Heights University Hospital

All Charges

Charge

Type

Setting

Price

REINFUSION

Facility

$1,670.40

Service Code	HCPCS 38241
Hospital Charge Code	3400306
Hospital Revenue Code	761
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$3,708.85
Rate for Payer: Aetna Commercial	$501.12
Rate for Payer: Aetna Medicare Advantage	$501.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.95
Rate for Payer: Cigna Commercial	$3,708.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.15
Rate for Payer: Oxford Commercial	$835.20
Rate for Payer: Qualcare PPO/HMO/WC	$250.56
Rate for Payer: UnitedHealthcare Commercial	$835.20

REINFUSION

Facility

$1,670.40

Service Code	HCPCS 38241
Hospital Charge Code	3400306
Hospital Revenue Code	761
Min. Negotiated Rate	$250.56
Max. Negotiated Rate	$250.56
Rate for Payer: Qualcare PPO/HMO/WC	$250.56

REINFUSION BAG SET******

Facility

$30.00

Hospital Charge Code	8002511
Hospital Revenue Code	279
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$9.00
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$15.00

REINFUSION BAG SET******

Facility

$30.00

Hospital Charge Code	8002511
Hospital Revenue Code	279
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

REINFUSION PACK125

Facility

$145.00

Hospital Charge Code	270679094
Hospital Revenue Code	272
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.85
Rate for Payer: Oxford Commercial	$72.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$72.50

REINFUSION PACK125

Facility

$145.00

Hospital Charge Code	270679094
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

REINSERT RUPTRD BIC/TC TENDON

Facility

$44,916.00

Service Code	HCPCS 24342
Hospital Charge Code	16000547
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

REINSERT RUPTRD BIC/TC TENDON

Facility

$44,916.00

Service Code	HCPCS 24342
Hospital Charge Code	16000547
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$13,474.80
Rate for Payer: Aetna Medicare Advantage	$13,474.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,453.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,453.58
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	$11,453.58
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,839.08
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

REINSERT SPINAL FIXATION DEVIC

Facility

$20,529.83

Service Code	HCPCS 22849
Hospital Charge Code	1600000304
Hospital Revenue Code	360
Min. Negotiated Rate	$3,079.47
Max. Negotiated Rate	$3,079.47
Rate for Payer: Qualcare PPO/HMO/WC	$3,079.47

REINSERT SPINAL FIXATION DEVIC

Facility

$20,529.83

Service Code	HCPCS 22849
Hospital Charge Code	1600000304
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$6,158.95
Rate for Payer: Aetna Medicare Advantage	$6,158.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,235.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,235.11
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	$5,235.11
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,668.88
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,079.47
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

RE-INSTALL DATA AND VOICE

Facility

$4,012.50

Hospital Charge Code	270659143
Hospital Revenue Code	278
Min. Negotiated Rate	$601.88
Max. Negotiated Rate	$2,006.25
Rate for Payer: Aetna Commercial	$1,203.75
Rate for Payer: Aetna Medicare Advantage	$1,203.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.19
Rate for Payer: Cigna Commercial	$2,006.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.02
Rate for Payer: Qualcare PPO/HMO/WC	$601.88

RE-INSTALL DATA AND VOICE

Facility

$4,012.50

Hospital Charge Code	270659143
Hospital Revenue Code	278
Min. Negotiated Rate	$601.88
Max. Negotiated Rate	$971.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.02
Rate for Payer: Qualcare PPO/HMO/WC	$601.88

RELAFEN/500MG

Facility

$5.00

Hospital Charge Code	60634809
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

RELAFEN/500MG

Facility

$5.00

Hospital Charge Code	60634809
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

RELEASE EXT TNDN HAND/FINGER

Facility

$14,854.00

Service Code	HCPCS 26445
Hospital Charge Code	16000362
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

RELEASE EXT TNDN HAND/FINGER

Facility

$14,854.00

Service Code	HCPCS 26445
Hospital Charge Code	16000362
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,456.20
Rate for Payer: Aetna Medicare Advantage	$4,456.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,787.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,787.77
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	$3,787.77
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,931.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

RELEASE FLEXOR TENDON PALM

Facility

$12,289.60

Service Code	HCPCS 26442
Hospital Charge Code	16000556
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.44
Max. Negotiated Rate	$1,843.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44

RELEASE FLEXOR TENDON PALM

Facility

$12,289.60

Service Code	HCPCS 26442
Hospital Charge Code	16000556
Hospital Revenue Code	360
Min. Negotiated Rate	$1,597.65
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,686.88
Rate for Payer: Aetna Medicare Advantage	$3,686.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,133.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,133.85
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	$3,133.85
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.65
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RELEASE HAND/FINGER TENDON

Facility

$13,687.25

Service Code	HCPCS 26445
Hospital Charge Code	323026445
Hospital Revenue Code	450
Min. Negotiated Rate	$2,053.09
Max. Negotiated Rate	$2,053.09
Rate for Payer: Qualcare PPO/HMO/WC	$2,053.09

RELEASE HAND/FINGER TENDON

Facility

$13,687.25

Service Code	HCPCS 26445
Hospital Charge Code	323026445
Hospital Revenue Code	450
Min. Negotiated Rate	$271.34
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,106.18
Rate for Payer: Aetna Medicare Advantage	$4,106.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,490.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,490.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$271.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,490.25
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,779.34
Rate for Payer: Qualcare PPO/HMO/WC	$2,053.09

RELEASE IP JNT CONTRACTURE-EA

Facility

$14,854.00

Service Code	HCPCS 26525
Hospital Charge Code	16000506
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,822.27
Rate for Payer: Aetna Better Health Medicaid	$8,649.28
Rate for Payer: Aetna Commercial	$4,456.20
Rate for Payer: Aetna Medicare Advantage	$4,456.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,787.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,787.77
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	$3,787.77
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,931.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$3,687.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.27
Rate for Payer: Wellpoint Medicaid Managed Care	$8,649.28

RELEASE IP JNT CONTRACTURE-EA

Facility

$14,854.00

Service Code	HCPCS 26525
Hospital Charge Code	16000506
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

RELEASE MULTIP TIB FIB ANKLE F

Facility

$12,289.60

Service Code	HCPCS 27681
Hospital Charge Code	16000714
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.44
Max. Negotiated Rate	$1,843.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44

RELEASE MULTIP TIB FIB ANKLE F

Facility

$12,289.60

Service Code	HCPCS 27681
Hospital Charge Code	16000714
Hospital Revenue Code	360
Min. Negotiated Rate	$1,597.65
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,686.88
Rate for Payer: Aetna Medicare Advantage	$3,686.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,133.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,133.85
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	$3,133.85
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.65
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.44
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RELEASE PALM CONTRACTURE

Facility

$14,972.60

Service Code	HCPCS 26045
Hospital Charge Code	16000840
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,491.78
Rate for Payer: Aetna Medicare Advantage	$4,491.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,818.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,818.01
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	$3,818.01
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,946.44
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,245.89
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges