Heights University Hospital

All Charges

Charge

Type

Setting

Price

SIGN: NOTICE AUTHERIZED PERSON

Facility

$57.15

Hospital Charge Code	270657158
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57

SIGN: NOTICE AUTHERIZED PERSON

Facility

$57.15

Hospital Charge Code	270657158
Hospital Revenue Code	270
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$28.57
Rate for Payer: Aetna Commercial	$17.14
Rate for Payer: Aetna Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.57
Rate for Payer: Cigna Commercial	$28.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.43
Rate for Payer: Oxford Commercial	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57
Rate for Payer: UnitedHealthcare Commercial	$28.57

SIGN: NOTICE KEEP THIS DOOR CL

Facility

$57.15

Hospital Charge Code	270657157
Hospital Revenue Code	270
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$28.57
Rate for Payer: Aetna Commercial	$17.14
Rate for Payer: Aetna Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.57
Rate for Payer: Cigna Commercial	$28.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.43
Rate for Payer: Oxford Commercial	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57
Rate for Payer: UnitedHealthcare Commercial	$28.57

SIGN: NOTICE KEEP THIS DOOR CL

Facility

$57.15

Hospital Charge Code	270657157
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57

SIGN POST 5 FT 19 IN W 19 IN D

Facility

$694.10

Hospital Charge Code	270683581
Hospital Revenue Code	272
Min. Negotiated Rate	$104.11
Max. Negotiated Rate	$104.11
Rate for Payer: Qualcare PPO/HMO/WC	$104.11

SIGN POST 5 FT 19 IN W 19 IN D

Facility

$694.10

Hospital Charge Code	270683581
Hospital Revenue Code	272
Min. Negotiated Rate	$90.23
Max. Negotiated Rate	$347.05
Rate for Payer: Aetna Commercial	$208.23
Rate for Payer: Aetna Medicare Advantage	$208.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.00
Rate for Payer: Cigna Commercial	$347.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.23
Rate for Payer: Oxford Commercial	$347.05
Rate for Payer: Qualcare PPO/HMO/WC	$104.11
Rate for Payer: UnitedHealthcare Commercial	$347.05

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC

Facility

$50,188.44

Service Code	MSDRG 555
Min. Negotiated Rate	$14,424.25
Max. Negotiated Rate	$50,188.44
Rate for Payer: Aetna Commercial	$44,570.93
Rate for Payer: Aetna Medicare Advantage	$14,424.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,593.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,593.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,729.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,593.80
Rate for Payer: Cigna Commercial	$28,446.46
Rate for Payer: Cigna Medicare Advantage	$16,729.48
Rate for Payer: Clover Medicare Advantage	$15,893.01
Rate for Payer: EmblemHealth Commercial	$50,188.44
Rate for Payer: Humana Medicare Advantage	$17,231.36
Rate for Payer: Oxford Commercial	$17,778.21
Rate for Payer: UnitedHealthcare Commercial	$20,179.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,729.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17,733.25
Rate for Payer: Wellcare Medicare Advantage	$16,729.48

SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC

Facility

$35,931.00

Service Code	MSDRG 556
Min. Negotiated Rate	$9,063.99
Max. Negotiated Rate	$35,931.00
Rate for Payer: Aetna Commercial	$28,007.73
Rate for Payer: Aetna Medicare Advantage	$9,063.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,604.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,604.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,977.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,604.94
Rate for Payer: Cigna Commercial	$17,875.34
Rate for Payer: Cigna Medicare Advantage	$11,977.00
Rate for Payer: Clover Medicare Advantage	$11,378.15
Rate for Payer: EmblemHealth Commercial	$35,931.00
Rate for Payer: Humana Medicare Advantage	$12,336.31
Rate for Payer: Oxford Commercial	$11,171.57
Rate for Payer: UnitedHealthcare Commercial	$12,680.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,977.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,695.62
Rate for Payer: Wellcare Medicare Advantage	$11,977.00

SIGNS AND SYMPTOMS WITH MCC

Facility

$48,667.50

Service Code	MSDRG 947
Min. Negotiated Rate	$13,852.43
Max. Negotiated Rate	$48,667.50
Rate for Payer: Aetna Commercial	$42,804.01
Rate for Payer: Aetna Medicare Advantage	$13,852.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,458.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,458.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,222.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,458.75
Rate for Payer: Cigna Commercial	$27,318.76
Rate for Payer: Cigna Medicare Advantage	$16,222.50
Rate for Payer: Clover Medicare Advantage	$15,411.38
Rate for Payer: EmblemHealth Commercial	$48,667.50
Rate for Payer: Humana Medicare Advantage	$16,709.17
Rate for Payer: Oxford Commercial	$17,073.43
Rate for Payer: UnitedHealthcare Commercial	$19,379.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,222.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17,195.85
Rate for Payer: Wellcare Medicare Advantage	$16,222.50

SIGNS AND SYMPTOMS WITHOUT MCC

Facility

$35,057.34

Service Code	MSDRG 948
Min. Negotiated Rate	$8,735.52
Max. Negotiated Rate	$35,057.34
Rate for Payer: Aetna Commercial	$26,992.76
Rate for Payer: Aetna Medicare Advantage	$8,735.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,685.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,053.60
Rate for Payer: Cigna Commercial	$17,227.56
Rate for Payer: Cigna Medicare Advantage	$11,685.78
Rate for Payer: Clover Medicare Advantage	$11,101.49
Rate for Payer: EmblemHealth Commercial	$35,057.34
Rate for Payer: Humana Medicare Advantage	$12,036.35
Rate for Payer: Oxford Commercial	$10,766.73
Rate for Payer: UnitedHealthcare Commercial	$12,221.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,685.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,386.93
Rate for Payer: Wellcare Medicare Advantage	$11,685.78

SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$5,152.65

Service Code	APR-DRG 8611
Min. Negotiated Rate	$4,150.30
Max. Negotiated Rate	$5,152.65
Rate for Payer: Aetna Better Health Medicaid	$5,051.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,152.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4,150.30

SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$8,417.85

Service Code	APR-DRG 8612
Min. Negotiated Rate	$5,428.14
Max. Negotiated Rate	$8,417.85
Rate for Payer: Aetna Better Health Medicaid	$8,252.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,417.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5,428.14

SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$17,571.65

Service Code	APR-DRG 8614
Min. Negotiated Rate	$16,334.03
Max. Negotiated Rate	$17,571.65
Rate for Payer: Aetna Better Health Medicaid	$17,227.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,571.65
Rate for Payer: Wellpoint Medicaid Managed Care	$16,334.03

SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS

Facility

$12,233.59

Service Code	APR-DRG 8613
Min. Negotiated Rate	$7,759.98
Max. Negotiated Rate	$12,233.59
Rate for Payer: Aetna Better Health Medicaid	$11,993.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,233.59
Rate for Payer: Wellpoint Medicaid Managed Care	$7,759.98

SI JOINTS 3+ VIEWS

Facility

$5,100.00

Service Code	HCPCS 72202
Hospital Charge Code	94061099
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SI JOINTS 3+ VIEWS

Facility

$5,100.00

Service Code	HCPCS 72202
Hospital Charge Code	94061099
Hospital Revenue Code	320
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$309.88
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
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	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$316.08

SILDENAFIL 10MG (HALF TAB)

Facility

$141.17

Service Code	HCPCS S0090
Hospital Charge Code	606390401
Hospital Revenue Code	636
Min. Negotiated Rate	$21.18
Max. Negotiated Rate	$70.58
Rate for Payer: Aetna Commercial	$42.35
Rate for Payer: Aetna Medicare Advantage	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.00
Rate for Payer: Cigna Commercial	$70.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.16
Rate for Payer: Qualcare PPO/HMO/WC	$21.18

SILDENAFIL 10MG (HALF TAB)

Facility

$141.17

Service Code	HCPCS S0090
Hospital Charge Code	606390401
Hospital Revenue Code	636
Min. Negotiated Rate	$21.18
Max. Negotiated Rate	$34.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.16
Rate for Payer: Qualcare PPO/HMO/WC	$21.18

SILDENAFIL CITRATE 20 MG TAB

Facility

$141.17

Service Code	NDC 13668018505
Hospital Charge Code	60630054
Hospital Revenue Code	250
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$70.58
Rate for Payer: Aetna Commercial	$42.35
Rate for Payer: Aetna Medicare Advantage	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.00
Rate for Payer: Cigna Commercial	$70.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.35
Rate for Payer: Oxford Commercial	$70.58
Rate for Payer: Qualcare PPO/HMO/WC	$21.18
Rate for Payer: UnitedHealthcare Commercial	$70.58

SILDENAFIL CITRATE 20 MG TAB

Facility

$141.17

Service Code	NDC 13668018505
Hospital Charge Code	60630054
Hospital Revenue Code	250
Min. Negotiated Rate	$21.18
Max. Negotiated Rate	$21.18
Rate for Payer: Qualcare PPO/HMO/WC	$21.18

SILICONE TUBING SET

Facility

$235.00

Hospital Charge Code	270332544
Hospital Revenue Code	272
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

SILICONE TUBING SET

Facility

$235.00

Hospital Charge Code	270332544
Hospital Revenue Code	272
Min. Negotiated Rate	$30.55
Max. Negotiated Rate	$117.50
Rate for Payer: Aetna Commercial	$70.50
Rate for Payer: Aetna Medicare Advantage	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.92
Rate for Payer: Cigna Commercial	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.55
Rate for Payer: Oxford Commercial	$117.50
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$117.50

SILSPORT W/CANNULA 5-12MM

Facility

$3,041.04

Hospital Charge Code	270664790
Hospital Revenue Code	272
Min. Negotiated Rate	$395.34
Max. Negotiated Rate	$1,520.52
Rate for Payer: Aetna Commercial	$912.31
Rate for Payer: Aetna Medicare Advantage	$912.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$775.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$775.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$775.47
Rate for Payer: Cigna Commercial	$1,520.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$395.34
Rate for Payer: Oxford Commercial	$1,520.52
Rate for Payer: Qualcare PPO/HMO/WC	$456.16
Rate for Payer: UnitedHealthcare Commercial	$1,520.52

SILSPORT W/CANNULA 5-12MM

Facility

$3,041.04

Hospital Charge Code	270664790
Hospital Revenue Code	272
Min. Negotiated Rate	$456.16
Max. Negotiated Rate	$456.16
Rate for Payer: Qualcare PPO/HMO/WC	$456.16

SI LUTION SCREW 12X45MM

Facility

$15,625.00

Hospital Charge Code	270702341
Hospital Revenue Code	278
Min. Negotiated Rate	$2,343.75
Max. Negotiated Rate	$3,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,781.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,343.75

Know your out-of-pocket cost for care.

All Charges