Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR ANTHROGRAM SACROILIAC JOINT

Facility

$1,238.40

Hospital Charge Code	2011441
Hospital Revenue Code	322
Min. Negotiated Rate	$185.76
Max. Negotiated Rate	$185.76
Rate for Payer: Qualcare PPO/HMO/WC	$185.76

XR ANTHROGRAM SACROILIAC JOINT

Facility

$1,238.40

Hospital Charge Code	2011441
Hospital Revenue Code	322
Min. Negotiated Rate	$160.99
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$371.52
Rate for Payer: Aetna Medicare Advantage	$371.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.79
Rate for Payer: Cigna Commercial	$619.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ARTERIOGRAM EXTREMITY BI***

Facility

$394.00

Service Code	HCPCS 75716
Hospital Charge Code	2000859
Hospital Revenue Code	323
Min. Negotiated Rate	$51.22
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$118.20
Rate for Payer: Aetna Medicare Advantage	$118.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.22
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.10
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ARTERIOGRAM EXTREMITY BI***

Facility

$394.00

Service Code	HCPCS 75716
Hospital Charge Code	2000859
Hospital Revenue Code	323
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$59.10
Rate for Payer: Qualcare PPO/HMO/WC	$59.10

XR ARTHERECTOMY OPEN TIBIOPERO

Facility

$40,990.35

Hospital Charge Code	5600111
Hospital Revenue Code	361
Min. Negotiated Rate	$6,148.55
Max. Negotiated Rate	$6,148.55
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55

XR ARTHERECTOMY OPEN TIBIOPERO

Facility

$40,990.35

Hospital Charge Code	5600111
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$20,495.17
Rate for Payer: Aetna Commercial	$12,297.10
Rate for Payer: Aetna Medicare Advantage	$12,297.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,452.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,452.54
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	$10,452.54
Rate for Payer: Cigna Commercial	$20,495.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,328.75
Rate for Payer: Qualcare PPO/HMO/WC	$6,148.55

XR ARTHROGRAM ANKLE

Facility

$1,238.40

Service Code	HCPCS 73615
Hospital Charge Code	2011436
Hospital Revenue Code	322
Min. Negotiated Rate	$75.40
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$371.52
Rate for Payer: Aetna Medicare Advantage	$371.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.79
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ARTHROGRAM ANKLE

Facility

$1,238.40

Service Code	HCPCS 73615
Hospital Charge Code	2011436
Hospital Revenue Code	322
Min. Negotiated Rate	$185.76
Max. Negotiated Rate	$185.76
Rate for Payer: Qualcare PPO/HMO/WC	$185.76

XR ARTHROGRAM ANKLE LT

Facility

$1,238.40

Service Code	HCPCS 73615
Hospital Charge Code	2000978
Hospital Revenue Code	322
Min. Negotiated Rate	$75.40
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$371.52
Rate for Payer: Aetna Medicare Advantage	$371.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.79
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ARTHROGRAM ANKLE LT

Facility

$1,238.40

Service Code	HCPCS 73615
Hospital Charge Code	2000978
Hospital Revenue Code	322
Min. Negotiated Rate	$185.76
Max. Negotiated Rate	$185.76
Rate for Payer: Qualcare PPO/HMO/WC	$185.76

XR ARTHROGRAM ANKLE RT

Facility

$1,238.40

Service Code	HCPCS 73615
Hospital Charge Code	2000979
Hospital Revenue Code	322
Min. Negotiated Rate	$75.40
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$371.52
Rate for Payer: Aetna Medicare Advantage	$371.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.79
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR ARTHROGRAM ANKLE RT

Facility

$1,238.40

Service Code	HCPCS 73615
Hospital Charge Code	2000979
Hospital Revenue Code	322
Min. Negotiated Rate	$185.76
Max. Negotiated Rate	$185.76
Rate for Payer: Qualcare PPO/HMO/WC	$185.76

XR ARTHROGRAM ELBOW LT

Facility

$1,238.40

Service Code	HCPCS 73085
Hospital Charge Code	2000976
Hospital Revenue Code	322
Min. Negotiated Rate	$33.94
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$595.10
Rate for Payer: Aetna Commercial	$371.52
Rate for Payer: Aetna Medicare Advantage	$371.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$315.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$315.79
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.99
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$185.76
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00

XR ARTHROGRAM ELBOW LT

Facility

$1,238.40

Service Code	HCPCS 73085
Hospital Charge Code	2000976
Hospital Revenue Code	322
Min. Negotiated Rate	$185.76
Max. Negotiated Rate	$185.76
Rate for Payer: Qualcare PPO/HMO/WC	$185.76

XR ARTHROGRAM ELBOW RT

Facility

$5,100.00

Service Code	HCPCS 73085
Hospital Charge Code	2000977
Hospital Revenue Code	322
Min. Negotiated Rate	$33.94
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$595.10
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) NJ Health	$33.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$607.00

XR ARTHROGRAM ELBOW RT

Facility

$5,100.00

Service Code	HCPCS 73085
Hospital Charge Code	2000977
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ARTHROGRAM HIP LT

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	2004281
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ARTHROGRAM HIP LT

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	2004281
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
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) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

XR ARTHROGRAM HIP RT

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	2004282
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ARTHROGRAM HIP RT

Facility

$5,100.00

Service Code	HCPCS 73525
Hospital Charge Code	2004282
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
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) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

XR ARTHROGRAM KNEE LT

Facility

$5,100.00

Service Code	HCPCS 73580
Hospital Charge Code	2000974
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
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) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

XR ARTHROGRAM KNEE LT

Facility

$5,100.00

Service Code	HCPCS 73580
Hospital Charge Code	2000974
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ARTHROGRAM KNEE RT

Facility

$5,100.00

Service Code	HCPCS 73580
Hospital Charge Code	2000975
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
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) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$830.80
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

XR ARTHROGRAM KNEE RT

Facility

$5,100.00

Service Code	HCPCS 73580
Hospital Charge Code	2000975
Hospital Revenue Code	322
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR ARTHROGRAM SHOULDER BILTERL

Facility

$2,520.00

Service Code	HCPCS 7304050
Hospital Charge Code	2011442
Hospital Revenue Code	322
Min. Negotiated Rate	$378.00
Max. Negotiated Rate	$378.00
Rate for Payer: Qualcare PPO/HMO/WC	$378.00

Know your out-of-pocket cost for care.

All Charges