Heights University Hospital

All Charges

Charge

Type

Setting

Price

PUTTY STIMBLAST

Facility

$4,000.00

Service Code	HCPCS C9359
Hospital Charge Code	270664775
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PUTTY STIMBLAST

Facility

$4,000.00

Service Code	HCPCS C9359
Hospital Charge Code	270664775
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PUTTY STIMBLAST 2.5CC

Facility

$2,200.00

Hospital Charge Code	270677565
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$660.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

PUTTY STIMBLAST 2.5CC

Facility

$2,200.00

Hospital Charge Code	270677565
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

PUTTY STIMUBLAST 1CC

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674925
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

PUTTY STIMUBLAST 1CC

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270674925
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

PUTTY STIMUBLAST 2.5CC

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270674926
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

PUTTY STIMUBLAST 2.5CC

Facility

$2,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270674926
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Aetna Commercial	$660.00
Rate for Payer: Aetna Medicare Advantage	$660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$561.00
Rate for Payer: Cigna Commercial	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$532.40
Rate for Payer: Qualcare PPO/HMO/WC	$330.00

PUTTY STIMUBLAST DBM 5CC

Facility

$4,000.00

Service Code	HCPCS C1765
Hospital Charge Code	27060927
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PUTTY STIMUBLAST DBM 5CC

Facility

$4,000.00

Service Code	HCPCS C1765
Hospital Charge Code	27060927
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

PUTTY STYLOS BA 2 CC

Facility

$5,840.00

Hospital Charge Code	270701999
Hospital Revenue Code	278
Min. Negotiated Rate	$876.00
Max. Negotiated Rate	$1,413.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,413.28
Rate for Payer: Qualcare PPO/HMO/WC	$876.00

PUTTY STYLOS BA 2 CC

Facility

$5,840.00

Hospital Charge Code	270701999
Hospital Revenue Code	278
Min. Negotiated Rate	$876.00
Max. Negotiated Rate	$2,920.00
Rate for Payer: Aetna Commercial	$1,752.00
Rate for Payer: Aetna Medicare Advantage	$1,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,489.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,489.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,489.20
Rate for Payer: Cigna Commercial	$2,920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,413.28
Rate for Payer: Qualcare PPO/HMO/WC	$876.00

PUTTY STYLOS BA 5 CC

Facility

$10,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270701998
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.00
Max. Negotiated Rate	$2,637.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,637.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.00

PUTTY STYLOS BA 5 CC

Facility

$10,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270701998
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.00
Max. Negotiated Rate	$5,450.00
Rate for Payer: Aetna Commercial	$3,270.00
Rate for Payer: Aetna Medicare Advantage	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,779.50
Rate for Payer: Cigna Commercial	$5,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,637.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,635.00

PUTY GRAF 2.5cc PRETREAT523103

Facility

$1,985.00

Hospital Charge Code	270634985
Hospital Revenue Code	278
Min. Negotiated Rate	$297.75
Max. Negotiated Rate	$992.50
Rate for Payer: Aetna Commercial	$595.50
Rate for Payer: Aetna Medicare Advantage	$595.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$506.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$506.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$506.18
Rate for Payer: Cigna Commercial	$992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.37
Rate for Payer: Qualcare PPO/HMO/WC	$297.75

PUTY GRAF 2.5cc PRETREAT523103

Facility

$1,985.00

Hospital Charge Code	270634985
Hospital Revenue Code	278
Min. Negotiated Rate	$297.75
Max. Negotiated Rate	$480.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$397.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$480.37
Rate for Payer: Qualcare PPO/HMO/WC	$297.75

PVA, Bearing.355-500 m.100 m

Facility

$2,652.00

Hospital Charge Code	270705187
Hospital Revenue Code	279
Min. Negotiated Rate	$344.76
Max. Negotiated Rate	$1,326.00
Rate for Payer: Aetna Commercial	$795.60
Rate for Payer: Aetna Medicare Advantage	$795.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.26
Rate for Payer: Cigna Commercial	$1,326.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.76
Rate for Payer: Oxford Commercial	$1,326.00
Rate for Payer: Qualcare PPO/HMO/WC	$397.80
Rate for Payer: UnitedHealthcare Commercial	$1,326.00

PVA, Bearing.355-500 m.100 m

Facility

$2,652.00

Hospital Charge Code	270705187
Hospital Revenue Code	279
Min. Negotiated Rate	$397.80
Max. Negotiated Rate	$397.80
Rate for Payer: Qualcare PPO/HMO/WC	$397.80

PVA, Bearing.45-150 m.100 m

Facility

$2,625.00

Hospital Charge Code	270705189
Hospital Revenue Code	279
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.25
Rate for Payer: Oxford Commercial	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$1,312.50

PVA, Bearing.45-150 m.100 m

Facility

$2,625.00

Hospital Charge Code	270705189
Hospital Revenue Code	279
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PVA,Bearing.710-1000m.100

Facility

$2,625.00

Hospital Charge Code	270705191
Hospital Revenue Code	279
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.25
Rate for Payer: Oxford Commercial	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$393.75
Rate for Payer: UnitedHealthcare Commercial	$1,312.50

PVA,Bearing.710-1000m.100

Facility

$2,625.00

Hospital Charge Code	270705191
Hospital Revenue Code	279
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PVR SEGMEN PRESS W/STRESS

Facility

$5,100.00

Service Code	HCPCS 93924
Hospital Charge Code	2692040
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

PVR SEGMEN PRESS W/STRESS

Facility

$5,100.00

Service Code	HCPCS 93924
Hospital Charge Code	2692040
Hospital Revenue Code	920
Min. Negotiated Rate	$377.20
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$377.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PVR SEGMEN PRESS W/STRESS

Facility

$479.00

Service Code	HCPCS 93924
Hospital Charge Code	74116035
Hospital Revenue Code	920
Min. Negotiated Rate	$71.85
Max. Negotiated Rate	$71.85
Rate for Payer: Qualcare PPO/HMO/WC	$71.85

Know your out-of-pocket cost for care.

All Charges