Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPL AVULSE NP,SGL

Facility

$723.29

Service Code	HCPCS 11730
Hospital Charge Code	1600000565
Hospital Revenue Code	360
Min. Negotiated Rate	$94.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$216.99
Rate for Payer: Aetna Medicare Advantage	$216.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.44
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	$184.44
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.03
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.49
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SPL AVULSE NP,SGL

Facility

$723.29

Service Code	HCPCS 11730
Hospital Charge Code	1600000565
Hospital Revenue Code	360
Min. Negotiated Rate	$108.49
Max. Negotiated Rate	$108.49
Rate for Payer: Qualcare PPO/HMO/WC	$108.49

SPLENECTOMY,TOTAL

Facility

$12,780.80

Service Code	HCPCS 38100
Hospital Charge Code	1600000498
Hospital Revenue Code	360
Min. Negotiated Rate	$1,169.15
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$3,834.24
Rate for Payer: Aetna Medicare Advantage	$3,834.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,259.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,259.10
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	$3,259.10
Rate for Payer: Cigna Commercial	$1,169.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,661.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.12
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

SPLENECTOMY,TOTAL

Facility

$12,780.80

Service Code	HCPCS 38100
Hospital Charge Code	1600000498
Hospital Revenue Code	360
Min. Negotiated Rate	$1,917.12
Max. Negotiated Rate	$1,917.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,917.12

SPLENECTOMY WITH CC

Facility

$94,732.63

Service Code	MSDRG 800
Min. Negotiated Rate	$29,566.26
Max. Negotiated Rate	$94,732.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77,738.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77,738.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77,738.94

SPLENECTOMY WITH MCC

Facility

$152,713.98

Service Code	MSDRG 799
Min. Negotiated Rate	$45,371.01
Max. Negotiated Rate	$152,713.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136,456.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136,456.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136,456.65

SPLENECTOMY WITHOUT CC/MCC

Facility

$67,229.46

Service Code	MSDRG 801
Min. Negotiated Rate	$20,831.03
Max. Negotiated Rate	$67,229.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,344.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,344.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,344.93

SPLENIC PROCEDURES

Facility

$19,093.96

Service Code	APR-DRG 6501
Min. Negotiated Rate	$12,345.02
Max. Negotiated Rate	$19,093.96
Rate for Payer: Aetna Better Health Medicaid	$18,719.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,093.96
Rate for Payer: Wellpoint Medicaid Managed Care	$12,345.02

SPLENIC PROCEDURES

Facility

$56,536.17

Service Code	APR-DRG 6504
Min. Negotiated Rate	$47,704.59
Max. Negotiated Rate	$56,536.17
Rate for Payer: Aetna Better Health Medicaid	$55,427.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$56,536.17
Rate for Payer: Wellpoint Medicaid Managed Care	$47,704.59

SPLENIC PROCEDURES

Facility

$35,390.38

Service Code	APR-DRG 6503
Min. Negotiated Rate	$23,826.97
Max. Negotiated Rate	$35,390.38
Rate for Payer: Aetna Better Health Medicaid	$34,696.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,390.38
Rate for Payer: Wellpoint Medicaid Managed Care	$23,826.97

SPLENIC PROCEDURES

Facility

$25,006.38

Service Code	APR-DRG 6502
Min. Negotiated Rate	$17,670.68
Max. Negotiated Rate	$25,006.38
Rate for Payer: Aetna Better Health Medicaid	$24,516.06
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$25,006.38
Rate for Payer: Wellpoint Medicaid Managed Care	$17,670.68

SPLENIC PROCEDURES WITH CC

Facility

$94,732.63

Service Code	MSDRG 800
Min. Negotiated Rate	$29,566.26
Max. Negotiated Rate	$94,732.63
Rate for Payer: Cigna Commercial	$60,461.10
Rate for Payer: Aetna Commercial	$94,732.63
Rate for Payer: Aetna Medicare Advantage	$30,657.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,122.38
Rate for Payer: Cigna Medicare Advantage	$31,122.38
Rate for Payer: Clover Medicare Advantage	$29,566.26
Rate for Payer: EmblemHealth Commercial	$93,367.14
Rate for Payer: Humana Medicare Advantage	$32,056.05
Rate for Payer: Oxford Commercial	$37,786.43
Rate for Payer: UnitedHealthcare Commercial	$42,891.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,122.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$32,989.72
Rate for Payer: Wellcare Medicare Advantage	$31,122.38

SPLENIC PROCEDURES WITH MCC

Facility

$152,713.98

Service Code	MSDRG 799
Min. Negotiated Rate	$45,371.01
Max. Negotiated Rate	$152,713.98
Rate for Payer: Aetna Commercial	$152,713.98
Rate for Payer: Aetna Medicare Advantage	$49,422.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47,758.96
Rate for Payer: Cigna Commercial	$97,466.46
Rate for Payer: Cigna Medicare Advantage	$47,758.96
Rate for Payer: Clover Medicare Advantage	$45,371.01
Rate for Payer: EmblemHealth Commercial	$143,276.88
Rate for Payer: Humana Medicare Advantage	$49,191.73
Rate for Payer: Oxford Commercial	$60,913.71
Rate for Payer: UnitedHealthcare Commercial	$69,142.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$47,758.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$50,624.50
Rate for Payer: Wellcare Medicare Advantage	$47,758.96

SPLENIC PROCEDURES WITHOUT CC/MCC

Facility

$67,229.46

Service Code	MSDRG 801
Min. Negotiated Rate	$20,831.03
Max. Negotiated Rate	$67,229.46
Rate for Payer: Aetna Commercial	$64,367.88
Rate for Payer: Aetna Medicare Advantage	$20,831.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,409.82
Rate for Payer: Cigna Commercial	$41,081.44
Rate for Payer: Cigna Medicare Advantage	$22,409.82
Rate for Payer: Clover Medicare Advantage	$21,289.33
Rate for Payer: EmblemHealth Commercial	$67,229.46
Rate for Payer: Humana Medicare Advantage	$23,082.11
Rate for Payer: Oxford Commercial	$25,674.71
Rate for Payer: UnitedHealthcare Commercial	$29,143.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,409.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23,754.41
Rate for Payer: Wellcare Medicare Advantage	$22,409.82

SPLINT ALUMIFOAM 1x18

Facility

$7.88

Hospital Charge Code	270649755
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$1.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.18

SPLINT ALUMIFOAM 1x18

Facility

$7.88

Hospital Charge Code	270649755
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$3.94
Rate for Payer: Aetna Commercial	$2.36
Rate for Payer: Aetna Medicare Advantage	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.02
Rate for Payer: Oxford Commercial	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.18
Rate for Payer: UnitedHealthcare Commercial	$3.94

SPLINT ALUMIFOAM 4x16

Facility

$26.93

Hospital Charge Code	270649753
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SPLINT ALUMIFOAM 4x16

Facility

$26.93

Hospital Charge Code	270649753
Hospital Revenue Code	272
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$8.08
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.87
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$13.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$13.46

SPLINT ALUMINUM *******

Facility

$25.00

Hospital Charge Code	8001976
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SPLINT ALUMINUM *******

Facility

$25.00

Hospital Charge Code	8001976
Hospital Revenue Code	279
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

SPLINT ALUMINUM FINGER

Facility

$9.65

Hospital Charge Code	270302020
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

SPLINT ALUMINUM FINGER

Facility

$9.65

Hospital Charge Code	270302020
Hospital Revenue Code	270
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

SPLINT BASEBALL ******

Facility

$9.00

Hospital Charge Code	8001984
Hospital Revenue Code	279
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SPLINT BASEBALL ******

Facility

$9.00

Hospital Charge Code	8001984
Hospital Revenue Code	279
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

SPLINT BASEBALL LARGE

Facility

$16.85

Hospital Charge Code	270600748
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

Know your out-of-pocket cost for care.

All Charges