Heights University Hospital

All Charges

Charge

Type

Setting

Price

RESTRICTOR FEM CEMENT 25MM

Facility

$668.00

Hospital Charge Code	270601213
Hospital Revenue Code	272
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$100.20
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

RESTRICTOR FEMORAL CANAL******

Facility

$48.50

Hospital Charge Code	1601632
Hospital Revenue Code	272
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$7.28
Rate for Payer: Qualcare PPO/HMO/WC	$7.28

RESTRICTOR FEMORAL CANAL******

Facility

$48.50

Hospital Charge Code	1601632
Hospital Revenue Code	272
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$24.25
Rate for Payer: Aetna Commercial	$14.55
Rate for Payer: Aetna Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.37
Rate for Payer: Cigna Commercial	$24.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.28
Rate for Payer: UnitedHealthcare Commercial	$24.25

REST TEST

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540010
Hospital Revenue Code	341
Min. Negotiated Rate	$947.31
Max. Negotiated Rate	$947.31
Rate for Payer: Qualcare PPO/HMO/WC	$947.31

REST TEST

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540010
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,894.62
Rate for Payer: Aetna Medicare Advantage	$1,894.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,610.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,610.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,610.43
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$821.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$947.31
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	74117002
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$3,196.41
Rate for Payer: Aetna Medicare Advantage	$3,196.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,716.95
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.11
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	94053001
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$3,196.41
Rate for Payer: Aetna Medicare Advantage	$3,196.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,716.95
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.11
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	74117002
Hospital Revenue Code	341
Min. Negotiated Rate	$1,598.21
Max. Negotiated Rate	$1,598.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	74116002
Hospital Revenue Code	341
Min. Negotiated Rate	$1,598.21
Max. Negotiated Rate	$1,598.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	94053001
Hospital Revenue Code	341
Min. Negotiated Rate	$1,598.21
Max. Negotiated Rate	$1,598.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	74115002
Hospital Revenue Code	341
Min. Negotiated Rate	$1,598.21
Max. Negotiated Rate	$1,598.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	5307001
Hospital Revenue Code	341
Min. Negotiated Rate	$1,598.21
Max. Negotiated Rate	$1,598.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	74115002
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$3,196.41
Rate for Payer: Aetna Medicare Advantage	$3,196.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,716.95
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.11
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	74116002
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$3,196.41
Rate for Payer: Aetna Medicare Advantage	$3,196.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,716.95
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.11
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

REST TEST

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	5307001
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$3,196.41
Rate for Payer: Aetna Medicare Advantage	$3,196.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,716.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,716.95
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.11
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

RESURFACING PATELLA

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677547
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

RESURFACING PATELLA

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677547
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

RESUSCITATION ADULT*****

Facility

$133.10

Hospital Charge Code	9500448
Hospital Revenue Code	279
Min. Negotiated Rate	$17.30
Max. Negotiated Rate	$66.55
Rate for Payer: Aetna Commercial	$39.93
Rate for Payer: Aetna Medicare Advantage	$39.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.94
Rate for Payer: Cigna Commercial	$66.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Oxford Commercial	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$19.96
Rate for Payer: UnitedHealthcare Commercial	$66.55

RESUSCITATION ADULT*****

Facility

$133.10

Hospital Charge Code	9500448
Hospital Revenue Code	279
Min. Negotiated Rate	$19.96
Max. Negotiated Rate	$19.96
Rate for Payer: Qualcare PPO/HMO/WC	$19.96

RESUSCITATION PEDIATRIC/INFANT

Facility

$264.85

Hospital Charge Code	9501230
Hospital Revenue Code	270
Min. Negotiated Rate	$34.43
Max. Negotiated Rate	$132.43
Rate for Payer: Aetna Commercial	$79.45
Rate for Payer: Aetna Medicare Advantage	$79.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.54
Rate for Payer: Cigna Commercial	$132.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.43
Rate for Payer: Oxford Commercial	$132.43
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$132.43

RESUSCITATION PEDIATRIC/INFANT

Facility

$264.85

Hospital Charge Code	9501230
Hospital Revenue Code	270
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

RESUSCITATOR ADULT MANUAL

Facility

$193.00

Hospital Charge Code	270331414
Hospital Revenue Code	272
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$28.95
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

RESUSCITATOR ADULT MANUAL

Facility

$193.00

Hospital Charge Code	270331414
Hospital Revenue Code	272
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$96.50
Rate for Payer: Aetna Commercial	$57.90
Rate for Payer: Aetna Medicare Advantage	$57.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.22
Rate for Payer: Cigna Commercial	$96.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.09
Rate for Payer: Oxford Commercial	$96.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.95
Rate for Payer: UnitedHealthcare Commercial	$96.50

RETACRIT ALFAEPBX 20000U/2MLVL

Facility

$1,239.50

Service Code	NDC 69131810
Hospital Charge Code	606390491
Hospital Revenue Code	635
Min. Negotiated Rate	$185.93
Max. Negotiated Rate	$185.93
Rate for Payer: Qualcare PPO/HMO/WC	$185.93

RETACRIT ALFAEPBX 20000U/2MLVL

Facility

$1,239.50

Service Code	NDC 69131810
Hospital Charge Code	606390491
Hospital Revenue Code	635
Min. Negotiated Rate	$161.13
Max. Negotiated Rate	$619.75
Rate for Payer: Aetna Commercial	$371.85
Rate for Payer: Aetna Medicare Advantage	$371.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.07
Rate for Payer: Cigna Commercial	$619.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.13
Rate for Payer: Oxford Commercial	$619.75
Rate for Payer: Qualcare PPO/HMO/WC	$185.93
Rate for Payer: UnitedHealthcare Commercial	$619.75

Know your out-of-pocket cost for care.

All Charges