Heights University Hospital

All Charges

Charge

Type

Setting

Price

TOE FLXBL HNGE SWNSN#6 4260006

Facility

$1,736.00

Service Code	HCPCS C1776
Hospital Charge Code	270611673
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$520.80
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLXBL HNGE SWNSN#7 4260007

Facility

$1,736.00

Hospital Charge Code	270611655
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLXBL HNGE SWNSN#7 4260007

Facility

$1,736.00

Hospital Charge Code	270611655
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$520.80
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLX HNGE W/GRMT#1 G4260001

Facility

$1,736.00

Hospital Charge Code	270611668
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$868.00
Rate for Payer: Aetna Commercial	$520.80
Rate for Payer: Aetna Medicare Advantage	$520.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$442.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$442.68
Rate for Payer: Cigna Commercial	$868.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

TOE FLX HNGE W/GRMT#1 G4260001

Facility

$1,736.00

Hospital Charge Code	270611668
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11

TOE GREAT TTNM SWNSN#0 4833110

Facility

$3,794.45

Hospital Charge Code	270611657
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$1,897.22
Rate for Payer: Aetna Commercial	$1,138.34
Rate for Payer: Aetna Medicare Advantage	$1,138.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.58
Rate for Payer: Cigna Commercial	$1,897.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#0 4833110

Facility

$3,794.45

Hospital Charge Code	270611657
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$918.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#1 4833101

Facility

$3,794.45

Hospital Charge Code	270611658
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$918.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#1 4833101

Facility

$3,794.45

Hospital Charge Code	270611658
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$1,897.22
Rate for Payer: Aetna Commercial	$1,138.34
Rate for Payer: Aetna Medicare Advantage	$1,138.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.58
Rate for Payer: Cigna Commercial	$1,897.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#2 4833102

Facility

$3,794.45

Hospital Charge Code	270611659
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$918.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#2 4833102

Facility

$3,794.45

Hospital Charge Code	270611659
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$1,897.22
Rate for Payer: Aetna Commercial	$1,138.34
Rate for Payer: Aetna Medicare Advantage	$1,138.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.58
Rate for Payer: Cigna Commercial	$1,897.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#3 4833103

Facility

$3,794.45

Hospital Charge Code	270611660
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$918.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#3 4833103

Facility

$3,794.45

Hospital Charge Code	270611660
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$1,897.22
Rate for Payer: Aetna Commercial	$1,138.34
Rate for Payer: Aetna Medicare Advantage	$1,138.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.58
Rate for Payer: Cigna Commercial	$1,897.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#4 4833104

Facility

$3,794.45

Hospital Charge Code	270611661
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$1,897.22
Rate for Payer: Aetna Commercial	$1,138.34
Rate for Payer: Aetna Medicare Advantage	$1,138.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.58
Rate for Payer: Cigna Commercial	$1,897.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE GREAT TTNM SWNSN#4 4833104

Facility

$3,794.45

Hospital Charge Code	270611661
Hospital Revenue Code	278
Min. Negotiated Rate	$569.17
Max. Negotiated Rate	$918.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.26
Rate for Payer: Qualcare PPO/HMO/WC	$569.17

TOE IMPLANT

Facility

$822.00

Hospital Charge Code	270335036
Hospital Revenue Code	278
Min. Negotiated Rate	$123.30
Max. Negotiated Rate	$411.00
Rate for Payer: Aetna Commercial	$246.60
Rate for Payer: Aetna Medicare Advantage	$246.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.61
Rate for Payer: Cigna Commercial	$411.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.92
Rate for Payer: Qualcare PPO/HMO/WC	$123.30

TOE IMPLANT

Facility

$822.00

Hospital Charge Code	270335036
Hospital Revenue Code	278
Min. Negotiated Rate	$123.30
Max. Negotiated Rate	$198.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.92
Rate for Payer: Qualcare PPO/HMO/WC	$123.30

TOE IMPLANT REG GREAT SZ1

Facility

$9,970.00

Service Code	HCPCS C1776
Hospital Charge Code	270634572
Hospital Revenue Code	278
Min. Negotiated Rate	$1,495.50
Max. Negotiated Rate	$4,985.00
Rate for Payer: Aetna Commercial	$2,991.00
Rate for Payer: Aetna Medicare Advantage	$2,991.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,542.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,542.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,994.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,542.35
Rate for Payer: Cigna Commercial	$4,985.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.50

TOE IMPLANT REG GREAT SZ1

Facility

$9,970.00

Service Code	HCPCS C1776
Hospital Charge Code	270634572
Hospital Revenue Code	278
Min. Negotiated Rate	$1,495.50
Max. Negotiated Rate	$2,412.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,994.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.50

TOE JOINT CUSTOM 14X10 17090

Facility

$4,488.85

Hospital Charge Code	270632197
Hospital Revenue Code	278
Min. Negotiated Rate	$673.33
Max. Negotiated Rate	$2,244.43
Rate for Payer: Aetna Commercial	$1,346.65
Rate for Payer: Aetna Medicare Advantage	$1,346.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,144.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,144.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$897.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,144.66
Rate for Payer: Cigna Commercial	$2,244.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,086.30
Rate for Payer: Qualcare PPO/HMO/WC	$673.33

TOE JOINT CUSTOM 14X10 17090

Facility

$4,488.85

Hospital Charge Code	270632197
Hospital Revenue Code	278
Min. Negotiated Rate	$673.33
Max. Negotiated Rate	$1,086.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$897.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,086.30
Rate for Payer: Qualcare PPO/HMO/WC	$673.33

TOE-LEFT FOOT, 2ND DIG

Facility

$250.00

Service Code	HCPCS 73660T1
Hospital Charge Code	94061409
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

TOE-LEFT FOOT, 2ND DIG

Facility

$250.00

Service Code	HCPCS 73660T1
Hospital Charge Code	94061409
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TOE-LEFT FOOT, 3RD DIG

Facility

$250.00

Service Code	HCPCS 73660T2
Hospital Charge Code	94061411
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TOE-LEFT FOOT, 3RD DIG

Facility

$250.00

Service Code	HCPCS 73660T2
Hospital Charge Code	94061411
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges