Heights University Hospital

All Charges

Charge

Type

Setting

Price

PEG SHOULDER STAND 37.5 STP375

Facility

$238.15

Hospital Charge Code	270634960
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOULDER STAND 37.5 STP375

Facility

$238.15

Hospital Charge Code	270634960
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STANDARD 35 STP35

Facility

$238.15

Hospital Charge Code	270634959
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STANDARD 35 STP35

Facility

$238.15

Hospital Charge Code	270634959
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOULDER STANDARD 40 STP40

Facility

$238.15

Hospital Charge Code	270634961
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOULDER STANDARD 40 STP40

Facility

$238.15

Hospital Charge Code	270634961
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOULDER STANDARD 45 STP45

Facility

$238.15

Hospital Charge Code	270634962
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOULDER STANDARD 45 STP45

Facility

$238.15

Hospital Charge Code	270634962
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X30.mSTP-30.0

Facility

$238.15

Hospital Charge Code	270636719
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X30.mSTP-30.0

Facility

$238.15

Hospital Charge Code	270636719
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOUL STD 4.0X35.0mSTP35.0

Facility

$238.15

Hospital Charge Code	270636721
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X35.0mSTP35.0

Facility

$238.15

Hospital Charge Code	270636721
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOUL STD 4.0X40.0mSTP40.0

Facility

$238.15

Hospital Charge Code	270636722
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SHOUL STD 4.0X40.0mSTP40.0

Facility

$238.15

Hospital Charge Code	270636722
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X45.0mSTP45.0

Facility

$238.15

Hospital Charge Code	270636723
Hospital Revenue Code	272
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$35.72
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

PEG SHOUL STD 4.0X45.0mSTP45.0

Facility

$238.15

Hospital Charge Code	270636723
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.96
Rate for Payer: Oxford Commercial	$119.08
Rate for Payer: Qualcare PPO/HMO/WC	$35.72
Rate for Payer: UnitedHealthcare Commercial	$119.08

PEG SMOOTH 2.0x16mm P-16

Facility

$347.25

Hospital Charge Code	270635658
Hospital Revenue Code	272
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

PEG SMOOTH 2.0x16mm P-16

Facility

$347.25

Hospital Charge Code	270635658
Hospital Revenue Code	272
Min. Negotiated Rate	$45.14
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$104.17
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.14
Rate for Payer: Oxford Commercial	$173.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$173.62

PEG SMOOTH 2 0 X 18 P18000

Facility

$375.00

Hospital Charge Code	270638278
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PEG SMOOTH 2 0 X 18 P18000

Facility

$375.00

Hospital Charge Code	270638278
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

PEG SMOOTH 2.0x20mm P-20

Facility

$347.25

Hospital Charge Code	270635660
Hospital Revenue Code	272
Min. Negotiated Rate	$45.14
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$104.17
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.14
Rate for Payer: Oxford Commercial	$173.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$173.62

PEG SMOOTH 2.0x20mm P-20

Facility

$347.25

Hospital Charge Code	270635660
Hospital Revenue Code	272
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

PEG SMOOTH 2 0 X 20 P20000

Facility

$375.00

Hospital Charge Code	270638279
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PEG SMOOTH 2 0 X 20 P20000

Facility

$375.00

Hospital Charge Code	270638279
Hospital Revenue Code	272
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

PEG SMOOTH 2.0x22mm P22

Facility

$347.25

Hospital Charge Code	270636498
Hospital Revenue Code	272
Min. Negotiated Rate	$45.14
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$104.17
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.14
Rate for Payer: Oxford Commercial	$173.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$173.62

Know your out-of-pocket cost for care.

All Charges