Heights University Hospital

All Charges

Charge

Type

Setting

Price

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	74110015
Hospital Revenue Code	481
Min. Negotiated Rate	$43.54
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$1,023.13
Rate for Payer: Aetna Medicare Advantage	$1,023.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$869.66
Rate for Payer: Cigna Commercial	$43.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.36
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.57
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

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	$43.54
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$1,023.13
Rate for Payer: Aetna Medicare Advantage	$1,023.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$869.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$869.66
Rate for Payer: Cigna Commercial	$43.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.36
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.57
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

S&I COR/SVG/IMA/AO

Facility

$3,410.45

Service Code	HCPCS 93568
Hospital Charge Code	74110015
Hospital Revenue Code	481
Min. Negotiated Rate	$511.57
Max. Negotiated Rate	$511.57
Rate for Payer: Qualcare PPO/HMO/WC	$511.57

SIDE CUTTER (ADULT)

Facility

$191.00

Hospital Charge Code	270335569
Hospital Revenue Code	272
Min. Negotiated Rate	$28.65
Max. Negotiated Rate	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.65

SIDE CUTTER (ADULT)

Facility

$191.00

Hospital Charge Code	270335569
Hospital Revenue Code	272
Min. Negotiated Rate	$24.83
Max. Negotiated Rate	$95.50
Rate for Payer: Aetna Commercial	$57.30
Rate for Payer: Aetna Medicare Advantage	$57.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.70
Rate for Payer: Cigna Commercial	$95.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.83
Rate for Payer: Oxford Commercial	$95.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.65
Rate for Payer: UnitedHealthcare Commercial	$95.50

SIDE CUTTER BUR AM-10

Facility

$310.00

Hospital Charge Code	270335564
Hospital Revenue Code	272
Min. Negotiated Rate	$40.30
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$155.00

SIDE CUTTER BUR AM-10

Facility

$310.00

Hospital Charge Code	270335564
Hospital Revenue Code	272
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

SIDE CUTTER BUR TU-10

Facility

$321.00

Hospital Charge Code	270335563
Hospital Revenue Code	272
Min. Negotiated Rate	$41.73
Max. Negotiated Rate	$160.50
Rate for Payer: Aetna Commercial	$96.30
Rate for Payer: Aetna Medicare Advantage	$96.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.86
Rate for Payer: Cigna Commercial	$160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.73
Rate for Payer: Oxford Commercial	$160.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.15
Rate for Payer: UnitedHealthcare Commercial	$160.50

SIDE CUTTER BUR TU-10

Facility

$321.00

Hospital Charge Code	270335563
Hospital Revenue Code	272
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$48.15
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

SIDE CUTTER CRANIOTOME

Facility

$186.00

Hospital Charge Code	270335568
Hospital Revenue Code	272
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

SIDE CUTTER CRANIOTOME

Facility

$186.00

Hospital Charge Code	270335568
Hospital Revenue Code	272
Min. Negotiated Rate	$24.18
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$55.80
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$93.00

SIDE CUTTING BUR 1.5 X7.5

Facility

$208.00

Hospital Charge Code	270332569
Hospital Revenue Code	272
Min. Negotiated Rate	$27.04
Max. Negotiated Rate	$104.00
Rate for Payer: Aetna Commercial	$62.40
Rate for Payer: Aetna Medicare Advantage	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.04
Rate for Payer: Cigna Commercial	$104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.04
Rate for Payer: Oxford Commercial	$104.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$104.00

SIDE CUTTING BUR 1.5 X7.5

Facility

$208.00

Hospital Charge Code	270332569
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

SIDE CUTTING BUR 2 X 19

Facility

$248.00

Hospital Charge Code	270332570
Hospital Revenue Code	272
Min. Negotiated Rate	$37.20
Max. Negotiated Rate	$37.20
Rate for Payer: Qualcare PPO/HMO/WC	$37.20

SIDE CUTTING BUR 2 X 19

Facility

$248.00

Hospital Charge Code	270332570
Hospital Revenue Code	272
Min. Negotiated Rate	$32.24
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.40
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$124.00

SIGMA SHIM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703545
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$1,475.00
Rate for Payer: Aetna Commercial	$885.00
Rate for Payer: Aetna Medicare Advantage	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.25
Rate for Payer: Cigna Commercial	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

SIGMA SHIM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270703545
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$713.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

SIGMA TLIF MIS

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270703775
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SIGMA TLIF MIS

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270703775
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SIGMOIDOSCOPE DISP

Facility

$10.15

Hospital Charge Code	270649352
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.52

SIGMOIDOSCOPE DISP

Facility

$19.25

Hospital Charge Code	270301975
Hospital Revenue Code	279
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SIGMOIDOSCOPE DISP

Facility

$10.15

Hospital Charge Code	270649352
Hospital Revenue Code	270
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$5.08
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$3.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.59
Rate for Payer: Cigna Commercial	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.32
Rate for Payer: Oxford Commercial	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.52
Rate for Payer: UnitedHealthcare Commercial	$5.08

SIGMOIDOSCOPE DISP

Facility

$19.25

Hospital Charge Code	270301975
Hospital Revenue Code	279
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

SIGMOIDOSCOPE W/SUBMUC INJ

Facility

$3,720.52

Service Code	HCPCS 45335
Hospital Charge Code	16000981
Hospital Revenue Code	360
Min. Negotiated Rate	$558.08
Max. Negotiated Rate	$558.08
Rate for Payer: Qualcare PPO/HMO/WC	$558.08

SIGMOIDOSCOPE W/SUBMUC INJ

Facility

$3,720.52

Service Code	HCPCS 45335
Hospital Charge Code	16000981
Hospital Revenue Code	360
Min. Negotiated Rate	$483.67
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,116.16
Rate for Payer: Aetna Medicare Advantage	$1,116.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$948.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$948.73
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	$948.73
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.67
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$558.08
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

Know your out-of-pocket cost for care.

All Charges