Heights University Hospital

All Charges

Charge

Type

Setting

Price

SM AND SM/RNP AB I

Facility

$390.00

Service Code	HCPCS 8623591
Hospital Charge Code	39990080A
Hospital Revenue Code	302
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

SM AND SM/RNP AB I

Facility

$390.00

Service Code	HCPCS 8623591
Hospital Charge Code	39990080A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SM AND SM/RNP AB II

Facility

$390.00

Service Code	HCPCS 8623591
Hospital Charge Code	39990080B
Hospital Revenue Code	302
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

SM AND SM/RNP AB II

Facility

$390.00

Service Code	HCPCS 8623591
Hospital Charge Code	39990080B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SMARTLOCK HMMF PLATE

Facility

$1,653.80

Service Code	HCPCS C1713
Hospital Charge Code	270705878
Hospital Revenue Code	278
Min. Negotiated Rate	$248.07
Max. Negotiated Rate	$826.90
Rate for Payer: Aetna Commercial	$496.14
Rate for Payer: Aetna Medicare Advantage	$496.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$421.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$421.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$421.72
Rate for Payer: Cigna Commercial	$826.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.22
Rate for Payer: Qualcare PPO/HMO/WC	$248.07

SMARTLOCK HMMF PLATE

Facility

$1,653.80

Service Code	HCPCS C1713
Hospital Charge Code	270705878
Hospital Revenue Code	278
Min. Negotiated Rate	$248.07
Max. Negotiated Rate	$400.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$330.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$400.22
Rate for Payer: Qualcare PPO/HMO/WC	$248.07

SMART PORT CT TI 8FRX66CM CATH

Facility

$1,705.00

Service Code	HCPCS C1788
Hospital Charge Code	270698053
Hospital Revenue Code	278
Min. Negotiated Rate	$255.75
Max. Negotiated Rate	$852.50
Rate for Payer: Aetna Commercial	$511.50
Rate for Payer: Aetna Medicare Advantage	$511.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$434.77
Rate for Payer: Cigna Commercial	$852.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.61
Rate for Payer: Qualcare PPO/HMO/WC	$255.75

SMART PORT CT TI 8FRX66CM CATH

Facility

$1,705.00

Service Code	HCPCS C1788
Hospital Charge Code	270698053
Hospital Revenue Code	278
Min. Negotiated Rate	$255.75
Max. Negotiated Rate	$412.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$341.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.61
Rate for Payer: Qualcare PPO/HMO/WC	$255.75

SM DISP BAYONET 18CMX1.5MM TIP

Facility

$10,980.00

Hospital Charge Code	270692098
Hospital Revenue Code	272
Min. Negotiated Rate	$1,647.00
Max. Negotiated Rate	$1,647.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,647.00

SM DISP BAYONET 18CMX1.5MM TIP

Facility

$10,980.00

Hospital Charge Code	270692098
Hospital Revenue Code	272
Min. Negotiated Rate	$1,427.40
Max. Negotiated Rate	$5,490.00
Rate for Payer: Aetna Commercial	$3,294.00
Rate for Payer: Aetna Medicare Advantage	$3,294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,799.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,799.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,799.90
Rate for Payer: Cigna Commercial	$5,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,427.40
Rate for Payer: Oxford Commercial	$5,490.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,647.00
Rate for Payer: UnitedHealthcare Commercial	$5,490.00

SME 14 FMT STD

Facility

$15,945.85

Hospital Charge Code	270657118
Hospital Revenue Code	278
Min. Negotiated Rate	$2,391.88
Max. Negotiated Rate	$7,972.93
Rate for Payer: Aetna Commercial	$4,783.76
Rate for Payer: Aetna Medicare Advantage	$4,783.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,066.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,066.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,189.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,066.19
Rate for Payer: Cigna Commercial	$7,972.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,858.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,391.88

SME 14 FMT STD

Facility

$15,945.85

Hospital Charge Code	270657118
Hospital Revenue Code	278
Min. Negotiated Rate	$2,391.88
Max. Negotiated Rate	$3,858.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,189.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,858.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,391.88

SMEAR FLUORESCENT/ACID STAIN

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	401087206
Hospital Revenue Code	306
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
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	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

SMEAR FLUORESCENT/ACID STAIN

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	401087206
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SMEAR,FOR OVA& PARASITES

Facility

$127.29

Service Code	HCPCS 87209
Hospital Charge Code	38475079
Hospital Revenue Code	309
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$19.09
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

SMEAR,FOR OVA& PARASITES

Facility

$127.29

Service Code	HCPCS 87209
Hospital Charge Code	38475079
Hospital Revenue Code	309
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.88
Rate for Payer: Cigna Commercial	$17.98
Rate for Payer: Cigna Medicare Advantage	$8.99
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.06
Rate for Payer: Wellcare Medicare Advantage	$17.98

SMEAR GRAM STAIN-SO

Facility

$63.94

Service Code	HCPCS 87205
Hospital Charge Code	40134446C
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.59
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

SMEAR GRAM STAIN-SO

Facility

$149.72

Service Code	HCPCS 87205
Hospital Charge Code	40464556B
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.46
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

SMEAR GRAM STAIN-SO

Facility

$94.66

Service Code	HCPCS 87205
Hospital Charge Code	4013388B
Hospital Revenue Code	306
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$14.20
Rate for Payer: Qualcare PPO/HMO/WC	$14.20

SMEAR GRAM STAIN-SO

Facility

$63.94

Service Code	HCPCS 87205
Hospital Charge Code	40134446C
Hospital Revenue Code	306
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$9.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.59

SMEAR GRAM STAIN-SO

Facility

$103.94

Service Code	HCPCS 87205
Hospital Charge Code	40134469B
Hospital Revenue Code	306
Min. Negotiated Rate	$15.59
Max. Negotiated Rate	$15.59
Rate for Payer: Qualcare PPO/HMO/WC	$15.59

SMEAR GRAM STAIN-SO

Facility

$103.94

Service Code	HCPCS 87205
Hospital Charge Code	40134469B
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.59
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

SMEAR GRAM STAIN-SO

Facility

$149.72

Service Code	HCPCS 87205
Hospital Charge Code	40464556B
Hospital Revenue Code	306
Min. Negotiated Rate	$22.46
Max. Negotiated Rate	$22.46
Rate for Payer: Qualcare PPO/HMO/WC	$22.46

SMEAR GRAM STAIN-SO

Facility

$94.66

Service Code	HCPCS 87205
Hospital Charge Code	4013388B
Hospital Revenue Code	306
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

SM INTESTINE F/U MULT ADD-ON

Facility

$5,100.00

Service Code	HCPCS 74248
Hospital Charge Code	404174248
Hospital Revenue Code	320
Min. Negotiated Rate	$68.82
Max. Negotiated Rate	$1,530.00
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	$68.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$89.86
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

Know your out-of-pocket cost for care.

All Charges