Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPLINT FINGER 2-1/4 11902

Facility

$45.90

Hospital Charge Code	270649340
Hospital Revenue Code	272
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$22.95
Rate for Payer: Aetna Commercial	$13.77
Rate for Payer: Aetna Medicare Advantage	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.70
Rate for Payer: Cigna Commercial	$22.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.97
Rate for Payer: Oxford Commercial	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$6.88
Rate for Payer: UnitedHealthcare Commercial	$22.95

SPLINT FINGER 3-1/4 9119-03

Facility

$39.30

Hospital Charge Code	270649343
Hospital Revenue Code	270
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$19.65
Rate for Payer: Aetna Commercial	$11.79
Rate for Payer: Aetna Medicare Advantage	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.02
Rate for Payer: Cigna Commercial	$19.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.11
Rate for Payer: Oxford Commercial	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$19.65

SPLINT FINGER 3-1/4 9119-03

Facility

$39.30

Hospital Charge Code	270649343
Hospital Revenue Code	270
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

SPLINT FINGER 4-1/4 9119-04

Facility

$47.30

Hospital Charge Code	270649344
Hospital Revenue Code	270
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

SPLINT FINGER 4-1/4 9119-04

Facility

$47.30

Hospital Charge Code	270649344
Hospital Revenue Code	270
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$23.65
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.06
Rate for Payer: Cigna Commercial	$23.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.15
Rate for Payer: Oxford Commercial	$23.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$23.65

SPLINT FINGER 5 1/2 11203

Facility

$48.65

Hospital Charge Code	270649345
Hospital Revenue Code	270
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.30

SPLINT FINGER 5 1/2 11203

Facility

$48.65

Hospital Charge Code	270649345
Hospital Revenue Code	270
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$24.32
Rate for Payer: Aetna Commercial	$14.60
Rate for Payer: Aetna Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.41
Rate for Payer: Cigna Commercial	$24.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.32
Rate for Payer: Oxford Commercial	$24.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.30
Rate for Payer: UnitedHealthcare Commercial	$24.32

SPLINT FINGER W/BLUB 3 1/4

Facility

$51.50

Hospital Charge Code	270649346
Hospital Revenue Code	270
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$25.75
Rate for Payer: Aetna Commercial	$15.45
Rate for Payer: Aetna Medicare Advantage	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.13
Rate for Payer: Cigna Commercial	$25.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.70
Rate for Payer: Oxford Commercial	$25.75
Rate for Payer: Qualcare PPO/HMO/WC	$7.72
Rate for Payer: UnitedHealthcare Commercial	$25.75

SPLINT FINGER W/BLUB 3 1/4

Facility

$51.50

Hospital Charge Code	270649346
Hospital Revenue Code	270
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$7.72

SPLINT FINGER W/BLUB 4 1/4

Facility

$57.55

Hospital Charge Code	270649347
Hospital Revenue Code	270
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$8.63

SPLINT FINGER W/BLUB 4 1/4

Facility

$57.55

Hospital Charge Code	270649347
Hospital Revenue Code	270
Min. Negotiated Rate	$7.48
Max. Negotiated Rate	$28.77
Rate for Payer: Aetna Commercial	$17.27
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.68
Rate for Payer: Cigna Commercial	$28.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.48
Rate for Payer: Oxford Commercial	$28.77
Rate for Payer: Qualcare PPO/HMO/WC	$8.63
Rate for Payer: UnitedHealthcare Commercial	$28.77

SPLINT FINGER W/BULB 5 1/4

Facility

$64.00

Hospital Charge Code	270649348
Hospital Revenue Code	271
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

SPLINT FINGER W/BULB 5 1/4

Facility

$64.00

Hospital Charge Code	270649348
Hospital Revenue Code	271
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

SPLINT FOREARM CHILD (ZIM)****

Facility

$51.00

Hospital Charge Code	8004186
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

SPLINT FOREARM CHILD (ZIM)****

Facility

$51.00

Hospital Charge Code	8004186
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

SPLINT FOREARM YOUTH/ADULT****

Facility

$54.00

Hospital Charge Code	8004178
Hospital Revenue Code	272
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Commercial	$27.00

SPLINT FOREARM YOUTH/ADULT****

Facility

$54.00

Hospital Charge Code	8004178
Hospital Revenue Code	272
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

SPLINT FREEDOM POSEY 8168M

Facility

$105.65

Hospital Charge Code	270613231
Hospital Revenue Code	270
Min. Negotiated Rate	$13.73
Max. Negotiated Rate	$52.83
Rate for Payer: Aetna Commercial	$31.70
Rate for Payer: Aetna Medicare Advantage	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.94
Rate for Payer: Cigna Commercial	$52.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.73
Rate for Payer: Oxford Commercial	$52.83
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$52.83

SPLINT FREEDOM POSEY 8168M

Facility

$105.65

Hospital Charge Code	270613231
Hospital Revenue Code	270
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

SPLINT FREEDOM X-SM

Facility

$104.44

Hospital Charge Code	270650266
Hospital Revenue Code	270
Min. Negotiated Rate	$13.58
Max. Negotiated Rate	$52.22
Rate for Payer: Aetna Commercial	$31.33
Rate for Payer: Aetna Medicare Advantage	$31.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.63
Rate for Payer: Cigna Commercial	$52.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.58
Rate for Payer: Oxford Commercial	$52.22
Rate for Payer: Qualcare PPO/HMO/WC	$15.67
Rate for Payer: UnitedHealthcare Commercial	$52.22

SPLINT FREEDOM X-SM

Facility

$104.44

Hospital Charge Code	270650266
Hospital Revenue Code	270
Min. Negotiated Rate	$15.67
Max. Negotiated Rate	$15.67
Rate for Payer: Qualcare PPO/HMO/WC	$15.67

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759W
Hospital Revenue Code	270
Min. Negotiated Rate	$36.71
Max. Negotiated Rate	$141.20
Rate for Payer: Aetna Commercial	$84.72
Rate for Payer: Aetna Medicare Advantage	$84.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.01
Rate for Payer: Cigna Commercial	$141.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.71
Rate for Payer: Oxford Commercial	$141.20
Rate for Payer: Qualcare PPO/HMO/WC	$42.36
Rate for Payer: UnitedHealthcare Commercial	$141.20

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759
Hospital Revenue Code	270
Min. Negotiated Rate	$42.36
Max. Negotiated Rate	$42.36
Rate for Payer: Qualcare PPO/HMO/WC	$42.36

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759W
Hospital Revenue Code	270
Min. Negotiated Rate	$42.36
Max. Negotiated Rate	$42.36
Rate for Payer: Qualcare PPO/HMO/WC	$42.36

SPLINT GLASS ROLL 3X15

Facility

$282.40

Hospital Charge Code	270600759
Hospital Revenue Code	270
Min. Negotiated Rate	$36.71
Max. Negotiated Rate	$141.20
Rate for Payer: Aetna Commercial	$84.72
Rate for Payer: Aetna Medicare Advantage	$84.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.01
Rate for Payer: Cigna Commercial	$141.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.71
Rate for Payer: Oxford Commercial	$141.20
Rate for Payer: Qualcare PPO/HMO/WC	$42.36
Rate for Payer: UnitedHealthcare Commercial	$141.20

Know your out-of-pocket cost for care.

All Charges