Heights University Hospital

All Charges

Charge

Type

Setting

Price

BRACE ANKLE LEFT STD

Facility

$274.45

Hospital Charge Code	270600737
Hospital Revenue Code	270
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$41.17
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

BRACE ANKLE LEFT STD

Facility

$274.45

Hospital Charge Code	270600737
Hospital Revenue Code	270
Min. Negotiated Rate	$35.68
Max. Negotiated Rate	$137.22
Rate for Payer: Aetna Commercial	$82.33
Rate for Payer: Aetna Medicare Advantage	$82.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.98
Rate for Payer: Cigna Commercial	$137.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.68
Rate for Payer: Oxford Commercial	$137.22
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Commercial	$137.22

BRACE ANKLE LG LEFT AIR STIRRP

Facility

$109.95

Hospital Charge Code	270651659
Hospital Revenue Code	270
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$54.98
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.04
Rate for Payer: Cigna Commercial	$54.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.29
Rate for Payer: Oxford Commercial	$54.98
Rate for Payer: Qualcare PPO/HMO/WC	$16.49
Rate for Payer: UnitedHealthcare Commercial	$54.98

BRACE ANKLE LG LEFT AIR STIRRP

Facility

$109.95

Hospital Charge Code	270651659
Hospital Revenue Code	270
Min. Negotiated Rate	$16.49
Max. Negotiated Rate	$16.49
Rate for Payer: Qualcare PPO/HMO/WC	$16.49

BRACE ANKLE LG RIGHT AIR STRIP

Facility

$109.95

Hospital Charge Code	270651660
Hospital Revenue Code	270
Min. Negotiated Rate	$14.29
Max. Negotiated Rate	$54.98
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$32.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.04
Rate for Payer: Cigna Commercial	$54.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.29
Rate for Payer: Oxford Commercial	$54.98
Rate for Payer: Qualcare PPO/HMO/WC	$16.49
Rate for Payer: UnitedHealthcare Commercial	$54.98

BRACE ANKLE LG RIGHT AIR STRIP

Facility

$109.95

Hospital Charge Code	270651660
Hospital Revenue Code	270
Min. Negotiated Rate	$16.49
Max. Negotiated Rate	$16.49
Rate for Payer: Qualcare PPO/HMO/WC	$16.49

BRACE ANKLE MED LEFT AIR STRIP

Facility

$107.20

Hospital Charge Code	270651661
Hospital Revenue Code	270
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$53.60
Rate for Payer: Aetna Commercial	$32.16
Rate for Payer: Aetna Medicare Advantage	$32.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.34
Rate for Payer: Cigna Commercial	$53.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.94
Rate for Payer: Oxford Commercial	$53.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.08
Rate for Payer: UnitedHealthcare Commercial	$53.60

BRACE ANKLE MED LEFT AIR STRIP

Facility

$107.20

Hospital Charge Code	270651661
Hospital Revenue Code	270
Min. Negotiated Rate	$16.08
Max. Negotiated Rate	$16.08
Rate for Payer: Qualcare PPO/HMO/WC	$16.08

BRACE ANKLE MED RIGHT AIR

Facility

$107.20

Hospital Charge Code	270653965
Hospital Revenue Code	272
Min. Negotiated Rate	$13.94
Max. Negotiated Rate	$53.60
Rate for Payer: Aetna Commercial	$32.16
Rate for Payer: Aetna Medicare Advantage	$32.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.34
Rate for Payer: Cigna Commercial	$53.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.94
Rate for Payer: Oxford Commercial	$53.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.08
Rate for Payer: UnitedHealthcare Commercial	$53.60

BRACE ANKLE MED RIGHT AIR

Facility

$107.20

Hospital Charge Code	270653965
Hospital Revenue Code	272
Min. Negotiated Rate	$16.08
Max. Negotiated Rate	$16.08
Rate for Payer: Qualcare PPO/HMO/WC	$16.08

BRACE ANKLE RIGHT STD

Facility

$274.45

Hospital Charge Code	270600747
Hospital Revenue Code	270
Min. Negotiated Rate	$35.68
Max. Negotiated Rate	$137.22
Rate for Payer: Aetna Commercial	$82.33
Rate for Payer: Aetna Medicare Advantage	$82.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.98
Rate for Payer: Cigna Commercial	$137.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.68
Rate for Payer: Oxford Commercial	$137.22
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Commercial	$137.22

BRACE ANKLE RIGHT STD

Facility

$274.45

Hospital Charge Code	270600747
Hospital Revenue Code	270
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$41.17
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

BRACE ANKLE RIGHT W/ WRAP SM 1

Facility

$101.70

Hospital Charge Code	270664515
Hospital Revenue Code	270
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$15.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.26

BRACE ANKLE RIGHT W/ WRAP SM 1

Facility

$101.70

Hospital Charge Code	270664515
Hospital Revenue Code	270
Min. Negotiated Rate	$13.22
Max. Negotiated Rate	$50.85
Rate for Payer: Aetna Commercial	$30.51
Rate for Payer: Aetna Medicare Advantage	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.93
Rate for Payer: Cigna Commercial	$50.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.22
Rate for Payer: Oxford Commercial	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.26
Rate for Payer: UnitedHealthcare Commercial	$50.85

BRACE ANKLE RIGHT W/ WRAP SM 8

Facility

$101.70

Hospital Charge Code	270664500
Hospital Revenue Code	270
Min. Negotiated Rate	$13.22
Max. Negotiated Rate	$50.85
Rate for Payer: Aetna Commercial	$30.51
Rate for Payer: Aetna Medicare Advantage	$30.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.93
Rate for Payer: Cigna Commercial	$50.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.22
Rate for Payer: Oxford Commercial	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.26
Rate for Payer: UnitedHealthcare Commercial	$50.85

BRACE ANKLE RIGHT W/ WRAP SM 8

Facility

$101.70

Hospital Charge Code	270664500
Hospital Revenue Code	270
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$15.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.26

BRACE ANKLE SM RIGHT AIR STRIP

Facility

$112.15

Hospital Charge Code	270651662
Hospital Revenue Code	270
Min. Negotiated Rate	$16.82
Max. Negotiated Rate	$16.82
Rate for Payer: Qualcare PPO/HMO/WC	$16.82

BRACE ANKLE SM RIGHT AIR STRIP

Facility

$112.15

Hospital Charge Code	270651662
Hospital Revenue Code	270
Min. Negotiated Rate	$14.58
Max. Negotiated Rate	$56.08
Rate for Payer: Aetna Commercial	$33.65
Rate for Payer: Aetna Medicare Advantage	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.60
Rate for Payer: Cigna Commercial	$56.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.58
Rate for Payer: Oxford Commercial	$56.08
Rate for Payer: Qualcare PPO/HMO/WC	$16.82
Rate for Payer: UnitedHealthcare Commercial	$56.08

BRACE ANKLE UNIVERSAL 02E

Facility

$93.89

Hospital Charge Code	270634716
Hospital Revenue Code	270
Min. Negotiated Rate	$14.08
Max. Negotiated Rate	$14.08
Rate for Payer: Qualcare PPO/HMO/WC	$14.08

BRACE ANKLE UNIVERSAL 02E

Facility

$93.89

Hospital Charge Code	270634716
Hospital Revenue Code	270
Min. Negotiated Rate	$12.21
Max. Negotiated Rate	$46.95
Rate for Payer: Aetna Commercial	$28.17
Rate for Payer: Aetna Medicare Advantage	$28.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.94
Rate for Payer: Cigna Commercial	$46.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: Oxford Commercial	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$14.08
Rate for Payer: UnitedHealthcare Commercial	$46.95

BRACE BME BILATERAL AFO

Facility

$2,437.65

Hospital Charge Code	270612667
Hospital Revenue Code	270
Min. Negotiated Rate	$365.65
Max. Negotiated Rate	$365.65
Rate for Payer: Qualcare PPO/HMO/WC	$365.65

BRACE BME BILATERAL AFO

Facility

$2,437.65

Hospital Charge Code	270612667
Hospital Revenue Code	270
Min. Negotiated Rate	$316.89
Max. Negotiated Rate	$1,218.83
Rate for Payer: Aetna Commercial	$731.29
Rate for Payer: Aetna Medicare Advantage	$731.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$621.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$621.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$621.60
Rate for Payer: Cigna Commercial	$1,218.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.89
Rate for Payer: Oxford Commercial	$1,218.83
Rate for Payer: Qualcare PPO/HMO/WC	$365.65
Rate for Payer: UnitedHealthcare Commercial	$1,218.83

BRACE BME TLSO CUSTOM

Facility

$607.25

Hospital Charge Code	270612780
Hospital Revenue Code	270
Min. Negotiated Rate	$91.09
Max. Negotiated Rate	$91.09
Rate for Payer: Qualcare PPO/HMO/WC	$91.09

BRACE BME TLSO CUSTOM

Facility

$5,184.00

Hospital Charge Code	270612725
Hospital Revenue Code	274
Min. Negotiated Rate	$777.60
Max. Negotiated Rate	$1,254.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,036.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.53
Rate for Payer: Qualcare PPO/HMO/WC	$777.60

BRACE BME TLSO CUSTOM

Facility

$607.25

Hospital Charge Code	270612780
Hospital Revenue Code	270
Min. Negotiated Rate	$78.94
Max. Negotiated Rate	$303.62
Rate for Payer: Aetna Commercial	$182.18
Rate for Payer: Aetna Medicare Advantage	$182.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.85
Rate for Payer: Cigna Commercial	$303.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.94
Rate for Payer: Oxford Commercial	$303.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.09
Rate for Payer: UnitedHealthcare Commercial	$303.62

Know your out-of-pocket cost for care.

All Charges