Heights University Hospital

All Charges

Charge

Type

Setting

Price

WC UNNA BOOT RIGHT

Facility

$348.75

Service Code	HCPCS 29580RT
Hospital Charge Code	9800171
Hospital Revenue Code	510
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

WC UNNA FLEX 4X10

Facility

$458.00

Service Code	HCPCS A6456
Hospital Charge Code	9808195
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$229.00
Rate for Payer: Aetna Commercial	$137.40
Rate for Payer: Aetna Medicare Advantage	$137.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.79
Rate for Payer: Cigna Commercial	$1.79
Rate for Payer: Cigna Medicare Advantage	$1.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.54
Rate for Payer: Oxford Commercial	$229.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.70
Rate for Payer: UnitedHealthcare Commercial	$229.00

WC UNNA FLEX 4X10

Facility

$458.00

Service Code	HCPCS A6456
Hospital Charge Code	9808195
Hospital Revenue Code	272
Min. Negotiated Rate	$68.70
Max. Negotiated Rate	$68.70
Rate for Payer: Qualcare PPO/HMO/WC	$68.70

WC US,PREGNT UTERUS,LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	83652271
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

WC US,PREGNT UTERUS,LIMITED

Facility

$6,700.00

Service Code	HCPCS 76815
Hospital Charge Code	83652271
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

WC WEDGE EXCISION NAIL

Facility

$545.00

Service Code	HCPCS 11765
Hospital Charge Code	9800072
Hospital Revenue Code	361
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
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	$138.97
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.85
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

WC WEDGE EXCISION NAIL

Facility

$545.00

Service Code	HCPCS 11765
Hospital Charge Code	9800072
Hospital Revenue Code	361
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	83652071
Hospital Revenue Code	761
Min. Negotiated Rate	$72.45
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$387.90
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.09
Rate for Payer: Oxford Commercial	$646.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$646.50

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	83652071
Hospital Revenue Code	761
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	87502505
Hospital Revenue Code	761
Min. Negotiated Rate	$72.45
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$387.90
Rate for Payer: Aetna Medicare Advantage	$387.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.71
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.09
Rate for Payer: Oxford Commercial	$646.50
Rate for Payer: Qualcare PPO/HMO/WC	$193.95
Rate for Payer: UnitedHealthcare Commercial	$646.50

WD REPAIR EXCL FEET/HNDS<2.5CM

Facility

$1,293.00

Service Code	HCPCS 12031
Hospital Charge Code	87502505
Hospital Revenue Code	761
Min. Negotiated Rate	$193.95
Max. Negotiated Rate	$193.95
Rate for Payer: Qualcare PPO/HMO/WC	$193.95

WEANING PARAMETERS

Facility

$6,100.00

Service Code	HCPCS 94150
Hospital Charge Code	9500050
Hospital Revenue Code	460
Min. Negotiated Rate	$74.75
Max. Negotiated Rate	$1,830.00
Rate for Payer: Aetna Commercial	$1,830.00
Rate for Payer: Aetna Medicare Advantage	$1,830.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,555.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,555.50
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

WEANING PARAMETERS

Facility

$6,100.00

Service Code	HCPCS 94150
Hospital Charge Code	9500050
Hospital Revenue Code	460
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Qualcare PPO/HMO/WC	$915.00

WEDGE 2 0X 20 X 8

Facility

$10,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687065
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$2,655.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25

WEDGE 2 0X 20 X 8

Facility

$10,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270687065
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$5,487.50
Rate for Payer: Aetna Commercial	$3,292.50
Rate for Payer: Aetna Medicare Advantage	$3,292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,798.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,798.62
Rate for Payer: Cigna Commercial	$5,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,655.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,646.25

WEDGE 3.1X13

Facility

$2,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705977
Hospital Revenue Code	278
Min. Negotiated Rate	$311.25
Max. Negotiated Rate	$502.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.15
Rate for Payer: Qualcare PPO/HMO/WC	$311.25

WEDGE 3.1X13

Facility

$2,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270705977
Hospital Revenue Code	278
Min. Negotiated Rate	$311.25
Max. Negotiated Rate	$1,037.50
Rate for Payer: Aetna Commercial	$622.50
Rate for Payer: Aetna Medicare Advantage	$622.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$529.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$529.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$415.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$529.12
Rate for Payer: Cigna Commercial	$1,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.15
Rate for Payer: Qualcare PPO/HMO/WC	$311.25

WEDGE ALLOGRAFT LAPIDUS 5MM 5D

Facility

$14,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

WEDGE ALLOGRAFT LAPIDUS 5MM 5D

Facility

$14,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270699356
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$4,425.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

WEDGE ANGLE 45DEG 7X24X7

Facility

$785.00

Hospital Charge Code	270646188
Hospital Revenue Code	272
Min. Negotiated Rate	$102.05
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$235.50
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.05
Rate for Payer: Oxford Commercial	$392.50
Rate for Payer: Qualcare PPO/HMO/WC	$117.75
Rate for Payer: UnitedHealthcare Commercial	$392.50

WEDGE ANGLE 45DEG 7X24X7

Facility

$785.00

Hospital Charge Code	270646188
Hospital Revenue Code	272
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$117.75
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

WEDGE AVITRAC MTP CORE 11 MM

Facility

$6,632.50

Hospital Charge Code	270701752
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$1,605.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 11 MM

Facility

$6,632.50

Hospital Charge Code	270701752
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$3,316.25
Rate for Payer: Aetna Commercial	$1,989.75
Rate for Payer: Aetna Medicare Advantage	$1,989.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,691.29
Rate for Payer: Cigna Commercial	$3,316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 13 MM

Facility

$6,632.50

Hospital Charge Code	270701751
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$3,316.25
Rate for Payer: Aetna Commercial	$1,989.75
Rate for Payer: Aetna Medicare Advantage	$1,989.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,691.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,691.29
Rate for Payer: Cigna Commercial	$3,316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

WEDGE AVITRAC MTP CORE 13 MM

Facility

$6,632.50

Hospital Charge Code	270701751
Hospital Revenue Code	278
Min. Negotiated Rate	$994.88
Max. Negotiated Rate	$1,605.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,605.07
Rate for Payer: Qualcare PPO/HMO/WC	$994.88

Know your out-of-pocket cost for care.

All Charges