Heights University Hospital

All Charges

Charge

Type

Setting

Price

SHUNT VALVE MED PRESS IMP

Facility

$5,553.60

Service Code	HCPCS L8699
Hospital Charge Code	270696362
Hospital Revenue Code	278
Min. Negotiated Rate	$833.04
Max. Negotiated Rate	$1,343.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.97
Rate for Payer: Qualcare PPO/HMO/WC	$833.04

SHUNT VALVE MED PRESS IMP

Facility

$5,553.60

Service Code	HCPCS L8699
Hospital Charge Code	270696362
Hospital Revenue Code	278
Min. Negotiated Rate	$833.04
Max. Negotiated Rate	$2,776.80
Rate for Payer: Aetna Commercial	$1,666.08
Rate for Payer: Aetna Medicare Advantage	$1,666.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,416.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,416.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,110.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,416.17
Rate for Payer: Cigna Commercial	$2,776.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,343.97
Rate for Payer: Qualcare PPO/HMO/WC	$833.04

SHUNT VCP DELTA L1 130CM

Facility

$9,366.05

Service Code	HCPCS L8699
Hospital Charge Code	270694798
Hospital Revenue Code	278
Min. Negotiated Rate	$1,404.91
Max. Negotiated Rate	$4,683.02
Rate for Payer: Aetna Commercial	$2,809.82
Rate for Payer: Aetna Medicare Advantage	$2,809.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,388.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,388.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,873.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,388.34
Rate for Payer: Cigna Commercial	$4,683.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,266.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,404.91

SHUNT VCP DELTA L1 130CM

Facility

$9,366.05

Service Code	HCPCS L8699
Hospital Charge Code	270694798
Hospital Revenue Code	278
Min. Negotiated Rate	$1,404.91
Max. Negotiated Rate	$2,266.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,873.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,266.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,404.91

SHUNT VP DELTA ASSY SM LEV 1.5

Facility

$10,665.60

Service Code	HCPCS C1729
Hospital Charge Code	270693250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,599.84
Max. Negotiated Rate	$2,581.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,133.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,581.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,599.84

SHUNT VP DELTA ASSY SM LEV 1.5

Facility

$10,665.60

Service Code	HCPCS C1729
Hospital Charge Code	270693250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,599.84
Max. Negotiated Rate	$5,332.80
Rate for Payer: Aetna Commercial	$3,199.68
Rate for Payer: Aetna Medicare Advantage	$3,199.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,719.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,719.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,133.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,719.73
Rate for Payer: Cigna Commercial	$5,332.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,581.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,599.84

SHUR CLENS WOUND CLEANSER*****

Facility

$9.00

Hospital Charge Code	8004012
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

SHUR CLENS WOUND CLEANSER*****

Facility

$9.00

Hospital Charge Code	8004012
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SHURFIT TPLIF2C 7MMX29MM

Facility

$22,100.00

Service Code	HCPCS C1889
Hospital Charge Code	270695749
Hospital Revenue Code	278
Min. Negotiated Rate	$3,315.00
Max. Negotiated Rate	$11,050.00
Rate for Payer: Aetna Commercial	$6,630.00
Rate for Payer: Aetna Medicare Advantage	$6,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,635.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,635.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,635.50
Rate for Payer: Cigna Commercial	$11,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,348.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,315.00

SHURFIT TPLIF2C 7MMX29MM

Facility

$22,100.00

Service Code	HCPCS C1889
Hospital Charge Code	270695749
Hospital Revenue Code	278
Min. Negotiated Rate	$3,315.00
Max. Negotiated Rate	$5,348.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,348.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,315.00

SIALIC ACID

Facility

$95.00

Service Code	HCPCS 84275
Hospital Charge Code	38477116
Hospital Revenue Code	301
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

SIALIC ACID

Facility

$95.00

Service Code	HCPCS 84275
Hospital Charge Code	38477116
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.55
Rate for Payer: Aetna Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.24
Rate for Payer: Cigna Commercial	$13.44
Rate for Payer: Cigna Medicare Advantage	$6.72
Rate for Payer: Clover Medicare Advantage	$12.77
Rate for Payer: EmblemHealth Commercial	$40.32
Rate for Payer: Humana Medicare Advantage	$13.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.25
Rate for Payer: Wellcare Medicare Advantage	$13.44

SICKLE CELL

Facility

$208.00

Service Code	HCPCS 85660
Hospital Charge Code	38473018
Hospital Revenue Code	305
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.85
Rate for Payer: Aetna Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.19
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: Cigna Medicare Advantage	$2.75
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.84
Rate for Payer: Wellcare Medicare Advantage	$5.51

SICKLE CELL

Facility

$208.00

Service Code	HCPCS 85660
Hospital Charge Code	38473018
Hospital Revenue Code	305
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

SICKLE CELL ANEMIA CRISIS

Facility

$9,441.65

Service Code	APR-DRG 6622
Min. Negotiated Rate	$7,592.40
Max. Negotiated Rate	$9,441.65
Rate for Payer: Aetna Better Health Medicaid	$9,256.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,441.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7,592.40

SICKLE CELL ANEMIA CRISIS

Facility

$28,417.68

Service Code	APR-DRG 6624
Min. Negotiated Rate	$27,640.84
Max. Negotiated Rate	$28,417.68
Rate for Payer: Aetna Better Health Medicaid	$27,860.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,417.68
Rate for Payer: Wellpoint Medicaid Managed Care	$27,640.84

SICKLE CELL ANEMIA CRISIS

Facility

$13,616.87

Service Code	APR-DRG 6623
Min. Negotiated Rate	$11,764.36
Max. Negotiated Rate	$13,616.87
Rate for Payer: Aetna Better Health Medicaid	$13,349.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,616.87
Rate for Payer: Wellpoint Medicaid Managed Care	$11,764.36

SICKLE CELL ANEMIA CRISIS

Facility

$6,910.97

Service Code	APR-DRG 6621
Min. Negotiated Rate	$5,542.66
Max. Negotiated Rate	$6,910.97
Rate for Payer: Aetna Better Health Medicaid	$6,775.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,910.97
Rate for Payer: Wellpoint Medicaid Managed Care	$5,542.66

SICKLE CELL SCREEN

Facility

$390.00

Service Code	HCPCS 85660
Hospital Charge Code	39900182
Hospital Revenue Code	305
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.85
Rate for Payer: Aetna Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.19
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: Cigna Medicare Advantage	$2.75
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
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	$5.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.84
Rate for Payer: Wellcare Medicare Advantage	$5.51

SICKLE CELL SCREEN

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3003621
Hospital Revenue Code	305
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.85
Rate for Payer: Aetna Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.19
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: Cigna Medicare Advantage	$2.75
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.84
Rate for Payer: Wellcare Medicare Advantage	$5.51

SICKLE CELL SCREEN

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3003621
Hospital Revenue Code	305
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$16.39
Rate for Payer: Qualcare PPO/HMO/WC	$16.39

SICKLE CELL SCREEN

Facility

$390.00

Service Code	HCPCS 85660
Hospital Charge Code	39900182
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SICKLING OF RBC, REDUCTION

Facility

$60.00

Service Code	HCPCS 85660
Hospital Charge Code	3001519B
Hospital Revenue Code	305
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

SICKLING OF RBC, REDUCTION

Facility

$60.00

Service Code	HCPCS 85660
Hospital Charge Code	3001519B
Hospital Revenue Code	305
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.85
Rate for Payer: Aetna Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.19
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: Cigna Medicare Advantage	$2.75
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.84
Rate for Payer: Wellcare Medicare Advantage	$5.51

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	5100110
Hospital Revenue Code	481
Min. Negotiated Rate	$511.57
Max. Negotiated Rate	$511.57
Rate for Payer: Qualcare PPO/HMO/WC	$511.57

Know your out-of-pocket cost for care.

All Charges