Heights University Hospital

All Charges

Charge

Type

Setting

Price

UNLSTD PROCEDURE FOREARM /WST

Facility

$859.60

Service Code	HCPCS 25999
Hospital Charge Code	16000698
Hospital Revenue Code	360
Min. Negotiated Rate	$128.94
Max. Negotiated Rate	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.94

UNLSTD PROCEDURE FOREARM /WST

Facility

$859.60

Service Code	HCPCS 25999
Hospital Charge Code	16000698
Hospital Revenue Code	360
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$257.88
Rate for Payer: Aetna Medicare Advantage	$257.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.20
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	$219.20
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.75
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.94
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLSTD PROCEDURE HANDS /FINGER

Facility

$1,007.96

Service Code	HCPCS 26989
Hospital Charge Code	16000363
Hospital Revenue Code	360
Min. Negotiated Rate	$131.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$302.39
Rate for Payer: Aetna Medicare Advantage	$302.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.03
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	$257.03
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.03
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.19
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLSTD PROCEDURE HANDS /FINGER

Facility

$1,007.96

Service Code	HCPCS 26989
Hospital Charge Code	16000363
Hospital Revenue Code	360
Min. Negotiated Rate	$151.19
Max. Negotiated Rate	$151.19
Rate for Payer: Qualcare PPO/HMO/WC	$151.19

UNLSTD PROCEDURE LEG OR ANKLE

Facility

$859.60

Service Code	HCPCS 27899
Hospital Charge Code	16000415
Hospital Revenue Code	360
Min. Negotiated Rate	$128.94
Max. Negotiated Rate	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.94

UNLSTD PROCEDURE LEG OR ANKLE

Facility

$859.60

Service Code	HCPCS 27899
Hospital Charge Code	16000415
Hospital Revenue Code	360
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$257.88
Rate for Payer: Aetna Medicare Advantage	$257.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.20
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	$219.20
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.75
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.94
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLSTD PROCEDURE LUNGS&PLEURA

Facility

$2,450.28

Service Code	HCPCS 32999
Hospital Charge Code	1600000513
Hospital Revenue Code	360
Min. Negotiated Rate	$367.54
Max. Negotiated Rate	$367.54
Rate for Payer: Qualcare PPO/HMO/WC	$367.54

UNLSTD PROCEDURE LUNGS&PLEURA

Facility

$2,450.28

Service Code	HCPCS 32999
Hospital Charge Code	1600000513
Hospital Revenue Code	360
Min. Negotiated Rate	$318.54
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$735.08
Rate for Payer: Aetna Medicare Advantage	$735.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.82
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	$624.82
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.54
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$367.54
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

UNLSTD PROCEDURE,NERVOUS-SYSTM

Facility

$5,954.30

Service Code	HCPCS 64999
Hospital Charge Code	160000243
Hospital Revenue Code	360
Min. Negotiated Rate	$730.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,786.29
Rate for Payer: Aetna Medicare Advantage	$1,786.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,518.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,518.35
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	$1,518.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$893.14
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLSTD PROCEDURE,NERVOUS-SYSTM

Facility

$5,954.30

Service Code	HCPCS 64999
Hospital Charge Code	160000243
Hospital Revenue Code	360
Min. Negotiated Rate	$893.14
Max. Negotiated Rate	$893.14
Rate for Payer: Qualcare PPO/HMO/WC	$893.14

UNLSTD PROCEDURE UNARY SYSTEM

Facility

$918.12

Service Code	HCPCS 53899
Hospital Charge Code	16000460
Hospital Revenue Code	360
Min. Negotiated Rate	$137.72
Max. Negotiated Rate	$137.72
Rate for Payer: Qualcare PPO/HMO/WC	$137.72

UNLSTD PROCEDURE UNARY SYSTEM

Facility

$918.12

Service Code	HCPCS 53899
Hospital Charge Code	16000460
Hospital Revenue Code	360
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$275.44
Rate for Payer: Aetna Medicare Advantage	$275.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.12
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	$234.12
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.36
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$137.72
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLSTD PROC FEMALE GENITAL SYS

Facility

$642.80

Service Code	HCPCS 58999
Hospital Charge Code	16001011
Hospital Revenue Code	360
Min. Negotiated Rate	$83.56
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$192.84
Rate for Payer: Aetna Medicare Advantage	$192.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.91
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	$163.91
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.42
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLSTD PROC FEMALE GENITAL SYS

Facility

$642.80

Service Code	HCPCS 58999
Hospital Charge Code	16001011
Hospital Revenue Code	360
Min. Negotiated Rate	$96.42
Max. Negotiated Rate	$96.42
Rate for Payer: Qualcare PPO/HMO/WC	$96.42

UNLSTD PROC SKIN MM & SQ TISS

Facility

$5,068.40

Service Code	HCPCS 17999
Hospital Charge Code	16000262
Hospital Revenue Code	360
Min. Negotiated Rate	$760.26
Max. Negotiated Rate	$760.26
Rate for Payer: Qualcare PPO/HMO/WC	$760.26

UNLSTD PROC SKIN MM & SQ TISS

Facility

$5,068.40

Service Code	HCPCS 17999
Hospital Charge Code	16000262
Hospital Revenue Code	360
Min. Negotiated Rate	$477.79
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,520.52
Rate for Payer: Aetna Medicare Advantage	$1,520.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,292.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,292.44
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	$1,292.44
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$658.89
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$760.26
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNLST PROC MATERNITY CARE&DEL

Facility

$642.80

Service Code	HCPCS 59899
Hospital Charge Code	16001015
Hospital Revenue Code	360
Min. Negotiated Rate	$96.42
Max. Negotiated Rate	$96.42
Rate for Payer: Qualcare PPO/HMO/WC	$96.42

UNLST PROC MATERNITY CARE&DEL

Facility

$642.80

Service Code	HCPCS 59899
Hospital Charge Code	16001015
Hospital Revenue Code	360
Min. Negotiated Rate	$83.56
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$192.84
Rate for Payer: Aetna Medicare Advantage	$192.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.91
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	$163.91
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.42
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

UNNA BOOT 4

Facility

$5.85

Service Code	HCPCS A6456
Hospital Charge Code	9808106
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.88

UNNA BOOT 4

Facility

$5.85

Service Code	HCPCS A6456
Hospital Charge Code	9808106
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$2.92
Rate for Payer: Aetna Commercial	$1.75
Rate for Payer: Aetna Medicare Advantage	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.49
Rate for Payer: Cigna Commercial	$1.79
Rate for Payer: Cigna Medicare Advantage	$1.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.76
Rate for Payer: Oxford Commercial	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.88
Rate for Payer: UnitedHealthcare Commercial	$2.92

UNNA BOOT 4X10YD

Facility

$27.48

Hospital Charge Code	270653063
Hospital Revenue Code	270
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$4.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.12

UNNA BOOT 4X10YD

Facility

$27.48

Hospital Charge Code	270653063
Hospital Revenue Code	270
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$13.74
Rate for Payer: Aetna Commercial	$8.24
Rate for Payer: Aetna Medicare Advantage	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.01
Rate for Payer: Cigna Commercial	$13.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.57
Rate for Payer: Oxford Commercial	$13.74
Rate for Payer: Qualcare PPO/HMO/WC	$4.12
Rate for Payer: UnitedHealthcare Commercial	$13.74

UNNA BOOT APPLICATION

Facility

$0.01

Service Code	HCPCS 29580
Hospital Charge Code	9108030
Hospital Revenue Code	420
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

UNNA BOOT APPLICATION

Facility

$0.01

Service Code	HCPCS 29580
Hospital Charge Code	9108030
Hospital Revenue Code	420
Max. Negotiated Rate	$686.00
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) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

UNNA BOOT APPLICATION

Facility

$476.00

Service Code	HCPCS 29580
Hospital Charge Code	421029580
Hospital Revenue Code	761
Min. Negotiated Rate	$33.50
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$142.80
Rate for Payer: Aetna Medicare Advantage	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.38
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.88
Rate for Payer: Oxford Commercial	$238.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.40
Rate for Payer: UnitedHealthcare Commercial	$238.00

Know your out-of-pocket cost for care.

All Charges