Heights University Hospital

All Charges

Charge

Type

Setting

Price

THREADED 1.1 K WIRE

Facility

$115.50

Service Code	HCPCS C1713
Hospital Charge Code	270701737
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$57.75
Rate for Payer: Aetna Commercial	$34.65
Rate for Payer: Aetna Medicare Advantage	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.45
Rate for Payer: Cigna Commercial	$57.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.32

THREADED 1.1 K WIRE

Facility

$115.50

Service Code	HCPCS C1713
Hospital Charge Code	270701737
Hospital Revenue Code	278
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$27.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.32

THREADED GUIDE PINS

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698741
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

THREADED GUIDE PINS

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698741
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

THREADED PEG LOCKING 2.3X14

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664357
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

THREADED PEG LOCKING 2.3X14

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664357
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$148.50
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

THREADED POST W/NUT

Facility

$640.50

Hospital Charge Code	270656557
Hospital Revenue Code	271
Min. Negotiated Rate	$96.08
Max. Negotiated Rate	$96.08
Rate for Payer: Qualcare PPO/HMO/WC	$96.08

THREADED POST W/NUT

Facility

$640.50

Hospital Charge Code	270656557
Hospital Revenue Code	271
Min. Negotiated Rate	$83.27
Max. Negotiated Rate	$320.25
Rate for Payer: Aetna Commercial	$192.15
Rate for Payer: Aetna Medicare Advantage	$192.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.33
Rate for Payer: Cigna Commercial	$320.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.27
Rate for Payer: Oxford Commercial	$320.25
Rate for Payer: Qualcare PPO/HMO/WC	$96.08
Rate for Payer: UnitedHealthcare Commercial	$320.25

THREE HOLE CLAMP

Facility

$2,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270689180
Hospital Revenue Code	278
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$625.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.57
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

THREE HOLE CLAMP

Facility

$2,585.00

Service Code	HCPCS C1713
Hospital Charge Code	270689180
Hospital Revenue Code	278
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$1,292.50
Rate for Payer: Aetna Commercial	$775.50
Rate for Payer: Aetna Medicare Advantage	$775.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.17
Rate for Payer: Cigna Commercial	$1,292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.57
Rate for Payer: Qualcare PPO/HMO/WC	$387.75

THRMBC/NFS DIALYSIS CIRCUIT

Facility

$20,340.00

Service Code	HCPCS 36904
Hospital Charge Code	16000951
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$6,102.00
Rate for Payer: Aetna Medicare Advantage	$6,102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,186.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,186.70
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	$5,186.70
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,644.20
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

THRMBC/NFS DIALYSIS CIRCUIT

Facility

$20,340.00

Service Code	HCPCS 36904
Hospital Charge Code	16000951
Hospital Revenue Code	360
Min. Negotiated Rate	$3,051.00
Max. Negotiated Rate	$3,051.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00

THROAT & NOSE CULTURE

Facility

$349.00

Service Code	HCPCS 87070
Hospital Charge Code	38475068
Hospital Revenue Code	306
Min. Negotiated Rate	$52.35
Max. Negotiated Rate	$52.35
Rate for Payer: Qualcare PPO/HMO/WC	$52.35

THROAT & NOSE CULTURE

Facility

$349.00

Service Code	HCPCS 87070
Hospital Charge Code	38475068
Hospital Revenue Code	306
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.58
Rate for Payer: Cigna Commercial	$8.62
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.14
Rate for Payer: Wellcare Medicare Advantage	$8.62

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	5100838
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
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	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	366836904
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
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	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	7412059
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	2709025
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$27,397.00

Service Code	HCPCS 36904
Hospital Charge Code	321036904
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$8,219.10
Rate for Payer: Aetna Medicare Advantage	$8,219.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,986.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,986.23
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	$6,986.23
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,561.61
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	2709025
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
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	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	5100838
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	7412059
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,553.85
Rate for Payer: Aetna Commercial	$7,234.74
Rate for Payer: Aetna Medicare Advantage	$7,234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,149.53
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	$6,149.53
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.05
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$24,115.80

Service Code	HCPCS 36904
Hospital Charge Code	366836904
Hospital Revenue Code	361
Min. Negotiated Rate	$3,617.37
Max. Negotiated Rate	$3,617.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,617.37

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$27,397.00

Service Code	HCPCS 36904
Hospital Charge Code	321036904
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$27,397.00

Service Code	HCPCS 36904
Hospital Charge Code	2692148
Hospital Revenue Code	361
Min. Negotiated Rate	$4,109.55
Max. Negotiated Rate	$4,109.55
Rate for Payer: Qualcare PPO/HMO/WC	$4,109.55

Know your out-of-pocket cost for care.

All Charges