Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCRW BNE LOCK 18Mx2.7M 5227618

Facility

$450.00

Hospital Charge Code	270640888
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BNE LOCK 18Mx2.7M 5227618

Facility

$450.00

Hospital Charge Code	270640888
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

SCRW BON CORT 130x40HAB6013040

Facility

$808.50

Hospital Charge Code	270635001
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$195.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.66
Rate for Payer: Qualcare PPO/HMO/WC	$121.28

SCRW BON CORT 130x40HAB6013040

Facility

$808.50

Hospital Charge Code	270635001
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$404.25
Rate for Payer: Aetna Commercial	$242.55
Rate for Payer: Aetna Medicare Advantage	$242.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$161.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.17
Rate for Payer: Cigna Commercial	$404.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.66
Rate for Payer: Qualcare PPO/HMO/WC	$121.28

SCRW CANC FT 4.0 X 65MM NS

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270704929
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW CANC FT 4.0 X 65MM NS

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270704929
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCRW CANLTD 2.3mmx11mm 2642311

Facility

$575.00

Hospital Charge Code	270643919
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCRW CANLTD 2.3mmx11mm 2642311

Facility

$575.00

Hospital Charge Code	270643919
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCRW CANLTD 2.3mmx18mm 2642318

Facility

$575.00

Hospital Charge Code	270643920
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCRW CANLTD 2.3mmx18mm 2642318

Facility

$575.00

Hospital Charge Code	270643920
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCRW CANN MATRIX 6.0MM 35MM

Facility

$9,715.00

Hospital Charge Code	270656696
Hospital Revenue Code	278
Min. Negotiated Rate	$1,457.25
Max. Negotiated Rate	$4,857.50
Rate for Payer: Aetna Commercial	$2,914.50
Rate for Payer: Aetna Medicare Advantage	$2,914.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,477.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,477.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,943.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,477.32
Rate for Payer: Cigna Commercial	$4,857.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,351.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,457.25

SCRW CANN MATRIX 6.0MM 35MM

Facility

$9,715.00

Hospital Charge Code	270656696
Hospital Revenue Code	278
Min. Negotiated Rate	$1,457.25
Max. Negotiated Rate	$2,351.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,943.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,351.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,457.25

SCRW CAN PRT THD 5X28 11425128

Facility

$568.60

Hospital Charge Code	270635956
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW CAN PRT THD 5X28 11425128

Facility

$568.60

Hospital Charge Code	270635956
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW CAN PRT THD 5X30 11425130

Facility

$568.60

Hospital Charge Code	270635957
Hospital Revenue Code	272
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$85.29
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW CAN PRT THD 5X30 11425130

Facility

$568.60

Hospital Charge Code	270635957
Hospital Revenue Code	272
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.92
Rate for Payer: Oxford Commercial	$284.30
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Commercial	$284.30

SCRW CAN PRT THD 5X32 11425132

Facility

$568.60

Hospital Charge Code	270635958
Hospital Revenue Code	272
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.92
Rate for Payer: Oxford Commercial	$284.30
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Commercial	$284.30

SCRW CAN PRT THD 5X32 11425132

Facility

$568.60

Hospital Charge Code	270635958
Hospital Revenue Code	272
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$85.29
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCRW COMP HEADLES 2.4x18MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681290
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$854.58
Rate for Payer: Aetna Commercial	$512.75
Rate for Payer: Aetna Medicare Advantage	$512.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.83
Rate for Payer: Cigna Commercial	$854.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEADLES 2.4x18MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681290
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$413.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEADLES 2.4x20MM LG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681289
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$413.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEADLES 2.4x20MM LG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681289
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$854.58
Rate for Payer: Aetna Commercial	$512.75
Rate for Payer: Aetna Medicare Advantage	$512.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.83
Rate for Payer: Cigna Commercial	$854.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

SCRW COMP HEADLES 2.4x20MM SRT

Facility

$1,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270663957
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$423.00
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCRW COMP HEADLES 2.4x20MM SRT

Facility

$1,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270663957
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCRW COMP HEADLES 2.4x22MM LNG

Facility

$1,709.15

Service Code	HCPCS C1713
Hospital Charge Code	270681288
Hospital Revenue Code	278
Min. Negotiated Rate	$256.37
Max. Negotiated Rate	$854.58
Rate for Payer: Aetna Commercial	$512.75
Rate for Payer: Aetna Medicare Advantage	$512.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$435.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$435.83
Rate for Payer: Cigna Commercial	$854.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$413.61
Rate for Payer: Qualcare PPO/HMO/WC	$256.37

Know your out-of-pocket cost for care.

All Charges