Heights University Hospital

All Charges

Charge

Type

Setting

Price

XOMED TUBING

Facility

$87.00

Hospital Charge Code	270335206
Hospital Revenue Code	272
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

XOPENEX HFA INH 15GM

Facility

$221.00

Hospital Charge Code	60635541
Hospital Revenue Code	250
Min. Negotiated Rate	$28.73
Max. Negotiated Rate	$110.50
Rate for Payer: Aetna Commercial	$66.30
Rate for Payer: Aetna Medicare Advantage	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.35
Rate for Payer: Cigna Commercial	$110.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.73
Rate for Payer: Oxford Commercial	$110.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.15
Rate for Payer: UnitedHealthcare Commercial	$110.50

XOPENEX HFA INH 15GM

Facility

$221.00

Hospital Charge Code	60635541
Hospital Revenue Code	250
Min. Negotiated Rate	$33.15
Max. Negotiated Rate	$33.15
Rate for Payer: Qualcare PPO/HMO/WC	$33.15

XPAC TLIF 10X28MM PARALELL

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704189
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

XPAC TLIF 10X28MM PARALELL

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704189
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

XPANDER 10/3 1ST FRACTURE

Facility

$19,625.00

Hospital Charge Code	270638554C
Hospital Revenue Code	272
Min. Negotiated Rate	$2,551.25
Max. Negotiated Rate	$9,812.50
Rate for Payer: Aetna Commercial	$5,887.50
Rate for Payer: Aetna Medicare Advantage	$5,887.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,004.38
Rate for Payer: Cigna Commercial	$9,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,551.25
Rate for Payer: Oxford Commercial	$9,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75
Rate for Payer: UnitedHealthcare Commercial	$9,812.50

XPANDER 10/3 1ST FRACTURE

Facility

$19,625.00

Hospital Charge Code	270638554C
Hospital Revenue Code	272
Min. Negotiated Rate	$2,943.75
Max. Negotiated Rate	$2,943.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75

XPANDER 15/3 1ST FRAC KPT1503

Facility

$19,625.00

Hospital Charge Code	270635272V
Hospital Revenue Code	272
Min. Negotiated Rate	$2,551.25
Max. Negotiated Rate	$9,812.50
Rate for Payer: Aetna Commercial	$5,887.50
Rate for Payer: Aetna Medicare Advantage	$5,887.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,004.38
Rate for Payer: Cigna Commercial	$9,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,551.25
Rate for Payer: Oxford Commercial	$9,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75
Rate for Payer: UnitedHealthcare Commercial	$9,812.50

XPANDER 15/3 1ST FRAC KPT1503

Facility

$19,625.00

Hospital Charge Code	270635272V
Hospital Revenue Code	272
Min. Negotiated Rate	$2,943.75
Max. Negotiated Rate	$2,943.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75

XPANDER 15/3 1ST FRAC KPT1503

Facility

$19,625.00

Hospital Charge Code	270635272
Hospital Revenue Code	272
Min. Negotiated Rate	$2,943.75
Max. Negotiated Rate	$2,943.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75

XPANDER 15/3 1ST FRAC KPT1503

Facility

$19,625.00

Hospital Charge Code	270635272
Hospital Revenue Code	272
Min. Negotiated Rate	$2,551.25
Max. Negotiated Rate	$9,812.50
Rate for Payer: Aetna Commercial	$5,887.50
Rate for Payer: Aetna Medicare Advantage	$5,887.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,004.38
Rate for Payer: Cigna Commercial	$9,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,551.25
Rate for Payer: Oxford Commercial	$9,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75
Rate for Payer: UnitedHealthcare Commercial	$9,812.50

XPANDER 15/3 FIR FRAC KPT1505

Facility

$21,842.70

Hospital Charge Code	270636258
Hospital Revenue Code	272
Min. Negotiated Rate	$2,839.55
Max. Negotiated Rate	$10,921.35
Rate for Payer: Aetna Commercial	$6,552.81
Rate for Payer: Aetna Medicare Advantage	$6,552.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,569.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,569.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,569.89
Rate for Payer: Cigna Commercial	$10,921.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.55
Rate for Payer: Oxford Commercial	$10,921.35
Rate for Payer: Qualcare PPO/HMO/WC	$3,276.41
Rate for Payer: UnitedHealthcare Commercial	$10,921.35

XPANDER 15/3 FIR FRAC KPT1505

Facility

$21,842.70

Hospital Charge Code	270636258
Hospital Revenue Code	272
Min. Negotiated Rate	$3,276.41
Max. Negotiated Rate	$3,276.41
Rate for Payer: Qualcare PPO/HMO/WC	$3,276.41

XPANDER20/3 IST FRCR W/KPT2002

Facility

$17,985.00

Hospital Charge Code	270630734
Hospital Revenue Code	272
Min. Negotiated Rate	$2,338.05
Max. Negotiated Rate	$8,992.50
Rate for Payer: Aetna Commercial	$5,395.50
Rate for Payer: Aetna Medicare Advantage	$5,395.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,586.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,586.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,586.18
Rate for Payer: Cigna Commercial	$8,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,338.05
Rate for Payer: Oxford Commercial	$8,992.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,697.75
Rate for Payer: UnitedHealthcare Commercial	$8,992.50

XPANDER20/3 IST FRCR W/KPT2002

Facility

$17,985.00

Hospital Charge Code	270630734
Hospital Revenue Code	272
Min. Negotiated Rate	$2,697.75
Max. Negotiated Rate	$2,697.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,697.75

XPANDER FRST FRAC 10/3 KPT1003

Facility

$19,625.00

Hospital Charge Code	270638554V
Hospital Revenue Code	272
Min. Negotiated Rate	$2,943.75
Max. Negotiated Rate	$2,943.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75

XPANDER FRST FRAC 10/3 KPT1003

Facility

$19,625.00

Hospital Charge Code	270638554V
Hospital Revenue Code	272
Min. Negotiated Rate	$2,551.25
Max. Negotiated Rate	$9,812.50
Rate for Payer: Aetna Commercial	$5,887.50
Rate for Payer: Aetna Medicare Advantage	$5,887.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,004.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,004.38
Rate for Payer: Cigna Commercial	$9,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,551.25
Rate for Payer: Oxford Commercial	$9,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,943.75
Rate for Payer: UnitedHealthcare Commercial	$9,812.50

XP EXPANDABLE LUMBAR INTERBODY

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270704667
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

XP EXPANDABLE LUMBAR INTERBODY

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270704667
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

X-PLATE VA LCKG 2.4/2.7MM MED

Facility

$4,347.60

Service Code	HCPCS C1713
Hospital Charge Code	270683072
Hospital Revenue Code	278
Min. Negotiated Rate	$652.14
Max. Negotiated Rate	$2,173.80
Rate for Payer: Aetna Commercial	$1,304.28
Rate for Payer: Aetna Medicare Advantage	$1,304.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,108.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,108.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$869.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,108.64
Rate for Payer: Cigna Commercial	$2,173.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.12
Rate for Payer: Qualcare PPO/HMO/WC	$652.14

X-PLATE VA LCKG 2.4/2.7MM MED

Facility

$4,347.60

Service Code	HCPCS C1713
Hospital Charge Code	270683072
Hospital Revenue Code	278
Min. Negotiated Rate	$652.14
Max. Negotiated Rate	$1,052.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$869.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.12
Rate for Payer: Qualcare PPO/HMO/WC	$652.14

X-PLATE VA LCKG 3.7MM MED

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689594
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$335.40
Rate for Payer: Aetna Commercial	$201.24
Rate for Payer: Aetna Medicare Advantage	$201.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.05
Rate for Payer: Cigna Commercial	$335.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

X-PLATE VA LCKG 3.7MM MED

Facility

$670.80

Service Code	HCPCS C1713
Hospital Charge Code	270689594
Hospital Revenue Code	278
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$162.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$134.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.33
Rate for Payer: Qualcare PPO/HMO/WC	$100.62

XR ABDMEN AP OBLIQUE CONE VIEW

Facility

$258.70

Service Code	HCPCS 74010
Hospital Charge Code	2011304
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$242.34
Rate for Payer: Aetna Commercial	$77.61
Rate for Payer: Aetna Medicare Advantage	$77.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.97
Rate for Payer: Cigna Commercial	$129.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.80
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$247.19

XR ABDMEN AP OBLIQUE CONE VIEW

Facility

$258.70

Service Code	HCPCS 74010
Hospital Charge Code	2011304
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

Know your out-of-pocket cost for care.

All Charges