Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHELL ZIM BIPOLAR 49 500149

Facility

$2,706.20

Hospital Charge Code	270625370
Hospital Revenue Code	278
Min. Negotiated Rate	$405.93
Max. Negotiated Rate	$654.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$541.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.90
Rate for Payer: Qualcare PPO/HMO/WC	$405.93

SHELL ZIM BIPOLAR 49 500149

Facility

$2,706.20

Hospital Charge Code	270625370
Hospital Revenue Code	278
Min. Negotiated Rate	$405.93
Max. Negotiated Rate	$1,353.10
Rate for Payer: Aetna Commercial	$811.86
Rate for Payer: Aetna Medicare Advantage	$811.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$690.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$690.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$541.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$690.08
Rate for Payer: Cigna Commercial	$1,353.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.90
Rate for Payer: Qualcare PPO/HMO/WC	$405.93

SHELL ZIM BIPOLAR 51 500151

Facility

$2,581.35

Hospital Charge Code	270626236
Hospital Revenue Code	278
Min. Negotiated Rate	$387.20
Max. Negotiated Rate	$624.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$516.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.69
Rate for Payer: Qualcare PPO/HMO/WC	$387.20

SHELL ZIM BIPOLAR 51 500151

Facility

$2,581.35

Hospital Charge Code	270626236
Hospital Revenue Code	278
Min. Negotiated Rate	$387.20
Max. Negotiated Rate	$1,290.67
Rate for Payer: Aetna Commercial	$774.40
Rate for Payer: Aetna Medicare Advantage	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$658.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$658.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$516.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$658.24
Rate for Payer: Cigna Commercial	$1,290.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.69
Rate for Payer: Qualcare PPO/HMO/WC	$387.20

SHELL ZIM BIPOLAR 55 500155

Facility

$2,706.20

Hospital Charge Code	270629555
Hospital Revenue Code	278
Min. Negotiated Rate	$405.93
Max. Negotiated Rate	$654.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$541.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.90
Rate for Payer: Qualcare PPO/HMO/WC	$405.93

SHELL ZIM BIPOLAR 55 500155

Facility

$2,706.20

Hospital Charge Code	270629555
Hospital Revenue Code	278
Min. Negotiated Rate	$405.93
Max. Negotiated Rate	$1,353.10
Rate for Payer: Aetna Commercial	$811.86
Rate for Payer: Aetna Medicare Advantage	$811.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$690.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$690.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$541.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$690.08
Rate for Payer: Cigna Commercial	$1,353.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.90
Rate for Payer: Qualcare PPO/HMO/WC	$405.93

SHEM 2MM HEAD ACRYLIC

Facility

$85.00

Hospital Charge Code	270676914
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

SHEM 2MM HEAD ACRYLIC

Facility

$85.00

Hospital Charge Code	270676914
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.05
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$42.50

SHEPARD GROMMET VENT WIRE

Facility

$66.00

Hospital Charge Code	270331993
Hospital Revenue Code	272
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

SHEPARD GROMMET VENT WIRE

Facility

$66.00

Hospital Charge Code	270331993
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

SHIELD BREAST

Facility

$39.25

Hospital Charge Code	270130185
Hospital Revenue Code	272
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$11.78
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$19.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$19.62

SHIELD BREAST

Facility

$39.25

Hospital Charge Code	270130185
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

SHIELD BREAST *******

Facility

$16.00

Hospital Charge Code	8000226
Hospital Revenue Code	279
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$4.80
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$8.00

SHIELD BREAST *******

Facility

$16.00

Hospital Charge Code	8000226
Hospital Revenue Code	279
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

SHIELD BREAST *******

Facility

$6.00

Hospital Charge Code	1801125
Hospital Revenue Code	279
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SHIELD BREAST *******

Facility

$6.00

Hospital Charge Code	1801125
Hospital Revenue Code	279
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

SHIELD BREAST ********

Facility

$32.00

Hospital Charge Code	1800085
Hospital Revenue Code	279
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SHIELD BREAST ********

Facility

$32.00

Hospital Charge Code	1800085
Hospital Revenue Code	279
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

SHIELD BREAST 4295089922

Facility

$36.85

Hospital Charge Code	270622862
Hospital Revenue Code	272
Min. Negotiated Rate	$5.53
Max. Negotiated Rate	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$5.53

SHIELD BREAST 4295089922

Facility

$36.85

Hospital Charge Code	270622862
Hospital Revenue Code	272
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$18.43
Rate for Payer: Aetna Commercial	$11.05
Rate for Payer: Aetna Medicare Advantage	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.40
Rate for Payer: Cigna Commercial	$18.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.79
Rate for Payer: Oxford Commercial	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$5.53
Rate for Payer: UnitedHealthcare Commercial	$18.43

SHIELD CONTACT NIPPLE 24MM

Facility

$21.67

Hospital Charge Code	270664917
Hospital Revenue Code	270
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.25

SHIELD CONTACT NIPPLE 24MM

Facility

$21.67

Hospital Charge Code	270664917
Hospital Revenue Code	270
Min. Negotiated Rate	$2.82
Max. Negotiated Rate	$10.84
Rate for Payer: Aetna Commercial	$6.50
Rate for Payer: Aetna Medicare Advantage	$6.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.53
Rate for Payer: Cigna Commercial	$10.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.82
Rate for Payer: Oxford Commercial	$10.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.25
Rate for Payer: UnitedHealthcare Commercial	$10.84

SHIELD DURA 10X15 555DS1015

Facility

$2,122.45

Hospital Charge Code	270619625
Hospital Revenue Code	278
Min. Negotiated Rate	$318.37
Max. Negotiated Rate	$1,061.22
Rate for Payer: Aetna Commercial	$636.74
Rate for Payer: Aetna Medicare Advantage	$636.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$424.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.22
Rate for Payer: Cigna Commercial	$1,061.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.63
Rate for Payer: Qualcare PPO/HMO/WC	$318.37

SHIELD DURA 10X15 555DS1015

Facility

$2,122.45

Hospital Charge Code	270619625
Hospital Revenue Code	278
Min. Negotiated Rate	$318.37
Max. Negotiated Rate	$513.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$424.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.63
Rate for Payer: Qualcare PPO/HMO/WC	$318.37

SHIELD EYE

Facility

$7.00

Hospital Charge Code	8000663
Hospital Revenue Code	279
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

Know your out-of-pocket cost for care.

All Charges