Heights University Hospital

All Charges

Charge

Type

Setting

Price

RYNATAN/TAB

Facility

$7.00

Hospital Charge Code	60633851
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

RYTHM EKG,INTERP.ONLY

Facility

$99.00

Service Code	HCPCS 93042
Hospital Charge Code	5780295
Hospital Revenue Code	730
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

RYTHM EKG,INTERP.ONLY

Facility

$99.00

Service Code	HCPCS 93042
Hospital Charge Code	5780295
Hospital Revenue Code	730
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$29.70
Rate for Payer: Aetna Medicare Advantage	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.25
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$603.00

RYTHMOL/150MG/TAB

Facility

$6.00

Hospital Charge Code	60633854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

RYTHMOL/150MG/TAB

Facility

$5.00

Hospital Charge Code	60634233
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

RYTHMOL/150MG/TAB

Facility

$6.00

Hospital Charge Code	60633854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

RYTHMOL/150MG/TAB

Facility

$5.00

Hospital Charge Code	60634233
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

S3 K-WIRE 2.0X152MM (6IN) NS

Facility

$165.00

Hospital Charge Code	270664306
Hospital Revenue Code	272
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$49.50
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.45
Rate for Payer: Oxford Commercial	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Commercial	$82.50

S3 K-WIRE 2.0X152MM (6IN) NS

Facility

$165.00

Hospital Charge Code	270664306
Hospital Revenue Code	272
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

SABER-C BODY 14X17X6MM 6DEG

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705813
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C BODY 14X17X6MM 6DEG

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705813
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C BODY 14X17X7MM 6DEG

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705815
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C BODY 14X17X7MM 6DEG

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705815
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C LOCKING PLATE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705810
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C LOCKING PLATE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705810
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C PLATE 14X17X6MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705814
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C PLATE 14X17X6MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705814
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C PLATE 14X17X7MM 6DEG

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705812
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C PLATE 14X17X7MM 6DEG

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705812
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C SPIKE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705811
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABER-C SPIKE

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705811
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SABLE SPACER 12X30, 7-14MM 15D

Facility

$29,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704736
Hospital Revenue Code	278
Min. Negotiated Rate	$4,387.50
Max. Negotiated Rate	$7,078.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,078.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,387.50

SABLE SPACER 12X30, 7-14MM 15D

Facility

$29,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270704736
Hospital Revenue Code	278
Min. Negotiated Rate	$4,387.50
Max. Negotiated Rate	$14,625.00
Rate for Payer: Aetna Commercial	$8,775.00
Rate for Payer: Aetna Medicare Advantage	$8,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,458.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,458.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,458.75
Rate for Payer: Cigna Commercial	$14,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,078.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,387.50

SACCHAROMYCES CEREVISIAE

Facility

$84.25

Service Code	HCPCS 86671
Hospital Charge Code	39900236
Hospital Revenue Code	302
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$12.64
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

SACCHAROMYCES CEREVISIAE

Facility

$84.25

Service Code	HCPCS 86671
Hospital Charge Code	39900236
Hospital Revenue Code	302
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.69
Rate for Payer: Aetna Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$12.25
Rate for Payer: Cigna Medicare Advantage	$6.12
Rate for Payer: Clover Medicare Advantage	$11.64
Rate for Payer: EmblemHealth Commercial	$36.75
Rate for Payer: Humana Medicare Advantage	$12.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.64
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.98
Rate for Payer: Wellcare Medicare Advantage	$12.25

Know your out-of-pocket cost for care.

All Charges