Heights University Hospital

All Charges

Charge

Type

Setting

Price

US EXTREMITY NON-VASCULAR BLTL

Facility

$359.75

Hospital Charge Code	2301009
Hospital Revenue Code	402
Min. Negotiated Rate	$46.77
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$107.92
Rate for Payer: Aetna Medicare Advantage	$107.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.74
Rate for Payer: Cigna Commercial	$179.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.77
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.96
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXTREMITY NON-VASCULAR BLTL

Facility

$359.75

Hospital Charge Code	2301009
Hospital Revenue Code	402
Min. Negotiated Rate	$53.96
Max. Negotiated Rate	$53.96
Rate for Payer: Qualcare PPO/HMO/WC	$53.96

US EXTREMITY NON-VASCULAR COMP

Facility

$6,700.00

Service Code	HCPCS 76881
Hospital Charge Code	2100263
Hospital Revenue Code	402
Min. Negotiated Rate	$95.44
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXTREMITY NON-VASCULAR COMP

Facility

$6,700.00

Service Code	HCPCS 76881
Hospital Charge Code	2100263M
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

US EXTREMITY NON-VASCULAR COMP

Facility

$6,700.00

Service Code	HCPCS 76881
Hospital Charge Code	2100263
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

US EXTREMITY NON-VASCULAR COMP

Facility

$6,700.00

Service Code	HCPCS 76881
Hospital Charge Code	2100263M
Hospital Revenue Code	402
Min. Negotiated Rate	$95.44
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXTREMITY NON-VASCULAR LEFT

Facility

$659.25

Hospital Charge Code	2301010
Hospital Revenue Code	402
Min. Negotiated Rate	$85.70
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$197.78
Rate for Payer: Aetna Medicare Advantage	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.11
Rate for Payer: Cigna Commercial	$329.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.70
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.89
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXTREMITY NON-VASCULAR LEFT

Facility

$659.25

Hospital Charge Code	2301010
Hospital Revenue Code	402
Min. Negotiated Rate	$98.89
Max. Negotiated Rate	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$98.89

US EXTREMITY NON-VASCULAR LT

Facility

$659.25

Hospital Charge Code	2100261
Hospital Revenue Code	402
Min. Negotiated Rate	$98.89
Max. Negotiated Rate	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$98.89

US EXTREMITY NON-VASCULAR LT

Facility

$659.25

Hospital Charge Code	2100261
Hospital Revenue Code	402
Min. Negotiated Rate	$85.70
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$197.78
Rate for Payer: Aetna Medicare Advantage	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.11
Rate for Payer: Cigna Commercial	$329.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.70
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.89
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXTREMITY NON-VASCULAR LT**

Facility

$234.00

Service Code	HCPCS 76880
Hospital Charge Code	3100262
Hospital Revenue Code	402
Min. Negotiated Rate	$30.42
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.42
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US EXTREMITY NON-VASCULAR LT**

Facility

$234.00

Service Code	HCPCS 76880
Hospital Charge Code	3100262
Hospital Revenue Code	402
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

US EXTREMITY NON-VASCULAR LTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	2100264
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

US EXTREMITY NON-VASCULAR LTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	2100264
Hospital Revenue Code	402
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$292.34
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$298.19

US EXTREMITY NON-VASCULAR LTD

Facility

$534.78

Service Code	HCPCS 76882
Hospital Charge Code	2100264M
Hospital Revenue Code	402
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Better Health Medicaid	$292.34
Rate for Payer: Aetna Commercial	$160.43
Rate for Payer: Aetna Medicare Advantage	$160.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.37
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.52
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.22
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$298.19

US EXTREMITY NON-VASCULAR LTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	94061505
Hospital Revenue Code	402
Min. Negotiated Rate	$24.42
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Better Health Medicaid	$292.34
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$298.19

US EXTREMITY NON-VASCULAR LTD

Facility

$6,700.00

Service Code	HCPCS 76882
Hospital Charge Code	94061505
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

US EXTREMITY NON-VASCULAR LTD

Facility

$534.78

Service Code	HCPCS 76882
Hospital Charge Code	2100264M
Hospital Revenue Code	402
Min. Negotiated Rate	$80.22
Max. Negotiated Rate	$80.22
Rate for Payer: Qualcare PPO/HMO/WC	$80.22

US EXTREMITY NON-VASCULAR RT

Facility

$659.25

Hospital Charge Code	2100262
Hospital Revenue Code	402
Min. Negotiated Rate	$98.89
Max. Negotiated Rate	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$98.89

US EXTREMITY NON-VASCULAR RT

Facility

$659.25

Hospital Charge Code	2100262
Hospital Revenue Code	402
Min. Negotiated Rate	$85.70
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$197.78
Rate for Payer: Aetna Medicare Advantage	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.11
Rate for Payer: Cigna Commercial	$329.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.70
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.89
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US-EXTREM NONVASCULAR-BIL

Facility

$517.00

Hospital Charge Code	2309060
Hospital Revenue Code	402
Min. Negotiated Rate	$77.55
Max. Negotiated Rate	$77.55
Rate for Payer: Qualcare PPO/HMO/WC	$77.55

US-EXTREM NONVASCULAR-BIL

Facility

$517.00

Hospital Charge Code	2309060
Hospital Revenue Code	402
Min. Negotiated Rate	$67.21
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$155.10
Rate for Payer: Aetna Medicare Advantage	$155.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.84
Rate for Payer: Cigna Commercial	$258.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.21
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.55
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

US FEM- POPLITEAL DUPLEX UNI

Facility

$2,497.57

Service Code	HCPCS 93971
Hospital Charge Code	2100188
Hospital Revenue Code	921
Min. Negotiated Rate	$374.64
Max. Negotiated Rate	$374.64
Rate for Payer: Qualcare PPO/HMO/WC	$374.64

US FEM- POPLITEAL DUPLEX UNI

Facility

$2,497.57

Service Code	HCPCS 93971
Hospital Charge Code	2100188
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$749.27
Rate for Payer: Aetna Medicare Advantage	$749.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$636.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$636.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$636.88
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.68
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$374.64
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

US FETAL AGE

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	2100030
Hospital Revenue Code	402
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

Know your out-of-pocket cost for care.

All Charges