Heights University Hospital

All Charges

Charge

Type

Setting

Price

SC CAN 7.0Dx45mL32mTHD11465032

Facility

$751.95

Hospital Charge Code	270638694
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

SC CAN 7.0Dx45mL32mTHD11465032

Facility

$751.95

Hospital Charge Code	270638694
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 COR 2.4x12mSELFTAP40151296

Facility

$297.65

Hospital Charge Code	270636269
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

SC COR 2.4x12mSELFTAP40151296

Facility

$297.65

Hospital Charge Code	270636269
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$72.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

SC COR 2.4x14m SELFTAP40151496

Facility

$297.65

Hospital Charge Code	270636270
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$148.82
Rate for Payer: Aetna Commercial	$89.30
Rate for Payer: Aetna Medicare Advantage	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.90
Rate for Payer: Cigna Commercial	$148.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

SC COR 2.4x14m SELFTAP40151496

Facility

$297.65

Hospital Charge Code	270636270
Hospital Revenue Code	278
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$72.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.03
Rate for Payer: Qualcare PPO/HMO/WC	$44.65

S. CERVISIAE IGA

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900374
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

S. CERVISIAE IGA

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900374
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	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
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

S. CERVISIAE IGG

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900373
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

S. CERVISIAE IGG

Facility

$390.00

Service Code	HCPCS 86671
Hospital Charge Code	39900373
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	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
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

SCEW BONE CORTICAL 5.0MMx40MM

Facility

$1,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270656705
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$280.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.72
Rate for Payer: Qualcare PPO/HMO/WC	$174.00

SCEW BONE CORTICAL 5.0MMx40MM

Facility

$1,160.00

Service Code	HCPCS C1713
Hospital Charge Code	270656705
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$580.00
Rate for Payer: Aetna Commercial	$348.00
Rate for Payer: Aetna Medicare Advantage	$348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.80
Rate for Payer: Cigna Commercial	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.72
Rate for Payer: Qualcare PPO/HMO/WC	$174.00

SCEW LCK T8 FL THS 2.4 X 22L

Facility

$1,316.85

Service Code	HCPCS C1713
Hospital Charge Code	270703687
Hospital Revenue Code	278
Min. Negotiated Rate	$197.53
Max. Negotiated Rate	$658.42
Rate for Payer: Aetna Commercial	$395.06
Rate for Payer: Aetna Medicare Advantage	$395.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$335.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$335.80
Rate for Payer: Cigna Commercial	$658.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.68
Rate for Payer: Qualcare PPO/HMO/WC	$197.53

SCEW LCK T8 FL THS 2.4 X 22L

Facility

$1,316.85

Service Code	HCPCS C1713
Hospital Charge Code	270703687
Hospital Revenue Code	278
Min. Negotiated Rate	$197.53
Max. Negotiated Rate	$318.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$263.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$318.68
Rate for Payer: Qualcare PPO/HMO/WC	$197.53

SCHISTOSOMA AB

Facility

$390.00

Service Code	HCPCS 86682
Hospital Charge Code	39900378
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCHISTOSOMA AB

Facility

$390.00

Service Code	HCPCS 86682
Hospital Charge Code	39900378
Hospital Revenue Code	302
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.15
Rate for Payer: Aetna Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.67
Rate for Payer: Cigna Commercial	$13.01
Rate for Payer: Cigna Medicare Advantage	$6.50
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.79
Rate for Payer: Wellcare Medicare Advantage	$13.01

SCHISTOSOMA AB IGG FMI

Facility

$88.75

Service Code	HCPCS 86682
Hospital Charge Code	39708007
Hospital Revenue Code	302
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$13.31
Rate for Payer: Qualcare PPO/HMO/WC	$13.31

SCHISTOSOMA AB IGG FMI

Facility

$88.75

Service Code	HCPCS 86682
Hospital Charge Code	39708007
Hospital Revenue Code	302
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.15
Rate for Payer: Aetna Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.67
Rate for Payer: Cigna Commercial	$13.01
Rate for Payer: Cigna Medicare Advantage	$6.50
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.31
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.79
Rate for Payer: Wellcare Medicare Advantage	$13.01

SCHISTOSOMIASIS,URINE I

Facility

$390.00

Service Code	HCPCS 87015
Hospital Charge Code	39990124A
Hospital Revenue Code	309
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.64
Rate for Payer: Aetna Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.48
Rate for Payer: Cigna Commercial	$6.68
Rate for Payer: Cigna Medicare Advantage	$3.34
Rate for Payer: Clover Medicare Advantage	$6.35
Rate for Payer: EmblemHealth Commercial	$20.04
Rate for Payer: Humana Medicare Advantage	$6.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.08
Rate for Payer: Wellcare Medicare Advantage	$6.68

SCHISTOSOMIASIS,URINE I

Facility

$390.00

Service Code	HCPCS 87015
Hospital Charge Code	39990124A
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCHISTOSOMIASIS,URINE II

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	39990124B
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SCHISTOSOMIASIS,URINE II

Facility

$390.00

Service Code	HCPCS 87210
Hospital Charge Code	39990124B
Hospital Revenue Code	309
Min. Negotiated Rate	$2.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.86
Rate for Payer: Aetna Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.32
Rate for Payer: Cigna Commercial	$5.82
Rate for Payer: Cigna Medicare Advantage	$2.91
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.17
Rate for Payer: Wellcare Medicare Advantage	$5.82

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$9,134.08

Service Code	APR-DRG 7502
Min. Negotiated Rate	$7,094.62
Max. Negotiated Rate	$9,134.08
Rate for Payer: Aetna Better Health Medicaid	$8,954.98
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,134.08
Rate for Payer: Wellpoint Medicaid Managed Care	$7,094.62

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$32,647.64

Service Code	APR-DRG 7504
Min. Negotiated Rate	$20,803.09
Max. Negotiated Rate	$32,647.64
Rate for Payer: Aetna Better Health Medicaid	$32,007.49
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$32,647.64
Rate for Payer: Wellpoint Medicaid Managed Care	$20,803.09

SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS

Facility

$14,656.09

Service Code	APR-DRG 7503
Min. Negotiated Rate	$10,350.15
Max. Negotiated Rate	$14,656.09
Rate for Payer: Aetna Better Health Medicaid	$14,368.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,656.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10,350.15

Know your out-of-pocket cost for care.

All Charges