Heights University Hospital

All Charges

Charge

Type

Setting

Price

TREATMENT KNEE FRACTURE

Facility

$1,412.50

Service Code	HCPCS 27538
Hospital Charge Code	1600000718
Hospital Revenue Code	360
Min. Negotiated Rate	$211.88
Max. Negotiated Rate	$211.88
Rate for Payer: Qualcare PPO/HMO/WC	$211.88

TREATMENT OF FIBULA FRACTURE

Facility

$49,807.20

Service Code	HCPCS 27784
Hospital Charge Code	16000628
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$14,942.16
Rate for Payer: Aetna Medicare Advantage	$14,942.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,700.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,700.84
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	$12,700.84
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,474.94
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,471.08
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TREATMENT OF FIBULA FRACTURE

Facility

$49,807.20

Service Code	HCPCS 27784
Hospital Charge Code	16000628
Hospital Revenue Code	360
Min. Negotiated Rate	$7,471.08
Max. Negotiated Rate	$7,471.08
Rate for Payer: Qualcare PPO/HMO/WC	$7,471.08

TREATMENT ON BLADDER LESION

Facility

$1,309.70

Service Code	HCPCS 51720
Hospital Charge Code	3400130
Hospital Revenue Code	361
Min. Negotiated Rate	$170.26
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$392.91
Rate for Payer: Aetna Medicare Advantage	$392.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$333.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$333.97
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	$333.97
Rate for Payer: Cigna Commercial	$1,660.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.26
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.46
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TREATMENT ON BLADDER LESION

Facility

$1,309.70

Service Code	HCPCS 51720
Hospital Charge Code	3400130
Hospital Revenue Code	361
Min. Negotiated Rate	$196.46
Max. Negotiated Rate	$196.46
Rate for Payer: Qualcare PPO/HMO/WC	$196.46

TREATMENT/RECOVERY ROOM***

Facility

$211.20

Hospital Charge Code	2300663
Hospital Revenue Code	279
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$31.68
Rate for Payer: Qualcare PPO/HMO/WC	$31.68

TREATMENT/RECOVERY ROOM***

Facility

$211.20

Hospital Charge Code	2300663
Hospital Revenue Code	279
Min. Negotiated Rate	$27.46
Max. Negotiated Rate	$105.60
Rate for Payer: Aetna Commercial	$63.36
Rate for Payer: Aetna Medicare Advantage	$63.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.86
Rate for Payer: Cigna Commercial	$105.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.46
Rate for Payer: Oxford Commercial	$105.60
Rate for Payer: Qualcare PPO/HMO/WC	$31.68
Rate for Payer: UnitedHealthcare Commercial	$105.60

TREATMENT RM 0-30 MINUTES

Facility

$97.20

Hospital Charge Code	3401005
Hospital Revenue Code	769
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$29.16
Rate for Payer: Aetna Medicare Advantage	$29.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.79
Rate for Payer: Cigna Commercial	$48.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.64
Rate for Payer: Oxford Commercial	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.58
Rate for Payer: UnitedHealthcare Commercial	$48.60

TREATMENT RM 0-30 MINUTES

Facility

$97.20

Hospital Charge Code	3401005
Hospital Revenue Code	769
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$14.58
Rate for Payer: Qualcare PPO/HMO/WC	$14.58

TREATMENT RM 120-180 MIN

Facility

$253.20

Hospital Charge Code	3400062
Hospital Revenue Code	769
Min. Negotiated Rate	$37.98
Max. Negotiated Rate	$37.98
Rate for Payer: Qualcare PPO/HMO/WC	$37.98

TREATMENT RM 120-180 MIN

Facility

$253.20

Hospital Charge Code	3400062
Hospital Revenue Code	769
Min. Negotiated Rate	$32.92
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$75.96
Rate for Payer: Aetna Medicare Advantage	$75.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.57
Rate for Payer: Cigna Commercial	$126.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.92
Rate for Payer: Oxford Commercial	$126.60
Rate for Payer: Qualcare PPO/HMO/WC	$37.98
Rate for Payer: UnitedHealthcare Commercial	$126.60

TREATMENT RM <1 HOUR****

Facility

$250.00

Hospital Charge Code	1001056
Hospital Revenue Code	761
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$125.00
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	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$125.00

TREATMENT RM <1 HOUR****

Facility

$250.00

Hospital Charge Code	1001056
Hospital Revenue Code	761
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

TREATMENT RM 2-4 HOURS*****

Facility

$490.00

Hospital Charge Code	1001064
Hospital Revenue Code	761
Min. Negotiated Rate	$63.70
Max. Negotiated Rate	$245.00
Rate for Payer: Aetna Commercial	$147.00
Rate for Payer: Aetna Medicare Advantage	$147.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.95
Rate for Payer: Cigna Commercial	$245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$245.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.50
Rate for Payer: UnitedHealthcare Commercial	$245.00

TREATMENT RM 2-4 HOURS*****

Facility

$490.00

Hospital Charge Code	1001064
Hospital Revenue Code	761
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$73.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.50

TREATMENT RM 3-4 HRS***

Facility

$291.60

Hospital Charge Code	3400061
Hospital Revenue Code	769
Min. Negotiated Rate	$43.74
Max. Negotiated Rate	$43.74
Rate for Payer: Qualcare PPO/HMO/WC	$43.74

TREATMENT RM 3-4 HRS***

Facility

$291.60

Hospital Charge Code	3400061
Hospital Revenue Code	769
Min. Negotiated Rate	$37.91
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$87.48
Rate for Payer: Aetna Medicare Advantage	$87.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.36
Rate for Payer: Cigna Commercial	$145.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.91
Rate for Payer: Oxford Commercial	$145.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.74
Rate for Payer: UnitedHealthcare Commercial	$145.80

TREATMENT RM/3 60-120 MIN

Facility

$364.80

Service Code	HCPCS 99999
Hospital Charge Code	3400058
Hospital Revenue Code	769
Min. Negotiated Rate	$54.72
Max. Negotiated Rate	$54.72
Rate for Payer: Qualcare PPO/HMO/WC	$54.72

TREATMENT RM/3 60-120 MIN

Facility

$364.80

Service Code	HCPCS 99999
Hospital Charge Code	3400058
Hospital Revenue Code	769
Min. Negotiated Rate	$47.42
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$109.44
Rate for Payer: Aetna Medicare Advantage	$109.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.02
Rate for Payer: Cigna Commercial	$182.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.42
Rate for Payer: Oxford Commercial	$182.40
Rate for Payer: Qualcare PPO/HMO/WC	$54.72
Rate for Payer: UnitedHealthcare Commercial	$182.40

TREATMENT RM 4-8 HRS

Facility

$453.60

Hospital Charge Code	3400060
Hospital Revenue Code	769
Min. Negotiated Rate	$68.04
Max. Negotiated Rate	$68.04
Rate for Payer: Qualcare PPO/HMO/WC	$68.04

TREATMENT RM 4-8 HRS

Facility

$453.60

Hospital Charge Code	3400060
Hospital Revenue Code	769
Min. Negotiated Rate	$58.97
Max. Negotiated Rate	$621.00
Rate for Payer: Aetna Commercial	$136.08
Rate for Payer: Aetna Medicare Advantage	$136.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.67
Rate for Payer: Cigna Commercial	$226.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.97
Rate for Payer: Oxford Commercial	$226.80
Rate for Payer: Qualcare PPO/HMO/WC	$68.04
Rate for Payer: UnitedHealthcare Commercial	$226.80

TREATMENT RM > 4 HOURS***

Facility

$1,642.00

Hospital Charge Code	1001098
Hospital Revenue Code	761
Min. Negotiated Rate	$246.30
Max. Negotiated Rate	$246.30
Rate for Payer: Qualcare PPO/HMO/WC	$246.30

TREATMENT RM > 4 HOURS***

Facility

$1,642.00

Hospital Charge Code	1001098
Hospital Revenue Code	761
Min. Negotiated Rate	$213.46
Max. Negotiated Rate	$821.00
Rate for Payer: Aetna Commercial	$492.60
Rate for Payer: Aetna Medicare Advantage	$492.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.71
Rate for Payer: Cigna Commercial	$821.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.46
Rate for Payer: Oxford Commercial	$821.00
Rate for Payer: Qualcare PPO/HMO/WC	$246.30
Rate for Payer: UnitedHealthcare Commercial	$821.00

TREATMENT RM - OV-4

Facility

$831.25

Hospital Charge Code	6900021
Hospital Revenue Code	361
Min. Negotiated Rate	$124.69
Max. Negotiated Rate	$124.69
Rate for Payer: Qualcare PPO/HMO/WC	$124.69

TREATMENT RM - OV-4

Facility

$831.25

Hospital Charge Code	6900021
Hospital Revenue Code	361
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$249.38
Rate for Payer: Aetna Medicare Advantage	$249.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.97
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	$211.97
Rate for Payer: Cigna Commercial	$415.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.06
Rate for Payer: Qualcare PPO/HMO/WC	$124.69

Know your out-of-pocket cost for care.

All Charges