Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHOULDER TISSUE ELEVATOR 15

Facility

$1,550.00

Hospital Charge Code	270656564
Hospital Revenue Code	272
Min. Negotiated Rate	$201.50
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$465.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$775.00

SHOULDER TISSUE ELEVATOR 30

Facility

$1,550.00

Hospital Charge Code	270656565
Hospital Revenue Code	272
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

SHOULDER TISSUE ELEVATOR 30

Facility

$1,550.00

Hospital Charge Code	270656565
Hospital Revenue Code	272
Min. Negotiated Rate	$201.50
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$465.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.50
Rate for Payer: Oxford Commercial	$775.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$775.00

SHOULDER TM PLATE REVERSE 25MM

Facility

$18,703.10

Service Code	HCPCS C1776
Hospital Charge Code	270696092
Hospital Revenue Code	278
Min. Negotiated Rate	$2,805.47
Max. Negotiated Rate	$9,351.55
Rate for Payer: Aetna Commercial	$5,610.93
Rate for Payer: Aetna Medicare Advantage	$5,610.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,769.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,769.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,740.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,769.29
Rate for Payer: Cigna Commercial	$9,351.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,526.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,805.47

SHOULDER TM PLATE REVERSE 25MM

Facility

$18,703.10

Service Code	HCPCS C1776
Hospital Charge Code	270696092
Hospital Revenue Code	278
Min. Negotiated Rate	$2,805.47
Max. Negotiated Rate	$4,526.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,740.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,526.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,805.47

SHOULDER TO HAND LONG ARM

Facility

$618.00

Service Code	HCPCS 29065
Hospital Charge Code	94186020
Hospital Revenue Code	361
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$185.40
Rate for Payer: Aetna Medicare Advantage	$185.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.59
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	$157.59
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.34
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SHOULDER TO HAND LONG ARM

Facility

$618.00

Service Code	HCPCS 29065
Hospital Charge Code	94186020
Hospital Revenue Code	361
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$31,594.36

Service Code	APR-DRG 3153
Min. Negotiated Rate	$21,467.91
Max. Negotiated Rate	$31,594.36
Rate for Payer: Aetna Better Health Medicaid	$30,974.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$31,594.36
Rate for Payer: Wellpoint Medicaid Managed Care	$21,467.91

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$21,272.17

Service Code	APR-DRG 3152
Min. Negotiated Rate	$14,922.49
Max. Negotiated Rate	$21,272.17
Rate for Payer: Aetna Better Health Medicaid	$20,855.07
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,272.17
Rate for Payer: Wellpoint Medicaid Managed Care	$14,922.49

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$13,489.11

Service Code	APR-DRG 3151
Min. Negotiated Rate	$8,821.55
Max. Negotiated Rate	$13,489.11
Rate for Payer: Aetna Better Health Medicaid	$13,224.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,489.11
Rate for Payer: Wellpoint Medicaid Managed Care	$8,821.55

SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT

Facility

$51,328.71

Service Code	APR-DRG 3154
Min. Negotiated Rate	$43,432.99
Max. Negotiated Rate	$51,328.71
Rate for Payer: Aetna Better Health Medicaid	$50,322.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$51,328.71
Rate for Payer: Wellpoint Medicaid Managed Care	$43,432.99

SHRIMP IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003G
Hospital Revenue Code	302
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
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	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

SHRIMP IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003G
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SHROUD MORTUARY LG ADULT

Facility

$19.25

Hospital Charge Code	270301960
Hospital Revenue Code	270
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SHROUD MORTUARY LG ADULT

Facility

$19.25

Hospital Charge Code	270301960
Hospital Revenue Code	270
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$9.62

SHRT ARM SPLNT FRRM TO HN

Facility

$614.91

Service Code	HCPCS 29125
Hospital Charge Code	412329125
Hospital Revenue Code	361
Min. Negotiated Rate	$92.24
Max. Negotiated Rate	$92.24
Rate for Payer: Qualcare PPO/HMO/WC	$92.24

SHRT ARM SPLNT FRRM TO HN

Facility

$288.00

Service Code	HCPCS 29125
Hospital Charge Code	94186040
Hospital Revenue Code	361
Min. Negotiated Rate	$37.44
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$86.40
Rate for Payer: Aetna Medicare Advantage	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.44
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	$73.44
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.20
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SHRT ARM SPLNT FRRM TO HN

Facility

$614.91

Service Code	HCPCS 29125
Hospital Charge Code	412329125
Hospital Revenue Code	361
Min. Negotiated Rate	$79.94
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$184.47
Rate for Payer: Aetna Medicare Advantage	$184.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.80
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	$156.80
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.94
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.24
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SHRT ARM SPLNT FRRM TO HN

Facility

$288.00

Service Code	HCPCS 29125
Hospital Charge Code	94186040
Hospital Revenue Code	361
Min. Negotiated Rate	$43.20
Max. Negotiated Rate	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$43.20

SHRT HUMERAL DIAPHYS CMNTLS -7

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686877
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

SHRT HUMERAL DIAPHYS CMNTLS -7

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686877
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

SHRT LG CST BLW KN TO TOE

Facility

$618.00

Service Code	HCPCS 29405
Hospital Charge Code	94186060
Hospital Revenue Code	361
Min. Negotiated Rate	$80.34
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$185.40
Rate for Payer: Aetna Medicare Advantage	$185.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.59
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	$157.59
Rate for Payer: Cigna Commercial	$666.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.34
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SHRT LG CST BLW KN TO TOE

Facility

$618.00

Service Code	HCPCS 29405
Hospital Charge Code	94186060
Hospital Revenue Code	361
Min. Negotiated Rate	$92.70
Max. Negotiated Rate	$92.70
Rate for Payer: Qualcare PPO/HMO/WC	$92.70

SHRT LG SPLNT CLF TO FOOT

Facility

$777.42

Service Code	HCPCS 29515
Hospital Charge Code	412329515
Hospital Revenue Code	361
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$233.23
Rate for Payer: Aetna Medicare Advantage	$233.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.24
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	$198.24
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.06
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.61
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SHRT LG SPLNT CLF TO FOOT

Facility

$288.00

Service Code	HCPCS 29515
Hospital Charge Code	94186075
Hospital Revenue Code	361
Min. Negotiated Rate	$37.44
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$86.40
Rate for Payer: Aetna Medicare Advantage	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.44
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	$73.44
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.44
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.20
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges