Heights University Hospital

All Charges

Charge

Type

Setting

Price

BONE GUIDE GLENOID LT

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270699507
Hospital Revenue Code	272
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

BONE GUIDE MINI LT REV SHLDR

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270693854
Hospital Revenue Code	272
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

BONE GUIDE MINI LT REV SHLDR

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270693854
Hospital Revenue Code	272
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.00
Rate for Payer: Oxford Commercial	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,850.00

BONE HOLDING FORCEP

Facility

$500.60

Hospital Charge Code	270655154
Hospital Revenue Code	272
Min. Negotiated Rate	$65.08
Max. Negotiated Rate	$250.30
Rate for Payer: Aetna Commercial	$150.18
Rate for Payer: Aetna Medicare Advantage	$150.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.65
Rate for Payer: Cigna Commercial	$250.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.08
Rate for Payer: Oxford Commercial	$250.30
Rate for Payer: Qualcare PPO/HMO/WC	$75.09
Rate for Payer: UnitedHealthcare Commercial	$250.30

BONE HOLDING FORCEP

Facility

$500.60

Hospital Charge Code	270655154
Hospital Revenue Code	272
Min. Negotiated Rate	$75.09
Max. Negotiated Rate	$75.09
Rate for Payer: Qualcare PPO/HMO/WC	$75.09

BONE IMAGING LMTD AREA

Facility

$741.24

Service Code	HCPCS 78300
Hospital Charge Code	406078300
Hospital Revenue Code	341
Min. Negotiated Rate	$111.19
Max. Negotiated Rate	$111.19
Rate for Payer: Qualcare PPO/HMO/WC	$111.19

BONE IMAGING LMTD AREA

Facility

$741.24

Service Code	HCPCS 78300
Hospital Charge Code	406078300
Hospital Revenue Code	341
Min. Negotiated Rate	$96.36
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Better Health Medicaid	$181.50
Rate for Payer: Aetna Commercial	$222.37
Rate for Payer: Aetna Medicare Advantage	$222.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.02
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.36
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.19
Rate for Payer: UnitedHealthcare Commercial	$3,540.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$185.13

BONE IMAGING MULT AREAS

Facility

$1,840.40

Service Code	HCPCS 78305
Hospital Charge Code	406078305
Hospital Revenue Code	341
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Better Health Medicaid	$1,181.50
Rate for Payer: Aetna Commercial	$552.12
Rate for Payer: Aetna Medicare Advantage	$552.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$469.30
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.25
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.06
Rate for Payer: UnitedHealthcare Commercial	$3,540.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,205.13

BONE IMAGING MULT AREAS

Facility

$1,840.40

Service Code	HCPCS 78305
Hospital Charge Code	406078305
Hospital Revenue Code	341
Min. Negotiated Rate	$276.06
Max. Negotiated Rate	$276.06
Rate for Payer: Qualcare PPO/HMO/WC	$276.06

BONE LENGTH STUDY

Facility

$5,100.00

Service Code	HCPCS 77073
Hospital Charge Code	94061195
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

BONE LENGTH STUDY

Facility

$5,100.00

Service Code	HCPCS 77073
Hospital Charge Code	94061195
Hospital Revenue Code	320
Min. Negotiated Rate	$24.24
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
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	$24.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
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	$216.59

BONE MARROW ******

Facility

$313.00

Hospital Charge Code	8002222
Hospital Revenue Code	279
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

BONE MARROW ******

Facility

$313.00

Hospital Charge Code	8002222
Hospital Revenue Code	279
Min. Negotiated Rate	$40.69
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$93.90
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.69
Rate for Payer: Oxford Commercial	$156.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Commercial	$156.50

BONE MARROW ASPIRATE CONCENTRA

Facility

$4,900.00

Hospital Charge Code	270665576
Hospital Revenue Code	270
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00

BONE MARROW ASPIRATE CONCENTRA

Facility

$4,900.00

Hospital Charge Code	270665576
Hospital Revenue Code	270
Min. Negotiated Rate	$637.00
Max. Negotiated Rate	$2,450.00
Rate for Payer: Aetna Commercial	$1,470.00
Rate for Payer: Aetna Medicare Advantage	$1,470.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,249.50
Rate for Payer: Cigna Commercial	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$637.00
Rate for Payer: Oxford Commercial	$2,450.00
Rate for Payer: Qualcare PPO/HMO/WC	$735.00
Rate for Payer: UnitedHealthcare Commercial	$2,450.00

BONE MARROW ASPIRATE KIT

Facility

$11,475.00

Hospital Charge Code	270671802
Hospital Revenue Code	272
Min. Negotiated Rate	$1,721.25
Max. Negotiated Rate	$1,721.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25

BONE MARROW ASPIRATE KIT

Facility

$11,475.00

Hospital Charge Code	270671802
Hospital Revenue Code	272
Min. Negotiated Rate	$1,491.75
Max. Negotiated Rate	$5,737.50
Rate for Payer: Aetna Commercial	$3,442.50
Rate for Payer: Aetna Medicare Advantage	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,926.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,926.12
Rate for Payer: Cigna Commercial	$5,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,491.75
Rate for Payer: Oxford Commercial	$5,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,721.25
Rate for Payer: UnitedHealthcare Commercial	$5,737.50

BONE MARROW ASPIRATION

Facility

$1,457.45

Service Code	HCPCS 38220
Hospital Charge Code	93500143
Hospital Revenue Code	761
Min. Negotiated Rate	$189.47
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$437.24
Rate for Payer: Aetna Medicare Advantage	$437.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.65
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.47
Rate for Payer: Oxford Commercial	$728.73
Rate for Payer: Qualcare PPO/HMO/WC	$218.62
Rate for Payer: UnitedHealthcare Commercial	$728.73

BONE MARROW ASPIRATION

Facility

$1,457.45

Service Code	HCPCS 38220
Hospital Charge Code	93500143
Hospital Revenue Code	761
Min. Negotiated Rate	$218.62
Max. Negotiated Rate	$218.62
Rate for Payer: Qualcare PPO/HMO/WC	$218.62

BONE MARROW ASPIRATION BL

Facility

$7,612.30

Service Code	HCPCS 38220
Hospital Charge Code	1600000754
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

BONE MARROW ASPIRATION BL

Facility

$7,612.30

Service Code	HCPCS 38220
Hospital Charge Code	1600000754
Hospital Revenue Code	360
Min. Negotiated Rate	$989.60
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,283.69
Rate for Payer: Aetna Medicare Advantage	$2,283.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,941.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,941.14
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	$1,941.14
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$989.60
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

BONE MARROW ASPIRATION DX

Facility

$8,995.35

Service Code	HCPCS 38220
Hospital Charge Code	404138220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,349.30
Max. Negotiated Rate	$1,349.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30

BONE MARROW ASPIRATION DX

Facility

$8,995.35

Service Code	HCPCS 38220
Hospital Charge Code	404138220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,169.40
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,698.61
Rate for Payer: Aetna Medicare Advantage	$2,698.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,293.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,293.81
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	$2,293.81
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,169.40
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

BONE MARROW ASPIRATION ONLY

Facility

$1,686.65

Service Code	HCPCS 38220
Hospital Charge Code	1001152
Hospital Revenue Code	361
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00

BONE MARROW ASPIRATION ONLY

Facility

$1,686.65

Service Code	HCPCS 38220
Hospital Charge Code	3401032
Hospital Revenue Code	361
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00

Know your out-of-pocket cost for care.

All Charges