Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCALPEL STER DISP #20

Facility

$7.25

Hospital Charge Code	270301925
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

SCALP VEINS****

Facility

$25.00

Hospital Charge Code	7000524
Hospital Revenue Code	279
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

SCALP VEINS****

Facility

$25.00

Hospital Charge Code	7000524
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SCAN PROC CRANIAL EXTRA

Facility

$2,905.13

Service Code	HCPCS 61782
Hospital Charge Code	1600000615
Hospital Revenue Code	360
Min. Negotiated Rate	$435.77
Max. Negotiated Rate	$435.77
Rate for Payer: Qualcare PPO/HMO/WC	$435.77

SCAN PROC CRANIAL EXTRA

Facility

$2,905.13

Service Code	HCPCS 61782
Hospital Charge Code	1600000615
Hospital Revenue Code	360
Min. Negotiated Rate	$155.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$871.54
Rate for Payer: Aetna Medicare Advantage	$871.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.81
Rate for Payer: Cigna Commercial	$155.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.67
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$435.77
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SCAN PROC SPINAL

Facility

$7,221.00

Service Code	HCPCS 61783
Hospital Charge Code	24001192
Hospital Revenue Code	360
Min. Negotiated Rate	$224.72
Max. Negotiated Rate	$2,166.30
Rate for Payer: Aetna Commercial	$2,166.30
Rate for Payer: Aetna Medicare Advantage	$2,166.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,841.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,841.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,841.36
Rate for Payer: Cigna Commercial	$224.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$938.73
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.15
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SCAN PROC SPINAL

Facility

$2,265.10

Service Code	HCPCS 61783
Hospital Charge Code	1600000623
Hospital Revenue Code	360
Min. Negotiated Rate	$339.76
Max. Negotiated Rate	$339.76
Rate for Payer: Qualcare PPO/HMO/WC	$339.76

SCAN PROC SPINAL

Facility

$2,265.10

Service Code	HCPCS 61783
Hospital Charge Code	1600000623
Hospital Revenue Code	360
Min. Negotiated Rate	$224.72
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$679.53
Rate for Payer: Aetna Medicare Advantage	$679.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$577.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$577.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$577.60
Rate for Payer: Cigna Commercial	$224.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.46
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$339.76
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SCAN PROC SPINAL

Facility

$7,221.00

Service Code	HCPCS 61783
Hospital Charge Code	24001192
Hospital Revenue Code	360
Min. Negotiated Rate	$1,083.15
Max. Negotiated Rate	$1,083.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.15

SCAPHOID STAPLE MED.LONG

Facility

$278.00

Hospital Charge Code	270331202
Hospital Revenue Code	278
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

SCAPHOID STAPLE MED.LONG

Facility

$278.00

Hospital Charge Code	270331202
Hospital Revenue Code	278
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$83.40
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.28
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

SCAPULA COMPL-BILAT

Facility

$5,100.00

Service Code	HCPCS 7301050
Hospital Charge Code	94061211
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SCAPULA COMPL-BILAT

Facility

$5,100.00

Service Code	HCPCS 7301050
Hospital Charge Code	94061211
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

SCAPULA COMPL-LT

Facility

$5,100.00

Service Code	HCPCS 73010LT
Hospital Charge Code	94061281
Hospital Revenue Code	320
Min. Negotiated Rate	$663.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

SCAPULA COMPL-LT

Facility

$5,100.00

Service Code	HCPCS 73010LT
Hospital Charge Code	94061281
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SCAPULA COMPL-RT

Facility

$294.00

Service Code	HCPCS 73010RT
Hospital Charge Code	94061283
Hospital Revenue Code	320
Min. Negotiated Rate	$38.22
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$88.20
Rate for Payer: Aetna Medicare Advantage	$88.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.97
Rate for Payer: Cigna Commercial	$147.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.22
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.10
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

SCAPULA COMPL-RT

Facility

$294.00

Service Code	HCPCS 73010RT
Hospital Charge Code	94061283
Hospital Revenue Code	320
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$44.10
Rate for Payer: Qualcare PPO/HMO/WC	$44.10

SCARLET RED OINT 5% 28GM

Facility

$52.50

Hospital Charge Code	6004832
Hospital Revenue Code	252
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

SCARLET RED OINT 5% 28GM

Facility

$52.50

Hospital Charge Code	6004832
Hospital Revenue Code	252
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.83
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$26.25

SCARLET RED OINT DRESSG 5 X 9

Facility

$25.60

Hospital Charge Code	6008577
Hospital Revenue Code	252
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$12.80
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.53
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.84
Rate for Payer: UnitedHealthcare Commercial	$12.80

SCARLET RED OINT DRESSG 5 X 9

Facility

$25.60

Hospital Charge Code	6008577
Hospital Revenue Code	252
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.84

SCAT TEST

Facility

$71.25

Service Code	HCPCS 83872
Hospital Charge Code	3006723
Hospital Revenue Code	301
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.99
Rate for Payer: Aetna Medicare Advantage	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.47
Rate for Payer: Cigna Commercial	$5.86
Rate for Payer: Cigna Medicare Advantage	$2.93
Rate for Payer: Clover Medicare Advantage	$5.57
Rate for Payer: EmblemHealth Commercial	$17.58
Rate for Payer: Humana Medicare Advantage	$6.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.21
Rate for Payer: Wellcare Medicare Advantage	$5.86

SCAT TEST

Facility

$71.25

Service Code	HCPCS 83872
Hospital Charge Code	3006723
Hospital Revenue Code	301
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

SC CAN 7.0Dx45mL32mTHD11464532

Facility

$751.95

Hospital Charge Code	270638693
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SC CAN 7.0Dx45mL32mTHD11464532

Facility

$751.95

Hospital Charge Code	270638693
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

Know your out-of-pocket cost for care.

All Charges