Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCRW CRTCL 130mmX40mm A6013040

Facility

$718.75

Hospital Charge Code	270637341
Hospital Revenue Code	278
Min. Negotiated Rate	$107.81
Max. Negotiated Rate	$359.38
Rate for Payer: Aetna Commercial	$215.62
Rate for Payer: Aetna Medicare Advantage	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.28
Rate for Payer: Cigna Commercial	$359.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.94
Rate for Payer: Qualcare PPO/HMO/WC	$107.81

SCRW CRTCL 130mmX40mm A6013040

Facility

$718.75

Hospital Charge Code	270637341
Hospital Revenue Code	278
Min. Negotiated Rate	$107.81
Max. Negotiated Rate	$173.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.94
Rate for Payer: Qualcare PPO/HMO/WC	$107.81

SCRW CRTICL 4.5mX44m 23472344

Facility

$111.65

Hospital Charge Code	270635859
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$55.83
Rate for Payer: Aetna Commercial	$33.49
Rate for Payer: Aetna Medicare Advantage	$33.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.47
Rate for Payer: Cigna Commercial	$55.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.75

SCRW CRTICL 4.5mX44m 23472344

Facility

$111.65

Hospital Charge Code	270635859
Hospital Revenue Code	278
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$27.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.02
Rate for Payer: Qualcare PPO/HMO/WC	$16.75

SCRW CRTIL 6.5mX65m 23472665

Facility

$116.95

Hospital Charge Code	270635861
Hospital Revenue Code	278
Min. Negotiated Rate	$17.54
Max. Negotiated Rate	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.54

SCRW CRTIL 6.5mX65m 23472665

Facility

$116.95

Hospital Charge Code	270635861
Hospital Revenue Code	278
Min. Negotiated Rate	$17.54
Max. Negotiated Rate	$58.48
Rate for Payer: Aetna Commercial	$35.09
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.82
Rate for Payer: Cigna Commercial	$58.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.54

SCRW CRT LO PRF SLFTPN3.5x18MM

Facility

$150.65

Service Code	HCPCS C1713
Hospital Charge Code	270680261
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$75.33
Rate for Payer: Aetna Commercial	$45.20
Rate for Payer: Aetna Medicare Advantage	$45.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.42
Rate for Payer: Cigna Commercial	$75.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60

SCRW CRT LO PRF SLFTPN3.5x18MM

Facility

$150.65

Service Code	HCPCS C1713
Hospital Charge Code	270680261
Hospital Revenue Code	278
Min. Negotiated Rate	$22.60
Max. Negotiated Rate	$36.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.60

SCRW LAG ONE-PC 11m85m22590135

Facility

$1,036.10

Hospital Charge Code	270636139
Hospital Revenue Code	278
Min. Negotiated Rate	$155.41
Max. Negotiated Rate	$518.05
Rate for Payer: Aetna Commercial	$310.83
Rate for Payer: Aetna Medicare Advantage	$310.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.21
Rate for Payer: Cigna Commercial	$518.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.74
Rate for Payer: Qualcare PPO/HMO/WC	$155.41

SCRW LAG ONE-PC 11m85m22590135

Facility

$1,036.10

Hospital Charge Code	270636139
Hospital Revenue Code	278
Min. Negotiated Rate	$155.41
Max. Negotiated Rate	$250.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.74
Rate for Payer: Qualcare PPO/HMO/WC	$155.41

SCRW LCK 4.5x24mm 27824

Facility

$610.00

Hospital Charge Code	270648675
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCRW LCK 4.5x24mm 27824

Facility

$610.00

Hospital Charge Code	270648675
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCRW LG CAN 5.5x85 N/LCK 26485

Facility

$405.00

Hospital Charge Code	270648673
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCRW LG CAN 5.5x85 N/LCK 26485

Facility

$405.00

Hospital Charge Code	270648673
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$121.50
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCRW LG CN 5.5x80 NNLCKG 26480

Facility

$375.00

Hospital Charge Code	270639195
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCRW LG CN 5.5x80 NNLCKG 26480

Facility

$375.00

Hospital Charge Code	270639195
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCRW LOCK FULL 5x35 189650538

Facility

$910.00

Hospital Charge Code	270639019
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$273.00
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCRW LOCK FULL 5x35 189650538

Facility

$910.00

Hospital Charge Code	270639019
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCRW LOW PROF 3mmX.75mm400.833

Facility

$282.45

Hospital Charge Code	270635020
Hospital Revenue Code	278
Min. Negotiated Rate	$42.37
Max. Negotiated Rate	$68.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.35
Rate for Payer: Qualcare PPO/HMO/WC	$42.37

SCRW LOW PROF 3mmX.75mm400.833

Facility

$282.45

Hospital Charge Code	270635020
Hospital Revenue Code	278
Min. Negotiated Rate	$42.37
Max. Negotiated Rate	$141.22
Rate for Payer: Aetna Commercial	$84.73
Rate for Payer: Aetna Medicare Advantage	$84.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.02
Rate for Payer: Cigna Commercial	$141.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.35
Rate for Payer: Qualcare PPO/HMO/WC	$42.37

SCRW MATR MIDFA 4MM04503224015

Facility

$365.00

Hospital Charge Code	270640740
Hospital Revenue Code	278
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$88.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

SCRW MATR MIDFA 4MM04503224015

Facility

$365.00

Hospital Charge Code	270640740
Hospital Revenue Code	278
Min. Negotiated Rate	$54.75
Max. Negotiated Rate	$182.50
Rate for Payer: Aetna Commercial	$109.50
Rate for Payer: Aetna Medicare Advantage	$109.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.08
Rate for Payer: Cigna Commercial	$182.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.33
Rate for Payer: Qualcare PPO/HMO/WC	$54.75

SCRW MD 3.5MMx18MM 8163-35-018

Facility

$1,245.00

Hospital Charge Code	270661593
Hospital Revenue Code	278
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$373.50
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

SCRW MD 3.5MMx18MM 8163-35-018

Facility

$1,245.00

Hospital Charge Code	270661593
Hospital Revenue Code	278
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$301.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.29
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

SCRW METPHYS SLFTP T8 2.7x10MM

Facility

$200.50

Service Code	HCPCS C1713
Hospital Charge Code	270677642
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$60.15
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

Know your out-of-pocket cost for care.

All Charges