Heights University Hospital

All Charges

Charge

Type

Setting

Price

TOTAL PROTEIN,SERUM

Facility

$116.00

Service Code	HCPCS 84155
Hospital Charge Code	38472584
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

TOTAL PROTEIN,SERUM

Facility

$116.00

Service Code	HCPCS 84155
Hospital Charge Code	38472584
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

TOTAL PROTEIN, SYNOVIAL FLUID

Facility

$390.00

Service Code	HCPCS 84157
Hospital Charge Code	3000375
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOTAL PROTEIN, SYNOVIAL FLUID

Facility

$390.00

Service Code	HCPCS 84157
Hospital Charge Code	3000375
Hospital Revenue Code	301
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$15,880.57
Rate for Payer: Aetna Better Health Medicaid	$15,569.19
Rate for Payer: Aetna Commercial	$12.96
Rate for Payer: Aetna Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.66
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: Cigna Medicare Advantage	$2.00
Rate for Payer: Clover Medicare Advantage	$3.80
Rate for Payer: EmblemHealth Commercial	$12.00
Rate for Payer: Humana Medicare Advantage	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.24
Rate for Payer: Wellcare Medicare Advantage	$4.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57

TOTAL PROTEIN, URINE

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	38472587
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOTAL PROTEIN, URINE

Facility

$390.00

Service Code	HCPCS 84156
Hospital Charge Code	38472587
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

TOTAL PROT.RDM UR

Facility

$116.00

Service Code	HCPCS 84156
Hospital Charge Code	38479042
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

TOTAL PROT.RDM UR

Facility

$116.00

Service Code	HCPCS 84156
Hospital Charge Code	38479042
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

TOTAL STABILIZER + TIBIAL INSE

Facility

$29,468.25

Service Code	HCPCS C1713
Hospital Charge Code	270704574
Hospital Revenue Code	278
Min. Negotiated Rate	$4,420.24
Max. Negotiated Rate	$7,131.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,893.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,131.32
Rate for Payer: Qualcare PPO/HMO/WC	$4,420.24

TOTAL STABILIZER + TIBIAL INSE

Facility

$29,468.25

Service Code	HCPCS C1713
Hospital Charge Code	270704574
Hospital Revenue Code	278
Min. Negotiated Rate	$4,420.24
Max. Negotiated Rate	$14,734.12
Rate for Payer: Aetna Commercial	$8,840.48
Rate for Payer: Aetna Medicare Advantage	$8,840.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,514.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,514.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,893.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,514.40
Rate for Payer: Cigna Commercial	$14,734.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,131.32
Rate for Payer: Qualcare PPO/HMO/WC	$4,420.24

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	16000270
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$7,299.05
Rate for Payer: Aetna Medicare Advantage	$7,299.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,204.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,204.19
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	$6,204.19
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	16000270
Hospital Revenue Code	360
Min. Negotiated Rate	$3,649.53
Max. Negotiated Rate	$3,649.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	1600000372
Hospital Revenue Code	360
Min. Negotiated Rate	$3,649.53
Max. Negotiated Rate	$3,649.53
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53

TOT KNEE ARTHROPLASTY

Facility

$24,330.17

Service Code	HCPCS 27447
Hospital Charge Code	1600000372
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$7,299.05
Rate for Payer: Aetna Medicare Advantage	$7,299.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,204.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,204.19
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	$6,204.19
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,162.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,649.53
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

TOURNIQUET L/F 1x18

Facility

$0.53

Hospital Charge Code	270649851
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.08

TOURNIQUET L/F 1x18

Facility

$0.53

Hospital Charge Code	270649851
Hospital Revenue Code	270
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.27
Rate for Payer: Aetna Commercial	$0.16
Rate for Payer: Aetna Medicare Advantage	$0.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.14
Rate for Payer: Cigna Commercial	$0.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.07
Rate for Payer: Oxford Commercial	$0.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.08
Rate for Payer: UnitedHealthcare Commercial	$0.27

TOURNIQUET VASCULAR KIT

Facility

$33.35

Hospital Charge Code	270686313
Hospital Revenue Code	272
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$16.68
Rate for Payer: Aetna Commercial	$10.01
Rate for Payer: Aetna Medicare Advantage	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.50
Rate for Payer: Cigna Commercial	$16.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.34
Rate for Payer: Oxford Commercial	$16.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.00
Rate for Payer: UnitedHealthcare Commercial	$16.68

TOURNIQUET VASCULAR KIT

Facility

$33.35

Hospital Charge Code	270686313
Hospital Revenue Code	272
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.00

TOWEL ABSORBENT

Facility

$1.03

Hospital Charge Code	270654107
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.52
Rate for Payer: Aetna Commercial	$0.31
Rate for Payer: Aetna Medicare Advantage	$0.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.52
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.52

TOWEL ABSORBENT

Facility

$1.03

Hospital Charge Code	270654107
Hospital Revenue Code	270
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

TOWEL ABSORBENT 89701/7550

Facility

$2.27

Hospital Charge Code	270649127
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.34

TOWEL ABSORBENT 89701/7550

Facility

$2.27

Hospital Charge Code	270649127
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$1.14
Rate for Payer: Aetna Commercial	$0.68
Rate for Payer: Aetna Medicare Advantage	$0.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.58
Rate for Payer: Cigna Commercial	$1.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.30
Rate for Payer: Oxford Commercial	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$0.34
Rate for Payer: UnitedHealthcare Commercial	$1.14

TOWEL BLUE STERILE DISP 704B

Facility

$3.51

Hospital Charge Code	270618060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$0.53
Rate for Payer: Qualcare PPO/HMO/WC	$0.53

TOWEL BLUE STERILE DISP 704B

Facility

$3.51

Hospital Charge Code	270618060
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$1.75
Rate for Payer: Aetna Commercial	$1.05
Rate for Payer: Aetna Medicare Advantage	$1.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.90
Rate for Payer: Cigna Commercial	$1.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.46
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.53
Rate for Payer: UnitedHealthcare Commercial	$1.75

TOWELLETS DISINFECTING CAVI

Facility

$22.53

Hospital Charge Code	270659016
Hospital Revenue Code	270
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

Know your out-of-pocket cost for care.

All Charges