Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCRW METPHYS SLFTP T8 2.7x30MM

Facility

$194.65

Service Code	HCPCS C1713
Hospital Charge Code	270677645
Hospital Revenue Code	278
Min. Negotiated Rate	$29.20
Max. Negotiated Rate	$47.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.11
Rate for Payer: Qualcare PPO/HMO/WC	$29.20

SCRW METPHYS SLFTP T8 2.7x30MM

Facility

$194.65

Service Code	HCPCS C1713
Hospital Charge Code	270677645
Hospital Revenue Code	278
Min. Negotiated Rate	$29.20
Max. Negotiated Rate	$97.33
Rate for Payer: Aetna Commercial	$58.40
Rate for Payer: Aetna Medicare Advantage	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.64
Rate for Payer: Cigna Commercial	$97.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.11
Rate for Payer: Qualcare PPO/HMO/WC	$29.20

SCRW N-LCK PIT R3CON 3.5X26MM

Facility

$612.00

Service Code	HCPCS C1713
Hospital Charge Code	270702048
Hospital Revenue Code	278
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$148.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.10
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

SCRW N-LCK PIT R3CON 3.5X26MM

Facility

$612.00

Service Code	HCPCS C1713
Hospital Charge Code	270702048
Hospital Revenue Code	278
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.10
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

SCRW RELN MAS 8.5X45MM 2CPLYAX

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686470
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$2,700.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SCRW RELN MAS 8.5X45MM 2CPLYAX

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686470
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SCRW SLF TAP VAR ANGL 3.5X44MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270678175
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$198.60
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCRW SLF TAP VAR ANGL 3.5X44MM

Facility

$662.00

Service Code	HCPCS C1713
Hospital Charge Code	270678175
Hospital Revenue Code	278
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$160.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.20
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

SCRW ST 4.5 X 14 MM

Facility

$2,700.00

Hospital Charge Code	270648863
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$810.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCRW ST 4.5 X 14 MM

Facility

$2,700.00

Hospital Charge Code	270648863
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCRW V-LOCK 90-DEG 3.8x26mNL26

Facility

$421.65

Hospital Charge Code	270636724
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$126.50
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SCRW V-LOCK 90-DEG 3.8x26mNL26

Facility

$421.65

Hospital Charge Code	270636724
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$102.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SCRW V-LOCK 90-DEG 3.8x36mNL36

Facility

$421.65

Hospital Charge Code	270636726
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$210.82
Rate for Payer: Aetna Commercial	$126.50
Rate for Payer: Aetna Medicare Advantage	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.52
Rate for Payer: Cigna Commercial	$210.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SCRW V-LOCK 90-DEG 3.8x36mNL36

Facility

$421.65

Hospital Charge Code	270636726
Hospital Revenue Code	278
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$102.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.04
Rate for Payer: Qualcare PPO/HMO/WC	$63.25

SCRW ZIM COMP HX 1 47-1162-21

Facility

$183.80

Hospital Charge Code	270602003
Hospital Revenue Code	278
Min. Negotiated Rate	$27.57
Max. Negotiated Rate	$44.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.48
Rate for Payer: Qualcare PPO/HMO/WC	$27.57

SCRW ZIM COMP HX 1 47-1162-21

Facility

$183.80

Hospital Charge Code	270602003
Hospital Revenue Code	278
Min. Negotiated Rate	$27.57
Max. Negotiated Rate	$91.90
Rate for Payer: Aetna Commercial	$55.14
Rate for Payer: Aetna Medicare Advantage	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.87
Rate for Payer: Cigna Commercial	$91.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.48
Rate for Payer: Qualcare PPO/HMO/WC	$27.57

SCRW ZIM CORT 4.5 38M 48453801

Facility

$63.75

Hospital Charge Code	270601791
Hospital Revenue Code	272
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$9.56
Rate for Payer: Qualcare PPO/HMO/WC	$9.56

SCRW ZIM CORT 4.5 38M 48453801

Facility

$63.75

Hospital Charge Code	270601791
Hospital Revenue Code	272
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$31.88
Rate for Payer: Aetna Commercial	$19.12
Rate for Payer: Aetna Medicare Advantage	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.26
Rate for Payer: Cigna Commercial	$31.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.29
Rate for Payer: Oxford Commercial	$31.88
Rate for Payer: Qualcare PPO/HMO/WC	$9.56
Rate for Payer: UnitedHealthcare Commercial	$31.88

SCW BO SELFTAP 6.5x20m62506520

Facility

$534.50

Service Code	HCPCS C1713
Hospital Charge Code	270638665
Hospital Revenue Code	278
Min. Negotiated Rate	$80.17
Max. Negotiated Rate	$129.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.35
Rate for Payer: Qualcare PPO/HMO/WC	$80.17

SCW BO SELFTAP 6.5x20m62506520

Facility

$534.50

Service Code	HCPCS C1713
Hospital Charge Code	270638665
Hospital Revenue Code	278
Min. Negotiated Rate	$80.17
Max. Negotiated Rate	$267.25
Rate for Payer: Aetna Commercial	$160.35
Rate for Payer: Aetna Medicare Advantage	$160.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.30
Rate for Payer: Cigna Commercial	$267.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.35
Rate for Payer: Qualcare PPO/HMO/WC	$80.17

SCW CAN SHT THD 3 X 38MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701646
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCW CAN SHT THD 3 X 38MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701646
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCW CAN SHT THD 4 X 46MM

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701644
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$262.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

SCW CAN SHT THD 4 X 46MM

Facility

$1,086.25

Service Code	HCPCS C1713
Hospital Charge Code	270701644
Hospital Revenue Code	278
Min. Negotiated Rate	$162.94
Max. Negotiated Rate	$543.12
Rate for Payer: Aetna Commercial	$325.88
Rate for Payer: Aetna Medicare Advantage	$325.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.99
Rate for Payer: Cigna Commercial	$543.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.94

Know your out-of-pocket cost for care.

All Charges