Heights University Hospital

All Charges

Charge

Type

Setting

Price

WRENCH IMPACT 1/2 4WM64

Facility

$957.00

Hospital Charge Code	270614607
Hospital Revenue Code	272
Min. Negotiated Rate	$124.41
Max. Negotiated Rate	$478.50
Rate for Payer: Aetna Commercial	$287.10
Rate for Payer: Aetna Medicare Advantage	$287.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.03
Rate for Payer: Cigna Commercial	$478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.41
Rate for Payer: Oxford Commercial	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$143.55
Rate for Payer: UnitedHealthcare Commercial	$478.50

WRENCH RATCH WRENCH 828003010

Facility

$1,959.25

Hospital Charge Code	270632400
Hospital Revenue Code	272
Min. Negotiated Rate	$254.70
Max. Negotiated Rate	$979.62
Rate for Payer: Aetna Commercial	$587.77
Rate for Payer: Aetna Medicare Advantage	$587.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.61
Rate for Payer: Cigna Commercial	$979.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.70
Rate for Payer: Oxford Commercial	$979.62
Rate for Payer: Qualcare PPO/HMO/WC	$293.89
Rate for Payer: UnitedHealthcare Commercial	$979.62

WRENCH RATCH WRENCH 828003010

Facility

$1,959.25

Hospital Charge Code	270632400
Hospital Revenue Code	272
Min. Negotiated Rate	$293.89
Max. Negotiated Rate	$293.89
Rate for Payer: Qualcare PPO/HMO/WC	$293.89

WRENCH T-HANDLE 7920-9-030

Facility

$3,525.00

Hospital Charge Code	270648631
Hospital Revenue Code	272
Min. Negotiated Rate	$528.75
Max. Negotiated Rate	$528.75
Rate for Payer: Qualcare PPO/HMO/WC	$528.75

WRENCH T-HANDLE 7920-9-030

Facility

$3,525.00

Hospital Charge Code	270648631
Hospital Revenue Code	272
Min. Negotiated Rate	$458.25
Max. Negotiated Rate	$1,762.50
Rate for Payer: Aetna Commercial	$1,057.50
Rate for Payer: Aetna Medicare Advantage	$1,057.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$898.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$898.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$898.88
Rate for Payer: Cigna Commercial	$1,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$458.25
Rate for Payer: Oxford Commercial	$1,762.50
Rate for Payer: Qualcare PPO/HMO/WC	$528.75
Rate for Payer: UnitedHealthcare Commercial	$1,762.50

WRIST 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7311050
Hospital Charge Code	94061229
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

WRIST 3 VIEWS-BILAT

Facility

$6,601.19

Service Code	HCPCS 7311050
Hospital Charge Code	94061229
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73110LT
Hospital Charge Code	94061317
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST 3 VIEWS-LT

Facility

$6,601.19

Service Code	HCPCS 73110LT
Hospital Charge Code	94061317
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

WRIST 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73110RT
Hospital Charge Code	94061319
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST 3 VIEWS-RT

Facility

$6,601.19

Service Code	HCPCS 73110RT
Hospital Charge Code	94061319
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

WRIST AP & LAT-BILAT

Facility

$5,100.00

Service Code	HCPCS 7310050
Hospital Charge Code	94061227
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST AP & LAT-BILAT

Facility

$5,100.00

Service Code	HCPCS 7310050
Hospital Charge Code	94061227
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

WRIST AP & LAT-LT

Facility

$5,100.00

Service Code	HCPCS 73100LT
Hospital Charge Code	94061309
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

WRIST AP & LAT-LT

Facility

$5,100.00

Service Code	HCPCS 73100LT
Hospital Charge Code	94061309
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST AP&LAT POST-LT

Facility

$254.00

Service Code	HCPCS 73100LT
Hospital Charge Code	94061311
Hospital Revenue Code	320
Min. Negotiated Rate	$38.10
Max. Negotiated Rate	$38.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.10

WRIST AP&LAT POST-LT

Facility

$254.00

Service Code	HCPCS 73100LT
Hospital Charge Code	94061311
Hospital Revenue Code	320
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$76.20
Rate for Payer: Aetna Medicare Advantage	$76.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.77
Rate for Payer: Cigna Commercial	$127.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.02
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.10
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST AP&LAT POSTRE-BI

Facility

$250.00

Service Code	HCPCS 7310050
Hospital Charge Code	94061225
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
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	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST AP&LAT POSTRE-BI

Facility

$250.00

Service Code	HCPCS 7310050
Hospital Charge Code	94061225
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

WRIST AP&LAT POSTRE-RT

Facility

$250.00

Service Code	HCPCS 73100RT
Hospital Charge Code	94061313
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

WRIST AP&LAT POSTRE-RT

Facility

$250.00

Service Code	HCPCS 73100RT
Hospital Charge Code	94061313
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
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	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST AP & LAT-RT

Facility

$5,100.00

Service Code	HCPCS 73100RT
Hospital Charge Code	94061315
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

WRIST AP & LAT-RT

Facility

$5,100.00

Service Code	HCPCS 73100RT
Hospital Charge Code	94061315
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

WRIST SUPP COMFORTFORM LEFT

Facility

$27.90

Hospital Charge Code	270659173
Hospital Revenue Code	270
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$4.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.18

WRIST SUPP COMFORTFORM LEFT

Facility

$27.90

Hospital Charge Code	270659173
Hospital Revenue Code	270
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$13.95
Rate for Payer: Aetna Commercial	$8.37
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.11
Rate for Payer: Cigna Commercial	$13.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Oxford Commercial	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.18
Rate for Payer: UnitedHealthcare Commercial	$13.95

Know your out-of-pocket cost for care.

All Charges