Heights University Hospital

All Charges

Charge

Type

Setting

Price

REVISION OPEN GASTRIC RESTRICT

Facility

$112,126.91

Service Code	HCPCS 43848
Hospital Charge Code	1600185
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$33,638.07
Rate for Payer: Aetna Commercial	$33,638.07
Rate for Payer: Aetna Medicare Advantage	$33,638.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,592.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,592.36
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	$28,592.36
Rate for Payer: Cigna Commercial	$1,949.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,576.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$16,819.04
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REVISION PCMK ATRIAL&VENT LEAD

Facility

$4,723.35

Service Code	HCPCS 33220
Hospital Charge Code	5100295
Hospital Revenue Code	361
Min. Negotiated Rate	$708.50
Max. Negotiated Rate	$708.50
Rate for Payer: Qualcare PPO/HMO/WC	$708.50

REVISION PCMK ATRIAL&VENT LEAD

Facility

$4,723.35

Service Code	HCPCS 33220
Hospital Charge Code	5100295
Hospital Revenue Code	361
Min. Negotiated Rate	$614.04
Max. Negotiated Rate	$8,899.18
Rate for Payer: Aetna Commercial	$1,417.01
Rate for Payer: Aetna Medicare Advantage	$1,417.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,204.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,204.45
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	$1,204.45
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$614.04
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$708.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REVISIT W/O MD*****

Facility

$23.00

Service Code	HCPCS 99211WF
Hospital Charge Code	9600025
Hospital Revenue Code	519
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

REVISIT W/O MD*****

Facility

$23.00

Service Code	HCPCS 99211WF
Hospital Charge Code	9600025
Hospital Revenue Code	519
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

REVIS RECONST SHOULDER JOINT

Facility

$2,701.00

Service Code	HCPCS 23474
Hospital Charge Code	1600000674
Hospital Revenue Code	360
Min. Negotiated Rate	$351.13
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$810.30
Rate for Payer: Aetna Medicare Advantage	$810.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.75
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	$688.75
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.13
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.15
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

REVIS RECONST SHOULDER JOINT

Facility

$2,701.00

Service Code	HCPCS 23474
Hospital Charge Code	1600000674
Hospital Revenue Code	360
Min. Negotiated Rate	$405.15
Max. Negotiated Rate	$405.15
Rate for Payer: Qualcare PPO/HMO/WC	$405.15

REVIS RECONST SHOULDER JOINT

Facility

$2,701.00

Service Code	HCPCS 23474
Hospital Charge Code	16000611
Hospital Revenue Code	360
Min. Negotiated Rate	$351.13
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$810.30
Rate for Payer: Aetna Medicare Advantage	$810.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.75
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	$688.75
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.13
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.15
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

REVIS RECONST SHOULDER JOINT

Facility

$39,644.20

Service Code	HCPCS 23473
Hospital Charge Code	1600000591
Hospital Revenue Code	360
Min. Negotiated Rate	$5,946.63
Max. Negotiated Rate	$5,946.63
Rate for Payer: Qualcare PPO/HMO/WC	$5,946.63

REVIS RECONST SHOULDER JOINT

Facility

$39,644.20

Service Code	HCPCS 23473
Hospital Charge Code	1600000591
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$11,893.26
Rate for Payer: Aetna Medicare Advantage	$11,893.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,109.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,109.27
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	$10,109.27
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,153.75
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,946.63
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

REVIS RECONST SHOULDER JOINT

Facility

$2,701.00

Service Code	HCPCS 23474
Hospital Charge Code	16000611
Hospital Revenue Code	360
Min. Negotiated Rate	$405.15
Max. Negotiated Rate	$405.15
Rate for Payer: Qualcare PPO/HMO/WC	$405.15

REVMOVER ADHESIVE SPRAY 1.7 OZ

Facility

$59.50

Hospital Charge Code	270650470
Hospital Revenue Code	270
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$8.93
Rate for Payer: Qualcare PPO/HMO/WC	$8.93

REVMOVER ADHESIVE SPRAY 1.7 OZ

Facility

$59.50

Hospital Charge Code	270650470
Hospital Revenue Code	270
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$29.75
Rate for Payer: Aetna Commercial	$17.85
Rate for Payer: Aetna Medicare Advantage	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.17
Rate for Payer: Cigna Commercial	$29.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.74
Rate for Payer: Oxford Commercial	$29.75
Rate for Payer: Qualcare PPO/HMO/WC	$8.93
Rate for Payer: UnitedHealthcare Commercial	$29.75

REVOLUTION NOZZLE BREAKAWAY

Facility

$3,503.30

Hospital Charge Code	270689586
Hospital Revenue Code	272
Min. Negotiated Rate	$525.50
Max. Negotiated Rate	$525.50
Rate for Payer: Qualcare PPO/HMO/WC	$525.50

REVOLUTION NOZZLE BREAKAWAY

Facility

$3,503.30

Hospital Charge Code	270689586
Hospital Revenue Code	272
Min. Negotiated Rate	$455.43
Max. Negotiated Rate	$1,751.65
Rate for Payer: Aetna Commercial	$1,050.99
Rate for Payer: Aetna Medicare Advantage	$1,050.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$893.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$893.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$893.34
Rate for Payer: Cigna Commercial	$1,751.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.43
Rate for Payer: Oxford Commercial	$1,751.65
Rate for Payer: Qualcare PPO/HMO/WC	$525.50
Rate for Payer: UnitedHealthcare Commercial	$1,751.65

REV PRESSFIT STEM NSLT 10 X 10

Facility

$11,322.50

Service Code	HCPCS C1776
Hospital Charge Code	270686903
Hospital Revenue Code	278
Min. Negotiated Rate	$1,698.38
Max. Negotiated Rate	$2,740.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,264.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,740.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,698.38

REV PRESSFIT STEM NSLT 10 X 10

Facility

$11,322.50

Service Code	HCPCS C1776
Hospital Charge Code	270686903
Hospital Revenue Code	278
Min. Negotiated Rate	$1,698.38
Max. Negotiated Rate	$5,661.25
Rate for Payer: Aetna Commercial	$3,396.75
Rate for Payer: Aetna Medicare Advantage	$3,396.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,887.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,887.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,887.24
Rate for Payer: Cigna Commercial	$5,661.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,740.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,698.38

REV /REM IMPL SPNL NS PG/REC

Facility

$27,115.93

Service Code	HCPCS 63688
Hospital Charge Code	1600000878
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,325.61
Rate for Payer: Aetna Commercial	$8,134.78
Rate for Payer: Aetna Medicare Advantage	$8,134.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,914.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,914.56
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	$6,914.56
Rate for Payer: Cigna Commercial	$8,325.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,525.07
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,067.39
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REV /REM IMPL SPNL NS PG/REC

Facility

$27,115.93

Service Code	HCPCS 63688
Hospital Charge Code	1600000878
Hospital Revenue Code	360
Min. Negotiated Rate	$4,067.39
Max. Negotiated Rate	$4,067.39
Rate for Payer: Qualcare PPO/HMO/WC	$4,067.39

REVSC EVASC FPVT ANGIO SF 1

Facility

$25,423.30

Service Code	HCPCS 37263
Hospital Charge Code	404637263
Hospital Revenue Code	481
Min. Negotiated Rate	$3,305.03
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,626.99
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,482.94
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,305.03
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

REVSC EVASC FPVT ANGIO SF 1

Facility

$25,423.30

Service Code	HCPCS 37263
Hospital Charge Code	403437263
Hospital Revenue Code	481
Min. Negotiated Rate	$3,305.03
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,626.99
Rate for Payer: Aetna Medicare Advantage	$7,626.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,482.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,482.94
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,305.03
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

REVSC EVASC FPVT ANGIO SF 1

Facility

$25,423.30

Service Code	HCPCS 37263
Hospital Charge Code	403437263
Hospital Revenue Code	481
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

REVSC EVASC FPVT ANGIO SF 1

Facility

$25,423.30

Service Code	HCPCS 37263
Hospital Charge Code	404637263
Hospital Revenue Code	481
Min. Negotiated Rate	$3,813.49
Max. Negotiated Rate	$3,813.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,813.49

REVSC EVASC FPVT ST CPLX 1ST

Facility

$68,574.00

Service Code	HCPCS 37269
Hospital Charge Code	404637269
Hospital Revenue Code	481
Min. Negotiated Rate	$10,286.10
Max. Negotiated Rate	$10,286.10
Rate for Payer: Qualcare PPO/HMO/WC	$10,286.10

REVSC EVASC FPVT ST CPLX 1ST

Facility

$68,574.00

Service Code	HCPCS 37269
Hospital Charge Code	404637269
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$27,491.26
Rate for Payer: Aetna Commercial	$20,572.20
Rate for Payer: Aetna Medicare Advantage	$20,572.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,486.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,486.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,486.37
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,914.62
Rate for Payer: Qualcare PPO/HMO/WC	$10,286.10

Know your out-of-pocket cost for care.

All Charges