Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHOULDER ARTHROSCOPY/SURGER-RT

Facility

$50,586.00

Service Code	HCPCS 29807
Hospital Charge Code	16000243
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$15,175.80
Rate for Payer: Aetna Medicare Advantage	$15,175.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,899.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,899.43
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	$12,899.43
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,576.18
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

SHOULDER ARTHROSCOPY/SURGERY

Facility

$26,295.79

Service Code	HCPCS 29820
Hospital Charge Code	16000296
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$7,888.74
Rate for Payer: Aetna Medicare Advantage	$7,888.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,705.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,705.43
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	$6,705.43
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,418.45
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,944.37
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

SHOULDER ARTHROSCOPY/SURGERY

Facility

$26,295.79

Service Code	HCPCS 29820
Hospital Charge Code	16000296
Hospital Revenue Code	360
Min. Negotiated Rate	$3,944.37
Max. Negotiated Rate	$3,944.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,944.37

SHOULDER ARTHROSCOPY/SURGRY-R

Facility

$50,586.00

Service Code	HCPCS 29806
Hospital Charge Code	16000341
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$15,175.80
Rate for Payer: Aetna Medicare Advantage	$15,175.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,899.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,899.43
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	$12,899.43
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,576.18
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

SHOULDER ARTHROSCOPY/SURGRY-R

Facility

$50,586.00

Service Code	HCPCS 29806
Hospital Charge Code	16000341
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

SHOULDER BMT 7 115 11-113703

Facility

$15,585.00

Hospital Charge Code	270619988
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$3,771.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

SHOULDER BMT 7 115 11-113703

Facility

$15,585.00

Hospital Charge Code	270619988
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$7,792.50
Rate for Payer: Aetna Commercial	$4,675.50
Rate for Payer: Aetna Medicare Advantage	$4,675.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,974.18
Rate for Payer: Cigna Commercial	$7,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

SHOULDER BMT 9 115 11-113705

Facility

$15,585.00

Hospital Charge Code	270620288
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$3,771.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

SHOULDER BMT 9 115 11-113705

Facility

$15,585.00

Hospital Charge Code	270620288
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$7,792.50
Rate for Payer: Aetna Commercial	$4,675.50
Rate for Payer: Aetna Medicare Advantage	$4,675.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,974.18
Rate for Payer: Cigna Commercial	$7,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

SHOULDER DEBRIDEMENT RASP

Facility

$1,900.00

Hospital Charge Code	270656561
Hospital Revenue Code	272
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$285.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

SHOULDER DEBRIDEMENT RASP

Facility

$1,900.00

Hospital Charge Code	270656561
Hospital Revenue Code	272
Min. Negotiated Rate	$247.00
Max. Negotiated Rate	$950.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.50
Rate for Payer: Cigna Commercial	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$247.00
Rate for Payer: Oxford Commercial	$950.00
Rate for Payer: Qualcare PPO/HMO/WC	$285.00
Rate for Payer: UnitedHealthcare Commercial	$950.00

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC

Facility

$72,178.35

Service Code	MSDRG 511
Min. Negotiated Rate	$22,691.62
Max. Negotiated Rate	$72,178.35
Rate for Payer: Aetna Commercial	$70,117.11
Rate for Payer: Aetna Medicare Advantage	$22,691.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,858.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,858.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,059.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,858.33
Rate for Payer: Cigna Commercial	$44,750.77
Rate for Payer: Cigna Medicare Advantage	$24,059.45
Rate for Payer: Clover Medicare Advantage	$22,856.48
Rate for Payer: EmblemHealth Commercial	$72,178.35
Rate for Payer: Humana Medicare Advantage	$24,781.23
Rate for Payer: Oxford Commercial	$27,967.93
Rate for Payer: UnitedHealthcare Commercial	$31,746.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,059.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25,503.02
Rate for Payer: Wellcare Medicare Advantage	$24,059.45

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC

Facility

$101,850.91

Service Code	MSDRG 510
Min. Negotiated Rate	$31,506.58
Max. Negotiated Rate	$101,850.91
Rate for Payer: Aetna Commercial	$101,850.91
Rate for Payer: Aetna Medicare Advantage	$32,961.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74,982.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74,982.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74,982.24
Rate for Payer: Cigna Commercial	$65,004.18
Rate for Payer: Cigna Medicare Advantage	$33,164.82
Rate for Payer: Clover Medicare Advantage	$31,506.58
Rate for Payer: EmblemHealth Commercial	$99,494.46
Rate for Payer: Humana Medicare Advantage	$34,159.76
Rate for Payer: Oxford Commercial	$40,625.72
Rate for Payer: UnitedHealthcare Commercial	$46,113.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$33,164.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$35,154.71
Rate for Payer: Wellcare Medicare Advantage	$33,164.82

SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC

Facility

$59,871.42

Service Code	MSDRG 512
Min. Negotiated Rate	$18,064.69
Max. Negotiated Rate	$59,871.42
Rate for Payer: Aetna Commercial	$55,819.89
Rate for Payer: Aetna Medicare Advantage	$18,064.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,382.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,382.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,957.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,382.87
Rate for Payer: Cigna Commercial	$35,625.86
Rate for Payer: Cigna Medicare Advantage	$19,957.14
Rate for Payer: Clover Medicare Advantage	$18,959.28
Rate for Payer: EmblemHealth Commercial	$59,871.42
Rate for Payer: Humana Medicare Advantage	$20,555.85
Rate for Payer: Oxford Commercial	$22,265.13
Rate for Payer: UnitedHealthcare Commercial	$25,272.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,957.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21,154.57
Rate for Payer: Wellcare Medicare Advantage	$19,957.14

SHOULDER EQUINOXE HUMERAL 0 mm

Facility

$27,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270679728
Hospital Revenue Code	278
Min. Negotiated Rate	$4,181.25
Max. Negotiated Rate	$6,745.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,745.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,181.25

SHOULDER EQUINOXE HUMERAL 0 mm

Facility

$27,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270679728
Hospital Revenue Code	278
Min. Negotiated Rate	$4,181.25
Max. Negotiated Rate	$13,937.50
Rate for Payer: Aetna Commercial	$8,362.50
Rate for Payer: Aetna Medicare Advantage	$8,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,108.12
Rate for Payer: Cigna Commercial	$13,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,745.75
Rate for Payer: Qualcare PPO/HMO/WC	$4,181.25

SHOULDER GD BN L

Facility

$5,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692333
Hospital Revenue Code	278
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$1,379.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.40
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

SHOULDER GD BN L

Facility

$5,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692333
Hospital Revenue Code	278
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.40
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

SHOULDER GD COMPRIT

Facility

$5,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692396
Hospital Revenue Code	278
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$1,379.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.40
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

SHOULDER GD COMPRIT

Facility

$5,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270692396
Hospital Revenue Code	278
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.40
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

SHOULDER GD COMPRIT R

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270693243
Hospital Revenue Code	272
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.50
Rate for Payer: Cigna Commercial	$2,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$741.00
Rate for Payer: Oxford Commercial	$2,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00
Rate for Payer: UnitedHealthcare Commercial	$2,850.00

SHOULDER GD COMPRIT R

Facility

$5,700.00

Service Code	HCPCS A4649
Hospital Charge Code	270693243
Hospital Revenue Code	272
Min. Negotiated Rate	$855.00
Max. Negotiated Rate	$855.00
Rate for Payer: Qualcare PPO/HMO/WC	$855.00

SHOULDER GLENOID BASEPLATE SM-

Facility

$6,300.00

Service Code	HCPCS C1776
Hospital Charge Code	270685158
Hospital Revenue Code	278
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$1,524.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,524.60
Rate for Payer: Qualcare PPO/HMO/WC	$945.00

SHOULDER GLENOID BASEPLATE SM-

Facility

$6,300.00

Service Code	HCPCS C1776
Hospital Charge Code	270685158
Hospital Revenue Code	278
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$3,150.00
Rate for Payer: Aetna Commercial	$1,890.00
Rate for Payer: Aetna Medicare Advantage	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,606.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,606.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,606.50
Rate for Payer: Cigna Commercial	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,524.60
Rate for Payer: Qualcare PPO/HMO/WC	$945.00

SHOULDER GLENOID FOSSA TM 12MM

Facility

$3,087.50

Service Code	HCPCS C1776
Hospital Charge Code	270696615
Hospital Revenue Code	278
Min. Negotiated Rate	$463.12
Max. Negotiated Rate	$1,543.75
Rate for Payer: Aetna Commercial	$926.25
Rate for Payer: Aetna Medicare Advantage	$926.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$787.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$787.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$617.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$787.31
Rate for Payer: Cigna Commercial	$1,543.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.17
Rate for Payer: Qualcare PPO/HMO/WC	$463.12

Know your out-of-pocket cost for care.

All Charges