Heights University Hospital

All Charges

Charge

Type

Setting

Price

TISSUE TRX ANY 30.1-60CM

Facility

$10,841.92

Service Code	HCPCS 14301
Hospital Charge Code	5792297
Hospital Revenue Code	450
Min. Negotiated Rate	$1,626.29
Max. Negotiated Rate	$1,626.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,626.29

TIS TRNFR F/C/C/M/N/A/G/H/F

Facility

$19,317.68

Service Code	HCPCS 14040
Hospital Charge Code	16000201
Hospital Revenue Code	360
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$5,795.30
Rate for Payer: Aetna Better Health Medicaid	$64.50
Rate for Payer: Aetna Commercial	$5,795.30
Rate for Payer: Aetna Medicare Advantage	$5,795.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,926.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,926.01
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	$4,926.01
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,511.30
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,897.65
Rate for Payer: UnitedHealthcare Commercial	$3,687.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$65.79
Rate for Payer: Wellpoint Medicaid Managed Care	$64.50

TIS TRNFR F/C/C/M/N/A/G/H/F

Facility

$19,317.68

Service Code	HCPCS 14040
Hospital Charge Code	16000201
Hospital Revenue Code	360
Min. Negotiated Rate	$2,897.65
Max. Negotiated Rate	$2,897.65
Rate for Payer: Qualcare PPO/HMO/WC	$2,897.65

TIS TRNFR S/A/L 10.1-30 SQCM

Facility

$7,256.44

Service Code	HCPCS 14021
Hospital Charge Code	16000269
Hospital Revenue Code	360
Min. Negotiated Rate	$943.34
Max. Negotiated Rate	$5,165.88
Rate for Payer: Aetna Better Health Medicaid	$5,064.59
Rate for Payer: Aetna Commercial	$2,176.93
Rate for Payer: Aetna Medicare Advantage	$2,176.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,850.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,850.39
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	$1,850.39
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.34
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.47
Rate for Payer: UnitedHealthcare Commercial	$3,687.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5,064.59

TIS TRNFR S/A/L 10.1-30 SQCM

Facility

$7,256.44

Service Code	HCPCS 14021
Hospital Charge Code	16000269
Hospital Revenue Code	360
Min. Negotiated Rate	$1,088.47
Max. Negotiated Rate	$1,088.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,088.47

Tis trnfr s/a/l 10 sq cm/<

Facility

$8,616.84

Service Code	HCPCS 14020
Hospital Charge Code	241175
Hospital Revenue Code	360
Min. Negotiated Rate	$1,120.19
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$2,585.05
Rate for Payer: Aetna Medicare Advantage	$2,585.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,197.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,197.29
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	$2,197.29
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,120.19
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.53
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Tis trnfr s/a/l 10 sq cm/<

Facility

$8,616.84

Service Code	HCPCS 14020
Hospital Charge Code	241175
Hospital Revenue Code	360
Min. Negotiated Rate	$1,292.53
Max. Negotiated Rate	$1,292.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.53

Tis trnfr s/a/l 10 sq cm/<

Facility

$8,616.84

Service Code	HCPCS 14020
Hospital Charge Code	16000171
Hospital Revenue Code	360
Min. Negotiated Rate	$1,120.19
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$2,585.05
Rate for Payer: Aetna Medicare Advantage	$2,585.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,197.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,197.29
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	$2,197.29
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,120.19
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.53
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

Tis trnfr s/a/l 10 sq cm/<

Facility

$8,616.84

Service Code	HCPCS 14020
Hospital Charge Code	16000171
Hospital Revenue Code	360
Min. Negotiated Rate	$1,292.53
Max. Negotiated Rate	$1,292.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,292.53

TIS TXFR FCCMNAGHF 10.1-30SQCM

Facility

$10,361.45

Service Code	HCPCS 14041
Hospital Charge Code	323014041
Hospital Revenue Code	450
Min. Negotiated Rate	$438.95
Max. Negotiated Rate	$5,165.88
Rate for Payer: Aetna Better Health Medicaid	$5,064.59
Rate for Payer: Aetna Commercial	$3,108.43
Rate for Payer: Aetna Medicare Advantage	$3,108.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,642.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,642.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$438.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,642.17
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,554.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88

TIS TXFR FCCMNAGHF 10.1-30SQCM

Facility

$10,361.45

Service Code	HCPCS 14041
Hospital Charge Code	323014041
Hospital Revenue Code	450
Min. Negotiated Rate	$1,554.22
Max. Negotiated Rate	$1,554.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,554.22

TITAN 3D WEDGE COTTON 5MM

Facility

$10,412.50

Service Code	HCPCS C1713
Hospital Charge Code	270701425
Hospital Revenue Code	278
Min. Negotiated Rate	$1,561.88
Max. Negotiated Rate	$2,519.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,519.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,561.88

TITAN 3D WEDGE COTTON 5MM

Facility

$10,412.50

Service Code	HCPCS C1713
Hospital Charge Code	270701425
Hospital Revenue Code	278
Min. Negotiated Rate	$1,561.88
Max. Negotiated Rate	$5,206.25
Rate for Payer: Aetna Commercial	$3,123.75
Rate for Payer: Aetna Medicare Advantage	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,655.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,655.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,082.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,655.19
Rate for Payer: Cigna Commercial	$5,206.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,519.82
Rate for Payer: Qualcare PPO/HMO/WC	$1,561.88

TITAN 3D WEDGE SYSTEM 8MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704487
Hospital Revenue Code	279
Min. Negotiated Rate	$1,300.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$5,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00
Rate for Payer: UnitedHealthcare Commercial	$5,000.00

TITAN 3D WEDGE SYSTEM 8MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704487
Hospital Revenue Code	279
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

TITANIUMCORTXSCREW W/CRUCIFORM

Facility

$2,675.00

Hospital Charge Code	270634480
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$647.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

TITANIUMCORTXSCREW W/CRUCIFORM

Facility

$2,675.00

Hospital Charge Code	270634480
Hospital Revenue Code	278
Min. Negotiated Rate	$401.25
Max. Negotiated Rate	$1,337.50
Rate for Payer: Aetna Commercial	$802.50
Rate for Payer: Aetna Medicare Advantage	$802.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$682.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$535.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$682.12
Rate for Payer: Cigna Commercial	$1,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$647.35
Rate for Payer: Qualcare PPO/HMO/WC	$401.25

TITANIUM HUMERAL NAIL 7MM

Facility

$7,605.00

Hospital Charge Code	270656701
Hospital Revenue Code	278
Min. Negotiated Rate	$1,140.75
Max. Negotiated Rate	$3,802.50
Rate for Payer: Aetna Commercial	$2,281.50
Rate for Payer: Aetna Medicare Advantage	$2,281.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,939.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,939.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,939.28
Rate for Payer: Cigna Commercial	$3,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,840.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,140.75

TITANIUM HUMERAL NAIL 7MM

Facility

$7,605.00

Hospital Charge Code	270656701
Hospital Revenue Code	278
Min. Negotiated Rate	$1,140.75
Max. Negotiated Rate	$1,840.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,521.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,840.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,140.75

TITANIUM MINI DCP

Facility

$492.00

Hospital Charge Code	270335049
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

TITANIUM MINI DCP

Facility

$492.00

Hospital Charge Code	270335049
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$246.00
Rate for Payer: Aetna Commercial	$147.60
Rate for Payer: Aetna Medicare Advantage	$147.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.46
Rate for Payer: Cigna Commercial	$246.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.06
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

TITANIUMTIP CYLDRICL TUBE SET

Facility

$2,475.00

Hospital Charge Code	270663200
Hospital Revenue Code	272
Min. Negotiated Rate	$321.75
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.75
Rate for Payer: Oxford Commercial	$1,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$1,237.50

TITANIUMTIP CYLDRICL TUBE SET

Facility

$2,475.00

Hospital Charge Code	270663200
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

TITER

Facility

$435.00

Service Code	HCPCS 86256
Hospital Charge Code	3035001B
Hospital Revenue Code	302
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$65.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

TITER

Facility

$435.00

Service Code	HCPCS 86256
Hospital Charge Code	3035001B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

Know your out-of-pocket cost for care.

All Charges