Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHORT STOP NEEDLE HOLDER SS20

Facility

$12.50

Hospital Charge Code	270646069C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SHORT STOP NEEDLE HOLDER SS20

Facility

$12.50

Hospital Charge Code	270646069C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$6.25

SHORT STOP NEEDLE HOLDER SS20

Facility

$301.25

Hospital Charge Code	270646069
Hospital Revenue Code	279
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$150.62
Rate for Payer: Aetna Commercial	$90.38
Rate for Payer: Aetna Medicare Advantage	$90.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.82
Rate for Payer: Cigna Commercial	$150.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.16
Rate for Payer: Oxford Commercial	$150.62
Rate for Payer: Qualcare PPO/HMO/WC	$45.19
Rate for Payer: UnitedHealthcare Commercial	$150.62

SHORT STOP NEEDLE HOLDER SS20

Facility

$301.25

Hospital Charge Code	270646069
Hospital Revenue Code	279
Min. Negotiated Rate	$45.19
Max. Negotiated Rate	$45.19
Rate for Payer: Qualcare PPO/HMO/WC	$45.19

SHOULD COMP RVS CNTRL 6.5X20MM

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	270693794
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SHOULD COMP RVS CNTRL 6.5X20MM

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	270693794
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SHOULDER 1 VIEW-BILAT

Facility

$250.00

Service Code	HCPCS 7302050
Hospital Charge Code	94061213
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

SHOULDER 1 VIEW-BILAT

Facility

$250.00

Service Code	HCPCS 7302050
Hospital Charge Code	94061213
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SHOULDER 1 VIEW-LT

Facility

$250.00

Service Code	HCPCS 73020LT
Hospital Charge Code	94061285
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

SHOULDER 1 VIEW-LT

Facility

$250.00

Service Code	HCPCS 73020LT
Hospital Charge Code	94061285
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SHOULDER 1 VIEW-RT

Facility

$6,601.19

Service Code	HCPCS 73020RT
Hospital Charge Code	94061287
Hospital Revenue Code	320
Min. Negotiated Rate	$990.18
Max. Negotiated Rate	$990.18
Rate for Payer: Qualcare PPO/HMO/WC	$990.18

SHOULDER 1 VIEW-RT

Facility

$6,601.19

Service Code	HCPCS 73020RT
Hospital Charge Code	94061287
Hospital Revenue Code	320
Min. Negotiated Rate	$858.15
Max. Negotiated Rate	$3,300.59
Rate for Payer: Aetna Commercial	$1,980.36
Rate for Payer: Aetna Medicare Advantage	$1,980.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.30
Rate for Payer: Cigna Commercial	$3,300.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.15
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$990.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

SHOULDER 36MM GLENOSPHERE

Facility

$12,525.00

Service Code	HCPCS C1776
Hospital Charge Code	270680625
Hospital Revenue Code	278
Min. Negotiated Rate	$1,878.75
Max. Negotiated Rate	$6,262.50
Rate for Payer: Aetna Commercial	$3,757.50
Rate for Payer: Aetna Medicare Advantage	$3,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,193.88
Rate for Payer: Cigna Commercial	$6,262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,031.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,878.75

SHOULDER 36MM GLENOSPHERE

Facility

$12,525.00

Service Code	HCPCS C1776
Hospital Charge Code	270680625
Hospital Revenue Code	278
Min. Negotiated Rate	$1,878.75
Max. Negotiated Rate	$3,031.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,031.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,878.75

SHOULDER AND ELBOW JOINT REPLACEMENT

Facility

$50,459.45

Service Code	APR-DRG 3224
Min. Negotiated Rate	$37,504.47
Max. Negotiated Rate	$50,459.45
Rate for Payer: Aetna Better Health Medicaid	$49,470.05
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$50,459.45
Rate for Payer: Wellpoint Medicaid Managed Care	$37,504.47

SHOULDER AND ELBOW JOINT REPLACEMENT

Facility

$35,068.83

Service Code	APR-DRG 3223
Min. Negotiated Rate	$22,363.10
Max. Negotiated Rate	$35,068.83
Rate for Payer: Aetna Better Health Medicaid	$34,381.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,068.83
Rate for Payer: Wellpoint Medicaid Managed Care	$22,363.10

SHOULDER AND ELBOW JOINT REPLACEMENT

Facility

$26,636.87

Service Code	APR-DRG 3222
Min. Negotiated Rate	$15,827.54
Max. Negotiated Rate	$26,636.87
Rate for Payer: Aetna Better Health Medicaid	$26,114.58
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,636.87
Rate for Payer: Wellpoint Medicaid Managed Care	$15,827.54

SHOULDER AND ELBOW JOINT REPLACEMENT

Facility

$24,683.39

Service Code	APR-DRG 3221
Min. Negotiated Rate	$14,520.66
Max. Negotiated Rate	$24,683.39
Rate for Payer: Aetna Better Health Medicaid	$24,199.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,683.39
Rate for Payer: Wellpoint Medicaid Managed Care	$14,520.66

SHOULDER,ARTHOSCOPY,DX

Facility

$25,603.80

Service Code	HCPCS 29805
Hospital Charge Code	16000728
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$7,681.14
Rate for Payer: Aetna Medicare Advantage	$7,681.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,528.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,528.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,528.97
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,328.49
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,840.57
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

SHOULDER,ARTHOSCOPY,DX

Facility

$25,603.80

Service Code	HCPCS 29805
Hospital Charge Code	16000728
Hospital Revenue Code	360
Min. Negotiated Rate	$3,840.57
Max. Negotiated Rate	$3,840.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,840.57

SHOULDER ARTHOSCOPY KIT

Facility

$647.00

Hospital Charge Code	270338754
Hospital Revenue Code	272
Min. Negotiated Rate	$84.11
Max. Negotiated Rate	$323.50
Rate for Payer: Aetna Commercial	$194.10
Rate for Payer: Aetna Medicare Advantage	$194.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.99
Rate for Payer: Cigna Commercial	$323.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.11
Rate for Payer: Oxford Commercial	$323.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.05
Rate for Payer: UnitedHealthcare Commercial	$323.50

SHOULDER ARTHOSCOPY KIT

Facility

$647.00

Hospital Charge Code	270338754
Hospital Revenue Code	272
Min. Negotiated Rate	$97.05
Max. Negotiated Rate	$97.05
Rate for Payer: Qualcare PPO/HMO/WC	$97.05

SHOULDER ARTHROGRAM INJ

Facility

$272.05

Service Code	HCPCS 23350
Hospital Charge Code	16000676
Hospital Revenue Code	360
Min. Negotiated Rate	$40.81
Max. Negotiated Rate	$40.81
Rate for Payer: Qualcare PPO/HMO/WC	$40.81

SHOULDER ARTHROGRAM INJ

Facility

$272.05

Service Code	HCPCS 23350
Hospital Charge Code	16000676
Hospital Revenue Code	360
Min. Negotiated Rate	$35.37
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$81.61
Rate for Payer: Aetna Medicare Advantage	$81.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.37
Rate for Payer: Cigna Commercial	$45.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.37
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.81
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SHOULDER ARTHROSCOPY/SURGER-RT

Facility

$50,586.00

Service Code	HCPCS 29807
Hospital Charge Code	16000243
Hospital Revenue Code	360
Min. Negotiated Rate	$7,587.90
Max. Negotiated Rate	$7,587.90
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90

Know your out-of-pocket cost for care.

All Charges