Heights University Hospital

All Charges

Charge

Type

Setting

Price

XR HAND RT 3RD DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F7
Hospital Charge Code	2000088
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

XR HAND RT 4TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F8
Hospital Charge Code	2000089
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR HAND RT 4TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F8
Hospital Charge Code	2000089
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

XR HAND RT 5TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F9
Hospital Charge Code	2000090
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR HAND RT 5TH DIGIT

Facility

$5,100.00

Service Code	HCPCS 73140F9
Hospital Charge Code	2000090
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

XR HAND RT THUMB

Facility

$5,100.00

Service Code	HCPCS 73140F5
Hospital Charge Code	2000086
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

XR HAND RT THUMB

Facility

$5,100.00

Service Code	HCPCS 73140F5
Hospital Charge Code	2000086
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR HEEL BILATERAL (CALCANEOUS)

Facility

$5,100.00

Service Code	HCPCS 7365050
Hospital Charge Code	2011313
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR HEEL BILATERAL (CALCANEOUS)

Facility

$5,100.00

Service Code	HCPCS 7365050
Hospital Charge Code	2011313
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

XR HEEL LT

Facility

$5,100.00

Service Code	HCPCS 73650LT
Hospital Charge Code	2002251
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

XR HEEL LT

Facility

$5,100.00

Service Code	HCPCS 73650LT
Hospital Charge Code	2002251
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR HEEL RT

Facility

$5,100.00

Service Code	HCPCS 73650RT
Hospital Charge Code	2002252
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

XR HEEL RT

Facility

$5,100.00

Service Code	HCPCS 73650RT
Hospital Charge Code	2002252
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

XR HIP COMPLETE BILATERAL

Facility

$258.70

Service Code	HCPCS 73510
Hospital Charge Code	2011346
Hospital Revenue Code	320
Min. Negotiated Rate	$33.63
Max. Negotiated Rate	$1,489.00
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

XR HIP COMPLETE BILATERAL

Facility

$258.70

Service Code	HCPCS 73510
Hospital Charge Code	2011346
Hospital Revenue Code	320
Min. Negotiated Rate	$38.80
Max. Negotiated Rate	$38.80
Rate for Payer: Qualcare PPO/HMO/WC	$38.80

XR HIP (DUR OPER PROC) LT

Facility

$570.45

Hospital Charge Code	2000115
Hospital Revenue Code	320
Min. Negotiated Rate	$74.16
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$171.13
Rate for Payer: Aetna Medicare Advantage	$171.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.46
Rate for Payer: Cigna Commercial	$285.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.16
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.57
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR HIP (DUR OPER PROC) LT

Facility

$570.45

Hospital Charge Code	2000115
Hospital Revenue Code	320
Min. Negotiated Rate	$85.57
Max. Negotiated Rate	$85.57
Rate for Payer: Qualcare PPO/HMO/WC	$85.57

XR HIP (DUR OPER PROC) RT

Facility

$570.45

Hospital Charge Code	2000116
Hospital Revenue Code	320
Min. Negotiated Rate	$74.16
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$171.13
Rate for Payer: Aetna Medicare Advantage	$171.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.46
Rate for Payer: Cigna Commercial	$285.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.16
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.57
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR HIP (DUR OPER PROC) RT

Facility

$570.45

Hospital Charge Code	2000116
Hospital Revenue Code	320
Min. Negotiated Rate	$85.57
Max. Negotiated Rate	$85.57
Rate for Payer: Qualcare PPO/HMO/WC	$85.57

XR HIP LT 1 VIEW

Facility

$181.65

Hospital Charge Code	2000123
Hospital Revenue Code	320
Min. Negotiated Rate	$23.61
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$54.49
Rate for Payer: Aetna Medicare Advantage	$54.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.32
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR HIP LT 1 VIEW

Facility

$181.65

Hospital Charge Code	2000123
Hospital Revenue Code	320
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

XR HIP LT 2 VIEWS

Facility

$246.45

Hospital Charge Code	2000107
Hospital Revenue Code	320
Min. Negotiated Rate	$36.97
Max. Negotiated Rate	$36.97
Rate for Payer: Qualcare PPO/HMO/WC	$36.97

XR HIP LT 2 VIEWS

Facility

$246.45

Hospital Charge Code	2000107
Hospital Revenue Code	320
Min. Negotiated Rate	$32.04
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$73.94
Rate for Payer: Aetna Medicare Advantage	$73.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.84
Rate for Payer: Cigna Commercial	$123.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.97
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

XR HIP OPERATIVE BILATERAL

Facility

$1,140.90

Hospital Charge Code	2011347
Hospital Revenue Code	320
Min. Negotiated Rate	$171.13
Max. Negotiated Rate	$171.13
Rate for Payer: Qualcare PPO/HMO/WC	$171.13

XR HIP OPERATIVE BILATERAL

Facility

$1,140.90

Hospital Charge Code	2011347
Hospital Revenue Code	320
Min. Negotiated Rate	$148.32
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$342.27
Rate for Payer: Aetna Medicare Advantage	$342.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.93
Rate for Payer: Cigna Commercial	$570.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.13
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges