

Service Code	HCPCS 97545GP
Hospital Charge Code	422597545
Hospital Revenue Code	422
Min. Negotiated Rate	$90.15
Max. Negotiated Rate	$90.15
Rate for Payer: Qualcare PPO/HMO/WC	$90.15

PT WORK HARDENING 1ST 2 HRS

Facility

$601.00

Service Code	HCPCS 97545GP
Hospital Charge Code	422597545
Hospital Revenue Code	422
Min. Negotiated Rate	$78.13
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$180.30
Rate for Payer: Aetna Medicare Advantage	$180.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.25
Rate for Payer: Cigna Commercial	$300.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.13
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WORK HARDENING EA ADD HR

Facility

$170.00

Service Code	HCPCS 97546GP
Hospital Charge Code	422597546
Hospital Revenue Code	422
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$686.00

PT WORK HARDENING EA ADD HR

Facility

$170.00

Service Code	HCPCS 97546GP
Hospital Charge Code	422597546
Hospital Revenue Code	422
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

PUDDLE-VAC LVT 9321

Facility

$75.00

Hospital Charge Code	270600358
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

PUDDLE-VAC LVT 9321

Facility

$75.00

Hospital Charge Code	270600358
Hospital Revenue Code	270
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92998
Hospital Charge Code	411092998
Hospital Revenue Code	481
Min. Negotiated Rate	$295.93
Max. Negotiated Rate	$10,799.53
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	$295.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,679.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.77
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PUL ART BALLOON REPR PERCUT

Facility

$35,998.40

Service Code	HCPCS 92997
Hospital Charge Code	411092997
Hospital Revenue Code	481
Min. Negotiated Rate	$5,399.76
Max. Negotiated Rate	$5,399.76
Rate for Payer: Qualcare PPO/HMO/WC	$5,399.76

PUL ART BALLOON REPR PERCUT

Facility

$35,998.44

Service Code	HCPCS 92998
Hospital Charge Code	411092998
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

Know your out-of-pocket cost for care.

All Charges