Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRANSL ATHERECTOMY,PERI ARTERY

Facility

$4,666.00

Service Code	HCPCS 75992
Hospital Charge Code	2680355
Hospital Revenue Code	320
Min. Negotiated Rate	$699.90
Max. Negotiated Rate	$699.90
Rate for Payer: Qualcare PPO/HMO/WC	$699.90

TRANSL ATHERECTOMY,PERI ARTERY

Facility

$4,666.00

Service Code	HCPCS 75992
Hospital Charge Code	2680355
Hospital Revenue Code	320
Min. Negotiated Rate	$606.58
Max. Negotiated Rate	$2,333.00
Rate for Payer: Aetna Commercial	$1,399.80
Rate for Payer: Aetna Medicare Advantage	$1,399.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,189.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,189.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,189.83
Rate for Payer: Cigna Commercial	$2,333.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$606.58
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$699.90
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

TRANSLOC 3D SCREW 8.5X40MM

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703905
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

TRANSLOC 3D SCREW 8.5X40MM

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703905
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50
Rate for Payer: Aetna Commercial	$6,375.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50

TRANSLOC 3D SCREW 8.5X45MM.

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703694
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

TRANSLOC 3D SCREW 8.5X45MM.

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703694
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$6,375.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

TRANSLOC 3D SCREW 8.5X50MM

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704430
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$10,625.00
Rate for Payer: Aetna Commercial	$6,375.00
Rate for Payer: Aetna Medicare Advantage	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,418.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,418.75
Rate for Payer: Cigna Commercial	$10,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

TRANSLOC 3D SCREW 8.5X50MM

Facility

$21,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704430
Hospital Revenue Code	278
Min. Negotiated Rate	$3,187.50
Max. Negotiated Rate	$5,142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,142.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,187.50

TRANSMITTER FOR EX1150

Facility

$0.01

Hospital Charge Code	270691634V
Hospital Revenue Code	271
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$0.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.01

TRANSMITTER FOR EX1150

Facility

$0.01

Hospital Charge Code	270691634V
Hospital Revenue Code	271
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

TRANS OR AVULSE OTH SPINAL NRV

Facility

$16,437.00

Service Code	HCPCS 64772
Hospital Charge Code	1600000532
Hospital Revenue Code	360
Min. Negotiated Rate	$2,465.55
Max. Negotiated Rate	$2,465.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55

TRANS OR AVULSE OTH SPINAL NRV

Facility

$16,437.00

Service Code	HCPCS 64772
Hospital Charge Code	1600000532
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$4,931.10
Rate for Payer: Aetna Medicare Advantage	$4,931.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,191.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,191.44
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	$4,191.44
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,136.81
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

TRANSPLANT FOREARM TENDON

Facility

$13,268.24

Service Code	HCPCS 25310
Hospital Charge Code	16000688
Hospital Revenue Code	360
Min. Negotiated Rate	$1,990.24
Max. Negotiated Rate	$1,990.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,990.24

TRANSPLANT FOREARM TENDON

Facility

$13,268.24

Service Code	HCPCS 25310
Hospital Charge Code	16000688
Hospital Revenue Code	360
Min. Negotiated Rate	$1,724.87
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,980.47
Rate for Payer: Aetna Medicare Advantage	$3,980.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,383.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,383.40
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	$3,383.40
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.87
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,990.24
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

TRANSPLANT/GRAFT HAND TENDON

Facility

$12,289.64

Service Code	HCPCS 26483
Hospital Charge Code	16000847
Hospital Revenue Code	360
Min. Negotiated Rate	$1,597.65
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,686.89
Rate for Payer: Aetna Medicare Advantage	$3,686.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,133.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,133.86
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	$3,133.86
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.65
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.45
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

TRANSPLANT/GRAFT HAND TENDON

Facility

$12,289.64

Service Code	HCPCS 26483
Hospital Charge Code	16000847
Hospital Revenue Code	360
Min. Negotiated Rate	$1,843.45
Max. Negotiated Rate	$1,843.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,843.45

TRANSPLANT HAND TENDON

Facility

$12,406.91

Service Code	HCPCS 26480
Hospital Charge Code	16000700
Hospital Revenue Code	360
Min. Negotiated Rate	$1,861.04
Max. Negotiated Rate	$1,861.04
Rate for Payer: Qualcare PPO/HMO/WC	$1,861.04

TRANSPLANT HAND TENDON

Facility

$12,406.91

Service Code	HCPCS 26480
Hospital Charge Code	16000700
Hospital Revenue Code	360
Min. Negotiated Rate	$1,612.90
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,722.07
Rate for Payer: Aetna Medicare Advantage	$3,722.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,163.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,163.76
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	$3,163.76
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,612.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,861.04
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

TRANSPLT AUTOL HCT/DONOR

Facility

$6,717.80

Service Code	HCPCS 38241
Hospital Charge Code	16000956
Hospital Revenue Code	360
Min. Negotiated Rate	$1,007.67
Max. Negotiated Rate	$1,007.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,007.67

TRANSPLT AUTOL HCT/DONOR

Facility

$6,717.80

Service Code	HCPCS 38241
Hospital Charge Code	16000956
Hospital Revenue Code	360
Min. Negotiated Rate	$873.31
Max. Negotiated Rate	$3,708.85
Rate for Payer: Aetna Commercial	$2,015.34
Rate for Payer: Aetna Medicare Advantage	$2,015.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,713.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,713.04
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	$1,713.04
Rate for Payer: Cigna Commercial	$3,708.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$873.31
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,007.67
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

TRANSPORTATION OF SURGI

Facility

$124.85

Hospital Charge Code	270605676
Hospital Revenue Code	270
Min. Negotiated Rate	$16.23
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$37.45
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.23
Rate for Payer: Oxford Commercial	$62.42
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$62.42

TRANSPORTATION OF SURGI

Facility

$124.85

Hospital Charge Code	270605676
Hospital Revenue Code	270
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

TRANSTELEPHONIC PACE CK D/S

Facility

$180.00

Service Code	HCPCS 93293
Hospital Charge Code	74117024
Hospital Revenue Code	732
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

TRANSTELEPHONIC PACE CK D/S

Facility

$160.85

Service Code	HCPCS 93293
Hospital Charge Code	94053100
Hospital Revenue Code	732
Min. Negotiated Rate	$20.91
Max. Negotiated Rate	$1,592.00
Rate for Payer: Aetna Commercial	$48.26
Rate for Payer: Aetna Medicare Advantage	$48.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.02
Rate for Payer: Cigna Commercial	$88.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.91
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.13
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

TRANSTELEPHONIC PACE CK D/S

Facility

$180.00

Service Code	HCPCS 93293
Hospital Charge Code	74117024
Hospital Revenue Code	732
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$1,592.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$88.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$1,404.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$1,592.00

Know your out-of-pocket cost for care.

All Charges