Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHIELD STRY BURR GRD 2296-302

Facility

$239.25

Hospital Charge Code	270610813
Hospital Revenue Code	272
Min. Negotiated Rate	$35.89
Max. Negotiated Rate	$35.89
Rate for Payer: Qualcare PPO/HMO/WC	$35.89

SHIELD STRY BURR GRD 2296-302

Facility

$239.25

Hospital Charge Code	270610813
Hospital Revenue Code	272
Min. Negotiated Rate	$31.10
Max. Negotiated Rate	$119.62
Rate for Payer: Aetna Commercial	$71.78
Rate for Payer: Aetna Medicare Advantage	$71.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.01
Rate for Payer: Cigna Commercial	$119.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.10
Rate for Payer: Oxford Commercial	$119.62
Rate for Payer: Qualcare PPO/HMO/WC	$35.89
Rate for Payer: UnitedHealthcare Commercial	$119.62

SHIGA TOXIN EIA W REFLX E COLI

Facility

$390.00

Service Code	HCPCS 87427
Hospital Charge Code	401187427
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
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	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

SHIGA TOXIN EIA W REFLX E COLI

Facility

$390.00

Service Code	HCPCS 87427
Hospital Charge Code	401187427
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SHILEY SG LUMAN SUB CAN UDAL**

Facility

$168.00

Hospital Charge Code	8002479
Hospital Revenue Code	279
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

SHILEY SG LUMAN SUB CAN UDAL**

Facility

$168.00

Hospital Charge Code	8002479
Hospital Revenue Code	279
Min. Negotiated Rate	$21.84
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$50.40
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$84.00

SHIM 10/12MMX29MM 6 DEGREE

Facility

$10,000.00

Hospital Charge Code	270702409
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 10/12MMX29MM 6 DEGREE

Facility

$10,000.00

Hospital Charge Code	270702409
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 10/13X29MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703703
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 10/13X29MM

Facility

$10,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703703
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 10MM X 30MM 0 DEGREE

Facility

$18,975.00

Service Code	HCPCS L8699
Hospital Charge Code	270693058
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$4,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

SHIM 10MM X 30MM 0 DEGREE

Facility

$18,975.00

Service Code	HCPCS L8699
Hospital Charge Code	270693058
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$9,487.50
Rate for Payer: Aetna Commercial	$5,692.50
Rate for Payer: Aetna Medicare Advantage	$5,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,838.62
Rate for Payer: Cigna Commercial	$9,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

SHIM 11/13 X 25 MM

Facility

$10,000.00

Hospital Charge Code	270703302
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 11/13 X 25 MM

Facility

$10,000.00

Hospital Charge Code	270703302
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 12 OR 14X29MM FH11 6D

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270695889
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$9,487.50
Rate for Payer: Aetna Commercial	$5,692.50
Rate for Payer: Aetna Medicare Advantage	$5,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,838.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,838.62
Rate for Payer: Cigna Commercial	$9,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

SHIM 12 OR 14X29MM FH11 6D

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270695889
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$4,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

SHIM 13X29MM 6DEG TI 9

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270694159
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$5,625.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

SHIM 13X29MM 6DEG TI 9

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270694159
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

SHIM 14MMX29MM 0 DEG STRL

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270694286
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$5,625.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

SHIM 14MMX29MM 0 DEG STRL

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270694286
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

SHIM 14MMX29MM 6DEG

Facility

$19,875.00

Service Code	HCPCS L8699
Hospital Charge Code	270692918
Hospital Revenue Code	278
Min. Negotiated Rate	$2,981.25
Max. Negotiated Rate	$9,937.50
Rate for Payer: Aetna Commercial	$5,962.50
Rate for Payer: Aetna Medicare Advantage	$5,962.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,068.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,068.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,068.12
Rate for Payer: Cigna Commercial	$9,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,809.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,981.25

SHIM 14MMX29MM 6DEG

Facility

$19,875.00

Service Code	HCPCS L8699
Hospital Charge Code	270692918
Hospital Revenue Code	278
Min. Negotiated Rate	$2,981.25
Max. Negotiated Rate	$4,809.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,809.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,981.25

SHIM 9MM 0 DEGREE

Facility

$10,000.00

Hospital Charge Code	270702408
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 9MM 0 DEGREE

Facility

$10,000.00

Hospital Charge Code	270702408
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

SHIM 9MM X3MM FH7 FLAREHAWK

Facility

$18,975.00

Service Code	HCPCS C1889
Hospital Charge Code	270692115
Hospital Revenue Code	278
Min. Negotiated Rate	$2,846.25
Max. Negotiated Rate	$4,591.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,591.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,846.25

Know your out-of-pocket cost for care.

All Charges