Heights University Hospital

All Charges

Charge

Type

Setting

Price

REPR FOOT EXTENSOR TENDON EA

Facility

$19,998.60

Service Code	HCPCS 28208
Hospital Charge Code	16000451
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

REPR FOOT FLEXOR TENDON EA BL

Facility

$20,537.30

Service Code	HCPCS 28200
Hospital Charge Code	16000278
Hospital Revenue Code	360
Min. Negotiated Rate	$3,080.59
Max. Negotiated Rate	$3,080.59
Rate for Payer: Qualcare PPO/HMO/WC	$3,080.59

REPR FOOT FLEXOR TENDON EA BL

Facility

$20,537.30

Service Code	HCPCS 28200
Hospital Charge Code	16000278
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,161.19
Rate for Payer: Aetna Medicare Advantage	$6,161.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,237.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,237.01
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	$5,237.01
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,669.85
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,080.59
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REPR TORN COLLATRAL KNEE LIGAM

Facility

$44,325.10

Service Code	HCPCS 27405
Hospital Charge Code	16000562
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$13,297.53
Rate for Payer: Aetna Medicare Advantage	$13,297.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,302.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,302.90
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	$11,302.90
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,762.26
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,648.77
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

REPR TORN COLLATRAL KNEE LIGAM

Facility

$44,325.10

Service Code	HCPCS 27405
Hospital Charge Code	16000562
Hospital Revenue Code	360
Min. Negotiated Rate	$6,648.77
Max. Negotiated Rate	$6,648.77
Rate for Payer: Qualcare PPO/HMO/WC	$6,648.77

REP TENDN/MSCL - FARM.WRIST

Facility

$12,832.72

Service Code	HCPCS 25260
Hospital Charge Code	16000833
Hospital Revenue Code	360
Min. Negotiated Rate	$649.28
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Better Health Medicaid	$649.28
Rate for Payer: Aetna Commercial	$3,849.82
Rate for Payer: Aetna Medicare Advantage	$3,849.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,272.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,272.34
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	$3,272.34
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,668.25
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.91
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$662.27
Rate for Payer: Wellpoint Medicaid Managed Care	$649.28

REP TENDN/MSCL - FARM.WRIST

Facility

$12,832.72

Service Code	HCPCS 25260
Hospital Charge Code	16000833
Hospital Revenue Code	360
Min. Negotiated Rate	$1,924.91
Max. Negotiated Rate	$1,924.91
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.91

REPTILASE TEST

Facility

$390.00

Service Code	HCPCS 85635
Hospital Charge Code	38477063
Hospital Revenue Code	305
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.91
Rate for Payer: Aetna Medicare Advantage	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.09
Rate for Payer: Cigna Commercial	$9.85
Rate for Payer: Cigna Medicare Advantage	$4.92
Rate for Payer: Clover Medicare Advantage	$9.36
Rate for Payer: EmblemHealth Commercial	$29.55
Rate for Payer: Humana Medicare Advantage	$10.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.44
Rate for Payer: Wellcare Medicare Advantage	$9.85

REPTILASE TEST

Facility

$390.00

Service Code	HCPCS 85635
Hospital Charge Code	38477063
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

REP T.M EXTENSOR FA/W,1' EA

Facility

$38,731.07

Service Code	HCPCS 25270
Hospital Charge Code	16000423
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,619.32
Rate for Payer: Aetna Better Health Medicaid	$8,649.26
Rate for Payer: Aetna Commercial	$11,619.32
Rate for Payer: Aetna Medicare Advantage	$11,619.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,876.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,876.42
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	$9,876.42
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,035.04
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,809.66
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,822.25
Rate for Payer: Wellpoint Medicaid Managed Care	$8,649.26

REP T.M EXTENSOR FA/W,1' EA

Facility

$38,731.07

Service Code	HCPCS 25270
Hospital Charge Code	16000423
Hospital Revenue Code	360
Min. Negotiated Rate	$5,809.66
Max. Negotiated Rate	$5,809.66
Rate for Payer: Qualcare PPO/HMO/WC	$5,809.66

REP TS FA/WR W FGRAFT

Facility

$30,651.00

Service Code	HCPCS 25275
Hospital Charge Code	16000834
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,195.30
Rate for Payer: Aetna Commercial	$9,195.30
Rate for Payer: Aetna Medicare Advantage	$9,195.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,816.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,816.01
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	$7,816.01
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,984.63
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,597.65
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REP TS FA/WR W FGRAFT

Facility

$30,651.00

Service Code	HCPCS 25275
Hospital Charge Code	16000834
Hospital Revenue Code	360
Min. Negotiated Rate	$4,597.65
Max. Negotiated Rate	$4,597.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,597.65

REP VENOUS BLOCK OPEN VENOUS

Facility

$7,917.57

Service Code	HCPCS 35460
Hospital Charge Code	5100609
Hospital Revenue Code	361
Min. Negotiated Rate	$1,187.64
Max. Negotiated Rate	$1,187.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.64

REP VENOUS BLOCK OPEN VENOUS

Facility

$7,917.57

Service Code	HCPCS 35460
Hospital Charge Code	5100609
Hospital Revenue Code	361
Min. Negotiated Rate	$1,029.28
Max. Negotiated Rate	$3,958.78
Rate for Payer: Aetna Commercial	$2,375.27
Rate for Payer: Aetna Medicare Advantage	$2,375.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.98
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	$2,018.98
Rate for Payer: Cigna Commercial	$3,958.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.64

REREPAIR ING HERNIA,REDUCE-RT

Facility

$30,877.00

Service Code	HCPCS 49520
Hospital Charge Code	160000242
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

REREPAIR ING HERNIA,REDUCE-RT

Facility

$30,877.00

Service Code	HCPCS 49520
Hospital Charge Code	160000242
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

RESCUE NET RETRIEVAL NET

Facility

$425.00

Hospital Charge Code	270680399
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

RESCUE NET RETRIEVAL NET

Facility

$425.00

Hospital Charge Code	270680399
Hospital Revenue Code	272
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$212.50

RESECT BACK TUM < 5 CM

Facility

$13,615.50

Service Code	HCPCS 21935
Hospital Charge Code	16000799
Hospital Revenue Code	360
Min. Negotiated Rate	$1,770.02
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$4,084.65
Rate for Payer: Aetna Medicare Advantage	$4,084.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,471.95
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	$3,471.95
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

RESECT BACK TUM < 5 CM

Facility

$13,615.50

Service Code	HCPCS 21935
Hospital Charge Code	16000799
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

RESECT BONE SPUR FOOT

Facility

$19,998.60

Service Code	HCPCS 28119
Hospital Charge Code	16000239
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
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	$7,791.93
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

RESECT BONE SPUR FOOT

Facility

$19,998.60

Service Code	HCPCS 28119
Hospital Charge Code	16000239
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

RESECT DIAPHRAGM SIMPLE

Facility

$17,181.00

Service Code	HCPCS 39560
Hospital Charge Code	1600000586
Hospital Revenue Code	360
Min. Negotiated Rate	$829.73
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$5,154.30
Rate for Payer: Aetna Medicare Advantage	$5,154.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,381.15
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	$4,381.15
Rate for Payer: Cigna Commercial	$829.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,233.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,577.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

RESECT DIAPHRAGM SIMPLE

Facility

$17,181.00

Service Code	HCPCS 39560
Hospital Charge Code	1600000586
Hospital Revenue Code	360
Min. Negotiated Rate	$2,577.15
Max. Negotiated Rate	$2,577.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,577.15

Know your out-of-pocket cost for care.

All Charges