Heights University Hospital

All Charges

Charge

Type

Setting

Price

RECONSTRUCTION KNEE

Facility

$60,854.80

Service Code	HCPCS 27429
Hospital Charge Code	1600000884
Hospital Revenue Code	360
Min. Negotiated Rate	$9,128.22
Max. Negotiated Rate	$9,128.22
Rate for Payer: Qualcare PPO/HMO/WC	$9,128.22

RECONSTRUCTION KNEE

Facility

$60,854.80

Service Code	HCPCS 27429
Hospital Charge Code	1600000884
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$18,256.44
Rate for Payer: Aetna Medicare Advantage	$18,256.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,517.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,517.97
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	$15,517.97
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,911.12
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,128.22
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

RECONSTRUCT TOE(S), SYNDACTYLY

Facility

$19,998.60

Service Code	HCPCS 28345
Hospital Charge Code	16000911
Hospital Revenue Code	360
Min. Negotiated Rate	$2,999.79
Max. Negotiated Rate	$2,999.79
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79

RECONSTRUCT TOE(S), SYNDACTYLY

Facility

$19,998.60

Service Code	HCPCS 28345
Hospital Charge Code	16000911
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,999.58
Rate for Payer: Aetna Commercial	$5,999.58
Rate for Payer: Aetna Medicare Advantage	$5,999.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,099.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,099.64
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	$5,099.64
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,599.82
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,999.79
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

Reconstruct ulna/radioulnar

Facility

$33,092.48

Service Code	HCPCS 25337
Hospital Charge Code	16000835
Hospital Revenue Code	360
Min. Negotiated Rate	$4,963.87
Max. Negotiated Rate	$4,963.87
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87

Reconstruct ulna/radioulnar

Facility

$33,092.48

Service Code	HCPCS 25337
Hospital Charge Code	16000835
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$9,927.74
Rate for Payer: Aetna Medicare Advantage	$9,927.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,438.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,438.58
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	$8,438.58
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,302.02
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,963.87
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

RECONSTRUCT VENA CAVA

Facility

$16,048.50

Service Code	HCPCS 34502
Hospital Charge Code	1600000688
Hospital Revenue Code	360
Min. Negotiated Rate	$2,407.28
Max. Negotiated Rate	$2,407.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.28

RECONSTRUCT VENA CAVA

Facility

$16,048.50

Service Code	HCPCS 34502
Hospital Charge Code	1600000688
Hospital Revenue Code	360
Min. Negotiated Rate	$1,534.77
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,814.55
Rate for Payer: Aetna Medicare Advantage	$4,814.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,092.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,092.37
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	$4,092.37
Rate for Payer: Cigna Commercial	$1,534.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,086.30
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,407.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RECORDER LOOP

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270696573S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

RECORDER LOOP

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270696573S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$6,450.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

RECORDER LOOP DM5300 ASSERT

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704451
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$4,719.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

RECORDER LOOP DM5300 ASSERT

Facility

$19,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270704451
Hospital Revenue Code	278
Min. Negotiated Rate	$2,925.00
Max. Negotiated Rate	$9,750.00
Rate for Payer: Aetna Commercial	$5,850.00
Rate for Payer: Aetna Medicare Advantage	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,972.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,972.50
Rate for Payer: Cigna Commercial	$9,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.00

RECORDER LP REVEAL MEDT 9526

Facility

$19,024.00

Service Code	HCPCS C1764
Hospital Charge Code	270625754
Hospital Revenue Code	278
Min. Negotiated Rate	$2,853.60
Max. Negotiated Rate	$4,603.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,804.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,603.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,853.60

RECORDER LP REVEAL MEDT 9526

Facility

$19,024.00

Service Code	HCPCS C1764
Hospital Charge Code	270625754
Hospital Revenue Code	278
Min. Negotiated Rate	$2,853.60
Max. Negotiated Rate	$9,512.00
Rate for Payer: Aetna Commercial	$5,707.20
Rate for Payer: Aetna Medicare Advantage	$5,707.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,851.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,851.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,804.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,851.12
Rate for Payer: Cigna Commercial	$9,512.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,603.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,853.60

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$7,492.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LNQ LOOP

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$7,492.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LNQ LOOP

Facility

$26,475.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999N
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$13,237.50
Rate for Payer: Aetna Commercial	$7,942.50
Rate for Payer: Aetna Medicare Advantage	$7,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,751.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,751.12
Rate for Payer: Cigna Commercial	$13,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

RECORDER REVEAL LNQ LOOP

Facility

$26,475.00

Service Code	HCPCS C1764
Hospital Charge Code	270669999N
Hospital Revenue Code	278
Min. Negotiated Rate	$3,971.25
Max. Negotiated Rate	$6,406.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,406.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,971.25

RECORDER REVEAL LOOP XL 9529

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

RECORDER REVEAL LOOP XL 9529

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230N
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$7,492.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECORDER REVEAL LOOP XL 9529

Facility

$21,500.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$6,450.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

RECORDER REVEAL LOOP XL 9529

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270662230N
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

RECOV EA ADD 30 MIN (NON-PACU)

Facility

$400.00

Hospital Charge Code	41101005
Hospital Revenue Code	710
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

Know your out-of-pocket cost for care.

All Charges