Heights University Hospital

All Charges

Charge

Type

Setting

Price

BRACHYTX, NON-STR,YTTRIUM-90

Facility

$82,538.65

Service Code	HCPCS C2616
Hospital Charge Code	5701123
Hospital Revenue Code	278
Min. Negotiated Rate	$12,380.80
Max. Negotiated Rate	$41,422.60
Rate for Payer: Aetna Medicare Advantage	$24,761.60
Rate for Payer: Aetna Commercial	$24,761.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,047.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,047.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,507.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,047.36
Rate for Payer: Cigna Commercial	$41,422.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,974.35
Rate for Payer: Qualcare PPO/HMO/WC	$12,380.80

BRACKET BEGG CRV BASE 256-650

Facility

$22.45

Hospital Charge Code	270611071
Hospital Revenue Code	272
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

BRACKET BEGG CRV BASE 256-650

Facility

$22.45

Hospital Charge Code	270611071
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

BRACKET BEGG CUSPID *****

Facility

$57.00

Hospital Charge Code	1604867
Hospital Revenue Code	272
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$28.50

BRACKET BEGG CUSPID *****

Facility

$57.00

Hospital Charge Code	1604867
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

BRACKET BEGG CUSPID 256-357

Facility

$19.25

Hospital Charge Code	270611036
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$9.62

BRACKET BEGG CUSPID 256-357

Facility

$19.25

Hospital Charge Code	270611036
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

BRACKET BEGG CUSPID 256-363

Facility

$16.85

Hospital Charge Code	270601064
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

BRACKET BEGG CUSPID 256-363

Facility

$16.85

Hospital Charge Code	270601064
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

BRACKET BEGG FLAT BASE 256-550

Facility

$19.25

Hospital Charge Code	270611070
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

BRACKET BEGG FLAT BASE 256-550

Facility

$19.25

Hospital Charge Code	270611070
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$9.62

BRACKET BEGG SLAT 256550*****

Facility

$57.00

Hospital Charge Code	1605112
Hospital Revenue Code	272
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$28.50

BRACKET BEGG SLAT 256550*****

Facility

$57.00

Hospital Charge Code	1605112
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

BRACKET BEGG UPPER LAT 256-360

Facility

$22.45

Hospital Charge Code	270611069
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

BRACKET BEGG UPPER LAT 256-360

Facility

$22.45

Hospital Charge Code	270611069
Hospital Revenue Code	272
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

BRACKET HOLDER 4P HALF MOON

Facility

$81.40

Hospital Charge Code	270678364
Hospital Revenue Code	272
Min. Negotiated Rate	$12.21
Max. Negotiated Rate	$12.21
Rate for Payer: Qualcare PPO/HMO/WC	$12.21

BRACKET HOLDER 4P HALF MOON

Facility

$81.40

Hospital Charge Code	270678364
Hospital Revenue Code	272
Min. Negotiated Rate	$10.58
Max. Negotiated Rate	$40.70
Rate for Payer: Aetna Commercial	$24.42
Rate for Payer: Aetna Medicare Advantage	$24.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.76
Rate for Payer: Cigna Commercial	$40.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.58
Rate for Payer: Oxford Commercial	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$12.21
Rate for Payer: UnitedHealthcare Commercial	$40.70

BRACKET UNIVRL KEYHOLE 9.25 14

Facility

$270.00

Hospital Charge Code	270665198
Hospital Revenue Code	270
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

BRACKET UNIVRL KEYHOLE 9.25 14

Facility

$270.00

Hospital Charge Code	270665198
Hospital Revenue Code	270
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$135.00

BRACKMANN PARTAL HA/C 11-12305

Facility

$920.85

Hospital Charge Code	270624163
Hospital Revenue Code	272
Min. Negotiated Rate	$138.13
Max. Negotiated Rate	$138.13
Rate for Payer: Qualcare PPO/HMO/WC	$138.13

BRACKMANN PARTAL HA/C 11-12305

Facility

$920.85

Hospital Charge Code	270624163
Hospital Revenue Code	272
Min. Negotiated Rate	$119.71
Max. Negotiated Rate	$460.43
Rate for Payer: Aetna Commercial	$276.25
Rate for Payer: Aetna Medicare Advantage	$276.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.82
Rate for Payer: Cigna Commercial	$460.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.71
Rate for Payer: Oxford Commercial	$460.43
Rate for Payer: Qualcare PPO/HMO/WC	$138.13
Rate for Payer: UnitedHealthcare Commercial	$460.43

BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA

Facility

$10,899.38

Service Code	APR-DRG 0562
Min. Negotiated Rate	$8,820.52
Max. Negotiated Rate	$10,899.38
Rate for Payer: Aetna Better Health Medicaid	$10,685.67
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,899.38
Rate for Payer: Wellpoint Medicaid Managed Care	$8,820.52

BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA

Facility

$16,500.10

Service Code	APR-DRG 0563
Min. Negotiated Rate	$14,594.65
Max. Negotiated Rate	$16,500.10
Rate for Payer: Aetna Better Health Medicaid	$16,176.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,500.10
Rate for Payer: Wellpoint Medicaid Managed Care	$14,594.65

BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA

Facility

$35,580.69

Service Code	APR-DRG 0564
Min. Negotiated Rate	$25,853.01
Max. Negotiated Rate	$35,580.69
Rate for Payer: Aetna Better Health Medicaid	$25,853.01
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,370.07
Rate for Payer: Wellpoint Medicaid Managed Care	$35,580.69

BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA

Facility

$8,159.49

Service Code	APR-DRG 0561
Min. Negotiated Rate	$6,496.30
Max. Negotiated Rate	$8,159.49
Rate for Payer: Aetna Better Health Medicaid	$7,999.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,159.49
Rate for Payer: Wellpoint Medicaid Managed Care	$6,496.30

Know your out-of-pocket cost for care.

All Charges