Heights University Hospital

All Charges

Charge

Type

Setting

Price

T WHIPPLEI DNA QUAL RTPCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3000376
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
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	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

TWINFIX 2.8 Ti W/NDL 2 #2.0

Facility

$1,300.00

Hospital Charge Code	270649964
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

TWINFIX 2.8 Ti W/NDL 2 #2.0

Facility

$1,300.00

Hospital Charge Code	270649964
Hospital Revenue Code	272
Min. Negotiated Rate	$169.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$650.00

TWIST DRILL 2.0mm REPLACEMENT

Facility

$107.80

Hospital Charge Code	270665031
Hospital Revenue Code	272
Min. Negotiated Rate	$14.01
Max. Negotiated Rate	$53.90
Rate for Payer: Aetna Commercial	$32.34
Rate for Payer: Aetna Medicare Advantage	$32.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.49
Rate for Payer: Cigna Commercial	$53.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.01
Rate for Payer: Oxford Commercial	$53.90
Rate for Payer: Qualcare PPO/HMO/WC	$16.17
Rate for Payer: UnitedHealthcare Commercial	$53.90

TWIST DRILL 2.0mm REPLACEMENT

Facility

$107.80

Hospital Charge Code	270665031
Hospital Revenue Code	272
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$16.17
Rate for Payer: Qualcare PPO/HMO/WC	$16.17

TWIST DRILL 4.3mmx203mm W/STOP

Facility

$825.00

Hospital Charge Code	270643632
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

TWIST DRILL 4.3mmx203mm W/STOP

Facility

$825.00

Hospital Charge Code	270643632
Hospital Revenue Code	272
Min. Negotiated Rate	$107.25
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$412.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$412.50

TWISTE PAIR RELOCATE DATA

Facility

$25,151.25

Hospital Charge Code	270659138
Hospital Revenue Code	278
Min. Negotiated Rate	$3,772.69
Max. Negotiated Rate	$6,086.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,030.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,086.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,772.69

TWISTE PAIR RELOCATE DATA

Facility

$25,151.25

Hospital Charge Code	270659138
Hospital Revenue Code	278
Min. Negotiated Rate	$3,772.69
Max. Negotiated Rate	$12,575.62
Rate for Payer: Aetna Commercial	$7,545.38
Rate for Payer: Aetna Medicare Advantage	$7,545.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,413.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,413.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,030.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,413.57
Rate for Payer: Cigna Commercial	$12,575.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,086.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,772.69

TWIST LOCK CABLE

Facility

$400.00

Hospital Charge Code	270684098
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

TWIST LOCK CABLE

Facility

$400.00

Hospital Charge Code	270684098
Hospital Revenue Code	272
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$200.00

TWO CAL HIGH NITROGEN

Facility

$36.00

Hospital Charge Code	60634860
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$18.00

TWO CAL HIGH NITROGEN

Facility

$36.00

Hospital Charge Code	60634860
Hospital Revenue Code	250
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

TX1 TISSUE REMOVAL

Facility

$3,825.00

Hospital Charge Code	270662536
Hospital Revenue Code	270
Min. Negotiated Rate	$573.75
Max. Negotiated Rate	$573.75
Rate for Payer: Qualcare PPO/HMO/WC	$573.75

TX1 TISSUE REMOVAL

Facility

$3,825.00

Hospital Charge Code	270662536
Hospital Revenue Code	270
Min. Negotiated Rate	$497.25
Max. Negotiated Rate	$1,912.50
Rate for Payer: Aetna Commercial	$1,147.50
Rate for Payer: Aetna Medicare Advantage	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$975.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$975.38
Rate for Payer: Cigna Commercial	$1,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$497.25
Rate for Payer: Oxford Commercial	$1,912.50
Rate for Payer: Qualcare PPO/HMO/WC	$573.75
Rate for Payer: UnitedHealthcare Commercial	$1,912.50

TXB PROCEDURE KIT

Facility

$6,475.00

Hospital Charge Code	270686890
Hospital Revenue Code	272
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$971.25
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

TXB PROCEDURE KIT

Facility

$6,475.00

Hospital Charge Code	270686890
Hospital Revenue Code	272
Min. Negotiated Rate	$841.75
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$1,942.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$841.75
Rate for Payer: Oxford Commercial	$3,237.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Commercial	$3,237.50

TX FX RAD INTRA-ARTICUL,2FRAGS

Facility

$63,943.60

Service Code	HCPCS 25608
Hospital Charge Code	16000410
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,183.08
Rate for Payer: Aetna Commercial	$19,183.08
Rate for Payer: Aetna Medicare Advantage	$19,183.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,305.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,305.62
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	$16,305.62
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,312.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TX FX RAD INTRA-ARTICUL,2FRAGS

Facility

$63,943.60

Service Code	HCPCS 25608
Hospital Charge Code	16000152
Hospital Revenue Code	360
Min. Negotiated Rate	$9,591.54
Max. Negotiated Rate	$9,591.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54

TX FX RAD INTRA-ARTICUL,2FRAGS

Facility

$63,943.60

Service Code	HCPCS 25608
Hospital Charge Code	16000152
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,183.08
Rate for Payer: Aetna Commercial	$19,183.08
Rate for Payer: Aetna Medicare Advantage	$19,183.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,305.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,305.62
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	$16,305.62
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,312.67
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TX FX RAD INTRA-ARTICUL,2FRAGS

Facility

$63,943.60

Service Code	HCPCS 25608
Hospital Charge Code	16000410
Hospital Revenue Code	360
Min. Negotiated Rate	$9,591.54
Max. Negotiated Rate	$9,591.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54

TX HUMERUS SH FX W IMLANT LT

Facility

$84,627.62

Service Code	HCPCS 24516
Hospital Charge Code	1600000823
Hospital Revenue Code	360
Min. Negotiated Rate	$12,694.14
Max. Negotiated Rate	$12,694.14
Rate for Payer: Qualcare PPO/HMO/WC	$12,694.14

TX HUMERUS SH FX W IMLANT LT

Facility

$84,627.62

Service Code	HCPCS 24516
Hospital Charge Code	1600000823
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$25,388.29
Rate for Payer: Aetna Medicare Advantage	$25,388.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,580.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,580.04
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	$21,580.04
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,001.59
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,694.14
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TX INTR/PR/S FEM FX IMED IMPLT

Facility

$19,503.55

Service Code	HCPCS 27245
Hospital Charge Code	160000197
Hospital Revenue Code	360
Min. Negotiated Rate	$2,925.53
Max. Negotiated Rate	$2,925.53
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.53

TX INTR/PR/S FEM FX IMED IMPLT

Facility

$19,503.55

Service Code	HCPCS 27245
Hospital Charge Code	160000197
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$5,851.06
Rate for Payer: Aetna Medicare Advantage	$5,851.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,973.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,973.41
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	$4,973.41
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,535.46
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,925.53
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

Know your out-of-pocket cost for care.

All Charges