Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPLINT MEDT DOYLE NASL 1524050

Facility

$278.00

Hospital Charge Code	270627434
Hospital Revenue Code	272
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$83.40
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.14
Rate for Payer: Oxford Commercial	$139.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$139.00

SPLINT METACARPAL************

Facility

$8.00

Hospital Charge Code	8003576
Hospital Revenue Code	279
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

SPLINT METACARPAL************

Facility

$8.00

Hospital Charge Code	8003576
Hospital Revenue Code	279
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

SPLINT METACARPAL L ADULT

Facility

$86.75

Hospital Charge Code	270610011
Hospital Revenue Code	270
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$43.38
Rate for Payer: Aetna Commercial	$26.02
Rate for Payer: Aetna Medicare Advantage	$26.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.12
Rate for Payer: Cigna Commercial	$43.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.28
Rate for Payer: Oxford Commercial	$43.38
Rate for Payer: Qualcare PPO/HMO/WC	$13.01
Rate for Payer: UnitedHealthcare Commercial	$43.38

SPLINT METACARPAL L ADULT

Facility

$86.75

Hospital Charge Code	270610011
Hospital Revenue Code	270
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$13.01
Rate for Payer: Qualcare PPO/HMO/WC	$13.01

SPLINT METACARPAL LEFT MEDIUM

Facility

$22.05

Hospital Charge Code	270653987
Hospital Revenue Code	272
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$11.03
Rate for Payer: Aetna Commercial	$6.62
Rate for Payer: Aetna Medicare Advantage	$6.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.62
Rate for Payer: Cigna Commercial	$11.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.87
Rate for Payer: Oxford Commercial	$11.03
Rate for Payer: Qualcare PPO/HMO/WC	$3.31
Rate for Payer: UnitedHealthcare Commercial	$11.03

SPLINT METACARPAL LEFT MEDIUM

Facility

$22.05

Hospital Charge Code	270653987
Hospital Revenue Code	272
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$3.31
Rate for Payer: Qualcare PPO/HMO/WC	$3.31

SPLINT METACARPAL PADDED SM LT

Facility

$27.30

Hospital Charge Code	270676701
Hospital Revenue Code	270
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$13.65
Rate for Payer: Aetna Commercial	$8.19
Rate for Payer: Aetna Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.96
Rate for Payer: Cigna Commercial	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.55
Rate for Payer: Oxford Commercial	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.09
Rate for Payer: UnitedHealthcare Commercial	$13.65

SPLINT METACARPAL PADDED SM LT

Facility

$27.30

Hospital Charge Code	270676701
Hospital Revenue Code	270
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.09

SPLINT METACARPAL RIGHT LARGE

Facility

$28.15

Hospital Charge Code	270653990
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$4.22

SPLINT METACARPAL RIGHT LARGE

Facility

$28.15

Hospital Charge Code	270653990
Hospital Revenue Code	272
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$14.07
Rate for Payer: Aetna Commercial	$8.45
Rate for Payer: Aetna Medicare Advantage	$8.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.18
Rate for Payer: Cigna Commercial	$14.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.66
Rate for Payer: Oxford Commercial	$14.07
Rate for Payer: Qualcare PPO/HMO/WC	$4.22
Rate for Payer: UnitedHealthcare Commercial	$14.07

SPLINT METACARPAL RIGHT MEDIUM

Facility

$28.15

Hospital Charge Code	270653989
Hospital Revenue Code	272
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$14.07
Rate for Payer: Aetna Commercial	$8.45
Rate for Payer: Aetna Medicare Advantage	$8.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.18
Rate for Payer: Cigna Commercial	$14.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.66
Rate for Payer: Oxford Commercial	$14.07
Rate for Payer: Qualcare PPO/HMO/WC	$4.22
Rate for Payer: UnitedHealthcare Commercial	$14.07

SPLINT METACARPAL RIGHT MEDIUM

Facility

$28.15

Hospital Charge Code	270653989
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$4.22

SPLINT NASAL DENVER LG

Facility

$219.41

Hospital Charge Code	270649758
Hospital Revenue Code	272
Min. Negotiated Rate	$32.91
Max. Negotiated Rate	$32.91
Rate for Payer: Qualcare PPO/HMO/WC	$32.91

SPLINT NASAL DENVER LG

Facility

$219.41

Hospital Charge Code	270649758
Hospital Revenue Code	272
Min. Negotiated Rate	$28.52
Max. Negotiated Rate	$109.70
Rate for Payer: Aetna Commercial	$65.82
Rate for Payer: Aetna Medicare Advantage	$65.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.95
Rate for Payer: Cigna Commercial	$109.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.52
Rate for Payer: Oxford Commercial	$109.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.91
Rate for Payer: UnitedHealthcare Commercial	$109.70

SPLINT NASAL DOYLE

Facility

$225.00

Hospital Charge Code	270649759
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SPLINT NASAL DOYLE

Facility

$225.00

Hospital Charge Code	270649759
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$112.50

SPLINT NASAL DOYLE II

Facility

$254.45

Hospital Charge Code	270061275
Hospital Revenue Code	272
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$76.33
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.08
Rate for Payer: Oxford Commercial	$127.22
Rate for Payer: Qualcare PPO/HMO/WC	$38.17
Rate for Payer: UnitedHealthcare Commercial	$127.22

SPLINT NASAL DOYLE II

Facility

$157.50

Hospital Charge Code	270649760
Hospital Revenue Code	272
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

SPLINT NASAL DOYLE II

Facility

$157.50

Hospital Charge Code	270649760
Hospital Revenue Code	272
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$78.75
Rate for Payer: Aetna Commercial	$47.25
Rate for Payer: Aetna Medicare Advantage	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.16
Rate for Payer: Cigna Commercial	$78.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.48
Rate for Payer: Oxford Commercial	$78.75
Rate for Payer: Qualcare PPO/HMO/WC	$23.62
Rate for Payer: UnitedHealthcare Commercial	$78.75

SPLINT NASAL DOYLE II

Facility

$254.45

Hospital Charge Code	270061275
Hospital Revenue Code	272
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$38.17
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

SPLINT NASAL EXTERNAL*******

Facility

$51.00

Hospital Charge Code	1600691
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

SPLINT NASAL EXTERNAL*******

Facility

$51.00

Hospital Charge Code	1600691
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 NASAL SILICONE DOYLE

Facility

$260.00

Hospital Charge Code	270650485
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

SPLINT NASAL SILICONE DOYLE

Facility

$260.00

Hospital Charge Code	270650485
Hospital Revenue Code	272
Min. Negotiated Rate	$33.80
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$78.00
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.80
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$130.00

Know your out-of-pocket cost for care.

All Charges