Heights University Hospital

All Charges

Charge

Type

Setting

Price

REP ARTIAL BLK OPN RENAL/OTHER

Facility

$9,003.10

Service Code	HCPCS 35450
Hospital Charge Code	5100605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,350.46
Max. Negotiated Rate	$1,350.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46

REP ARTIAL BLK OPN RENAL/OTHER

Facility

$9,003.10

Service Code	HCPCS 35450
Hospital Charge Code	5100605
Hospital Revenue Code	361
Min. Negotiated Rate	$1,170.40
Max. Negotiated Rate	$4,501.55
Rate for Payer: Aetna Commercial	$2,700.93
Rate for Payer: Aetna Medicare Advantage	$2,700.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.79
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	$2,295.79
Rate for Payer: Cigna Commercial	$4,501.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,170.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.46

REP COMP TUN CV DEV W SQ PORT

Facility

$14,614.45

Service Code	HCPCS 36582
Hospital Charge Code	404336582
Hospital Revenue Code	361
Min. Negotiated Rate	$2,192.17
Max. Negotiated Rate	$2,192.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17

REP COMP TUN CV DEV W SQ PORT

Facility

$14,614.45

Service Code	HCPCS 36582
Hospital Charge Code	404336582
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,384.34
Rate for Payer: Aetna Medicare Advantage	$4,384.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,726.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,726.68
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	$3,726.68
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.88
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,192.17
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REP DURL/CSF LEAK WO LAMINCTMY

Facility

$10,338.30

Service Code	HCPCS 63707
Hospital Charge Code	16000770
Hospital Revenue Code	360
Min. Negotiated Rate	$1,550.74
Max. Negotiated Rate	$1,550.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.74

REP DURL/CSF LEAK WO LAMINCTMY

Facility

$10,338.30

Service Code	HCPCS 63707
Hospital Charge Code	16000770
Hospital Revenue Code	360
Min. Negotiated Rate	$1,023.05
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$3,101.49
Rate for Payer: Aetna Medicare Advantage	$3,101.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,636.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,636.27
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	$2,636.27
Rate for Payer: Cigna Commercial	$1,023.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.98
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,550.74
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REPERFUSIONCATHKITRED43 138CM

Facility

$13,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270700367S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

REPERFUSIONCATHKITRED43 138CM

Facility

$13,750.00

Service Code	HCPCS C1887
Hospital Charge Code	270700367S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

REPERFUSION CATH RED43 138CM

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270700366S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

REPERFUSION CATH RED43 138CM

Facility

$11,950.00

Service Code	HCPCS C1725
Hospital Charge Code	270700366S
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

REP FLXR TNDN NT Z2 WO GRFT EA

Facility

$26,471.80

Service Code	HCPCS 26350
Hospital Charge Code	16000338
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,941.54
Rate for Payer: Aetna Commercial	$7,941.54
Rate for Payer: Aetna Medicare Advantage	$7,941.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.31
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	$6,750.31
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,441.33
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REP FLXR TNDN NT Z2 WO GRFT EA

Facility

$26,471.80

Service Code	HCPCS 26350
Hospital Charge Code	16000338
Hospital Revenue Code	360
Min. Negotiated Rate	$3,970.77
Max. Negotiated Rate	$3,970.77
Rate for Payer: Qualcare PPO/HMO/WC	$3,970.77

REP INCOMPL CIRCUMCIS

Facility

$19,343.80

Service Code	HCPCS 54163
Hospital Charge Code	1600000505
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,803.14
Rate for Payer: Aetna Commercial	$5,803.14
Rate for Payer: Aetna Medicare Advantage	$5,803.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,932.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,932.67
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	$4,932.67
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.69
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,901.57
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REP INCOMPL CIRCUMCIS

Facility

$19,343.80

Service Code	HCPCS 54163
Hospital Charge Code	1600000505
Hospital Revenue Code	360
Min. Negotiated Rate	$2,901.57
Max. Negotiated Rate	$2,901.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,901.57

REP INIT FEM HRN RDCBL,INCARCE

Facility

$30,877.00

Service Code	HCPCS 49553
Hospital Charge Code	1600000308
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,263.10
Rate for Payer: Aetna Commercial	$9,263.10
Rate for Payer: Aetna Medicare Advantage	$9,263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,873.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,873.64
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	$7,873.64
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,014.01
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REP INIT FEM HRN RDCBL,INCARCE

Facility

$30,877.00

Service Code	HCPCS 49553
Hospital Charge Code	1600000308
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

REP INIT INCI/ VENTRAL HERNIA

Facility

$30,877.00

Service Code	HCPCS 49560
Hospital Charge Code	16000989
Hospital Revenue Code	360
Min. Negotiated Rate	$4,631.55
Max. Negotiated Rate	$4,631.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

REP INIT INCI/ VENTRAL HERNIA

Facility

$30,877.00

Service Code	HCPCS 49560
Hospital Charge Code	16000989
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,438.50
Rate for Payer: Aetna Commercial	$9,263.10
Rate for Payer: Aetna Medicare Advantage	$9,263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,873.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,873.64
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	$7,873.64
Rate for Payer: Cigna Commercial	$15,438.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,014.01
Rate for Payer: Qualcare PPO/HMO/WC	$4,631.55

REPLACE CVAD CATH

Facility

$3,931.88

Service Code	HCPCS 36580
Hospital Charge Code	16000947
Hospital Revenue Code	360
Min. Negotiated Rate	$511.14
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Commercial	$1,179.56
Rate for Payer: Aetna Medicare Advantage	$1,179.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,002.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,002.63
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	$1,002.63
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.14
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$589.78
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

REPLACE CVAD CATH

Facility

$3,931.88

Service Code	HCPCS 36580
Hospital Charge Code	16000947
Hospital Revenue Code	360
Min. Negotiated Rate	$589.78
Max. Negotiated Rate	$589.78
Rate for Payer: Qualcare PPO/HMO/WC	$589.78

REPLACE GASTROSTOMY/CECOSTOMY

Facility

$1,891.00

Service Code	HCPCS 45760
Hospital Charge Code	5792245
Hospital Revenue Code	450
Min. Negotiated Rate	$245.83
Max. Negotiated Rate	$945.50
Rate for Payer: Aetna Commercial	$567.30
Rate for Payer: Aetna Medicare Advantage	$567.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.20
Rate for Payer: Cigna Commercial	$945.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.83
Rate for Payer: Qualcare PPO/HMO/WC	$283.65

REPLACE GASTROSTOMY/CECOSTOMY

Facility

$1,891.00

Service Code	HCPCS 45760
Hospital Charge Code	5792245
Hospital Revenue Code	450
Min. Negotiated Rate	$283.65
Max. Negotiated Rate	$283.65
Rate for Payer: Qualcare PPO/HMO/WC	$283.65

REPLACE G/C TUBE PERC

Facility

$270.35

Service Code	HCPCS 49450
Hospital Charge Code	5792271
Hospital Revenue Code	450
Min. Negotiated Rate	$35.15
Max. Negotiated Rate	$2,159.89
Rate for Payer: Aetna Commercial	$81.11
Rate for Payer: Aetna Medicare Advantage	$81.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.94
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.15
Rate for Payer: Qualcare PPO/HMO/WC	$40.55

REPLACE G/C TUBE PERC

Facility

$2,973.96

Service Code	HCPCS 49450
Hospital Charge Code	16000521
Hospital Revenue Code	360
Min. Negotiated Rate	$386.61
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$892.19
Rate for Payer: Aetna Medicare Advantage	$892.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.36
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	$758.36
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.61
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$446.09
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

REPLACE G/C TUBE PERC

Facility

$2,973.96

Service Code	HCPCS 49450
Hospital Charge Code	16000521
Hospital Revenue Code	360
Min. Negotiated Rate	$446.09
Max. Negotiated Rate	$446.09
Rate for Payer: Qualcare PPO/HMO/WC	$446.09

Know your out-of-pocket cost for care.

All Charges