Heights University Hospital

All Charges

Charge

Type

Setting

Price

BRACE KNEE XL

Facility

$49.55

Hospital Charge Code	270649578
Hospital Revenue Code	272
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$24.77
Rate for Payer: Aetna Commercial	$14.87
Rate for Payer: Aetna Medicare Advantage	$14.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.64
Rate for Payer: Cigna Commercial	$24.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.44
Rate for Payer: Oxford Commercial	$24.77
Rate for Payer: Qualcare PPO/HMO/WC	$7.43
Rate for Payer: UnitedHealthcare Commercial	$24.77

BRACE KNEE XXL 12

Facility

$51.80

Hospital Charge Code	270649579
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$25.90
Rate for Payer: Aetna Commercial	$15.54
Rate for Payer: Aetna Medicare Advantage	$15.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.21
Rate for Payer: Cigna Commercial	$25.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.73
Rate for Payer: Oxford Commercial	$25.90
Rate for Payer: Qualcare PPO/HMO/WC	$7.77
Rate for Payer: UnitedHealthcare Commercial	$25.90

BRACE KNEE XXL 12

Facility

$51.80

Hospital Charge Code	270649579
Hospital Revenue Code	272
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$7.77
Rate for Payer: Qualcare PPO/HMO/WC	$7.77

BRACE KNEE XXL 19

Facility

$74.90

Hospital Charge Code	270649580
Hospital Revenue Code	272
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$37.45
Rate for Payer: Aetna Commercial	$22.47
Rate for Payer: Aetna Medicare Advantage	$22.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.10
Rate for Payer: Cigna Commercial	$37.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.74
Rate for Payer: Oxford Commercial	$37.45
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$37.45

BRACE KNEE XXL 19

Facility

$74.90

Hospital Charge Code	270649580
Hospital Revenue Code	272
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

BRACE KNIGHT TAYLOR CUSTOM

Facility

$2,441.00

Service Code	HCPCS L0520
Hospital Charge Code	270612936
Hospital Revenue Code	274
Min. Negotiated Rate	$366.15
Max. Negotiated Rate	$1,220.50
Rate for Payer: Aetna Commercial	$732.30
Rate for Payer: Aetna Medicare Advantage	$732.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.46
Rate for Payer: Cigna Commercial	$1,220.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.72
Rate for Payer: Qualcare PPO/HMO/WC	$366.15

BRACE KNIGHT TAYLOR CUSTOM

Facility

$2,441.00

Service Code	HCPCS L0520
Hospital Charge Code	270612936
Hospital Revenue Code	274
Min. Negotiated Rate	$366.15
Max. Negotiated Rate	$590.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$488.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$590.72
Rate for Payer: Qualcare PPO/HMO/WC	$366.15

BRACE L/S W/FITTING FEE

Facility

$718.45

Hospital Charge Code	270606584
Hospital Revenue Code	270
Min. Negotiated Rate	$93.40
Max. Negotiated Rate	$359.23
Rate for Payer: Aetna Commercial	$215.53
Rate for Payer: Aetna Medicare Advantage	$215.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.20
Rate for Payer: Cigna Commercial	$359.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.40
Rate for Payer: Oxford Commercial	$359.23
Rate for Payer: Qualcare PPO/HMO/WC	$107.77
Rate for Payer: UnitedHealthcare Commercial	$359.23

BRACE L/S W/FITTING FEE

Facility

$1,577.65

Hospital Charge Code	270607056
Hospital Revenue Code	270
Min. Negotiated Rate	$205.09
Max. Negotiated Rate	$788.83
Rate for Payer: Aetna Commercial	$473.30
Rate for Payer: Aetna Medicare Advantage	$473.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$402.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$402.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$402.30
Rate for Payer: Cigna Commercial	$788.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.09
Rate for Payer: Oxford Commercial	$788.83
Rate for Payer: Qualcare PPO/HMO/WC	$236.65
Rate for Payer: UnitedHealthcare Commercial	$788.83

BRACE L/S W/FITTING FEE

Facility

$718.45

Hospital Charge Code	270606584
Hospital Revenue Code	270
Min. Negotiated Rate	$107.77
Max. Negotiated Rate	$107.77
Rate for Payer: Qualcare PPO/HMO/WC	$107.77

BRACE L/S W/FITTING FEE

Facility

$1,577.65

Hospital Charge Code	270607056
Hospital Revenue Code	270
Min. Negotiated Rate	$236.65
Max. Negotiated Rate	$236.65
Rate for Payer: Qualcare PPO/HMO/WC	$236.65

BRACE LUMBAR SUPPORT CUSTOM

Facility

$730.00

Service Code	HCPCS L0515
Hospital Charge Code	270612867
Hospital Revenue Code	274
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

BRACE LUMBAR SUPPORT CUSTOM

Facility

$730.00

Service Code	HCPCS L0515
Hospital Charge Code	270612867
Hospital Revenue Code	274
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$219.00
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

BRACE NECK-HIP L0700

Facility

$6,368.85

Hospital Charge Code	270622823
Hospital Revenue Code	270
Min. Negotiated Rate	$955.33
Max. Negotiated Rate	$955.33
Rate for Payer: Qualcare PPO/HMO/WC	$955.33

BRACE NECK-HIP L0700

Facility

$6,368.85

Hospital Charge Code	270622823
Hospital Revenue Code	270
Min. Negotiated Rate	$827.95
Max. Negotiated Rate	$3,184.43
Rate for Payer: Aetna Commercial	$1,910.65
Rate for Payer: Aetna Medicare Advantage	$1,910.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,624.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,624.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,624.06
Rate for Payer: Cigna Commercial	$3,184.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$827.95
Rate for Payer: Oxford Commercial	$3,184.43
Rate for Payer: Qualcare PPO/HMO/WC	$955.33
Rate for Payer: UnitedHealthcare Commercial	$3,184.43

BRACE ORTHO 16

Facility

$695.25

Hospital Charge Code	270674929
Hospital Revenue Code	271
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$347.62
Rate for Payer: Aetna Commercial	$208.57
Rate for Payer: Aetna Medicare Advantage	$208.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.29
Rate for Payer: Cigna Commercial	$347.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.38
Rate for Payer: Oxford Commercial	$347.62
Rate for Payer: Qualcare PPO/HMO/WC	$104.29
Rate for Payer: UnitedHealthcare Commercial	$347.62

BRACE ORTHO 16

Facility

$695.25

Hospital Charge Code	270674929
Hospital Revenue Code	271
Min. Negotiated Rate	$104.29
Max. Negotiated Rate	$104.29
Rate for Payer: Qualcare PPO/HMO/WC	$104.29

BRACE PTB FX

Facility

$3,933.65

Hospital Charge Code	270606239
Hospital Revenue Code	270
Min. Negotiated Rate	$511.37
Max. Negotiated Rate	$1,966.83
Rate for Payer: Aetna Commercial	$1,180.10
Rate for Payer: Aetna Medicare Advantage	$1,180.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,003.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,003.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,003.08
Rate for Payer: Cigna Commercial	$1,966.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$511.37
Rate for Payer: Oxford Commercial	$1,966.83
Rate for Payer: Qualcare PPO/HMO/WC	$590.05
Rate for Payer: UnitedHealthcare Commercial	$1,966.83

BRACE PTB FX

Facility

$3,933.65

Hospital Charge Code	270606239
Hospital Revenue Code	270
Min. Negotiated Rate	$590.05
Max. Negotiated Rate	$590.05
Rate for Payer: Qualcare PPO/HMO/WC	$590.05

BRACE SHOULDER ARC 2.0

Facility

$895.00

Hospital Charge Code	270678204
Hospital Revenue Code	270
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$134.25
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

BRACE SHOULDER ARC 2.0

Facility

$895.00

Hospital Charge Code	270678204
Hospital Revenue Code	270
Min. Negotiated Rate	$116.35
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$268.50
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.35
Rate for Payer: Oxford Commercial	$447.50
Rate for Payer: Qualcare PPO/HMO/WC	$134.25
Rate for Payer: UnitedHealthcare Commercial	$447.50

BRACE SHOULDER SLINGSHOT

Facility

$8.61

Hospital Charge Code	270655443
Hospital Revenue Code	270
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$4.30
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.12
Rate for Payer: Oxford Commercial	$4.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$4.30

BRACE SHOULDER SLINGSHOT

Facility

$8.61

Hospital Charge Code	270655443
Hospital Revenue Code	270
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

BRACHIAL DRAPE

Facility

$13.00

Hospital Charge Code	270658351
Hospital Revenue Code	271
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

BRACHIAL DRAPE

Facility

$13.00

Hospital Charge Code	270658351
Hospital Revenue Code	271
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

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All Charges