Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPEED IMPLANT TITAN 18x18x18MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEED IMPLANT TITAN 18x18x18MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270679103
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEEDLOCK KNOTLESS FIXATION

Facility

$5,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270668394
Hospital Revenue Code	278
Min. Negotiated Rate	$811.50
Max. Negotiated Rate	$1,309.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: Qualcare PPO/HMO/WC	$811.50

SPEEDLOCK KNOTLESS FIXATION

Facility

$5,410.00

Service Code	HCPCS C1713
Hospital Charge Code	270668394
Hospital Revenue Code	278
Min. Negotiated Rate	$811.50
Max. Negotiated Rate	$2,705.00
Rate for Payer: Aetna Commercial	$1,623.00
Rate for Payer: Aetna Medicare Advantage	$1,623.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,379.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,379.55
Rate for Payer: Cigna Commercial	$2,705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,309.22
Rate for Payer: Qualcare PPO/HMO/WC	$811.50

SPEED MTP 3.5 HEADLESS SCREW

Facility

$3,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704033
Hospital Revenue Code	278
Min. Negotiated Rate	$492.75
Max. Negotiated Rate	$794.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: Qualcare PPO/HMO/WC	$492.75

SPEED MTP 3.5 HEADLESS SCREW

Facility

$3,285.00

Service Code	HCPCS C1713
Hospital Charge Code	270704033
Hospital Revenue Code	278
Min. Negotiated Rate	$492.75
Max. Negotiated Rate	$1,642.50
Rate for Payer: Aetna Commercial	$985.50
Rate for Payer: Aetna Medicare Advantage	$985.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$837.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$837.67
Rate for Payer: Cigna Commercial	$1,642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$794.97
Rate for Payer: Qualcare PPO/HMO/WC	$492.75

SPEED MTP FAST PITCH SCREW

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704032
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SPEED MTP FAST PITCH SCREW

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704032
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SPEED MTP IMPLANT

Facility

$18,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704031
Hospital Revenue Code	278
Min. Negotiated Rate	$2,811.75
Max. Negotiated Rate	$4,536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,749.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,536.29
Rate for Payer: Qualcare PPO/HMO/WC	$2,811.75

SPEED MTP IMPLANT

Facility

$18,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270704031
Hospital Revenue Code	278
Min. Negotiated Rate	$2,811.75
Max. Negotiated Rate	$9,372.50
Rate for Payer: Aetna Commercial	$5,623.50
Rate for Payer: Aetna Medicare Advantage	$5,623.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,779.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,779.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,749.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,779.98
Rate for Payer: Cigna Commercial	$9,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,536.29
Rate for Payer: Qualcare PPO/HMO/WC	$2,811.75

SPEEDPLATE LAPIPLASTY 18X17MM

Facility

$16,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270700192
Hospital Revenue Code	278
Min. Negotiated Rate	$2,530.50
Max. Negotiated Rate	$8,435.00
Rate for Payer: Aetna Commercial	$5,061.00
Rate for Payer: Aetna Medicare Advantage	$5,061.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,301.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,301.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,301.85
Rate for Payer: Cigna Commercial	$8,435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,082.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,530.50

SPEEDPLATE LAPIPLASTY 18X17MM

Facility

$16,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270700192
Hospital Revenue Code	278
Min. Negotiated Rate	$2,530.50
Max. Negotiated Rate	$4,082.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,082.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,530.50

SPEED RELEASE DISP SN20

Facility

$2,500.00

Hospital Charge Code	270696796
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

SPEED RELEASE DISP SN20

Facility

$2,500.00

Hospital Charge Code	270696796
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SPEEDSTITCH BLACK CO-BRAID

Facility

$1,416.67

Hospital Charge Code	270674888
Hospital Revenue Code	272
Min. Negotiated Rate	$184.17
Max. Negotiated Rate	$708.34
Rate for Payer: Aetna Commercial	$425.00
Rate for Payer: Aetna Medicare Advantage	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$361.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$361.25
Rate for Payer: Cigna Commercial	$708.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.17
Rate for Payer: Oxford Commercial	$708.34
Rate for Payer: Qualcare PPO/HMO/WC	$212.50
Rate for Payer: UnitedHealthcare Commercial	$708.34

SPEEDSTITCH BLACK CO-BRAID

Facility

$1,416.67

Hospital Charge Code	270674888
Hospital Revenue Code	272
Min. Negotiated Rate	$212.50
Max. Negotiated Rate	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$212.50

SPEEDSTITCH CO-BRAID CUT CART

Facility

$1,375.00

Hospital Charge Code	270669994
Hospital Revenue Code	272
Min. Negotiated Rate	$178.75
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$412.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.75
Rate for Payer: Oxford Commercial	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$687.50

SPEEDSTITCH CO-BRAID CUT CART

Facility

$1,375.00

Hospital Charge Code	270669994
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SPEED TITAN IMPLANT 25x20x20MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,815.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPEED TITAN IMPLANT 25x20x20MM

Facility

$7,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

SPERM ANTIBODIES

Facility

$75.59

Service Code	HCPCS 89325
Hospital Charge Code	38477075
Hospital Revenue Code	300
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.57
Rate for Payer: Aetna Medicare Advantage	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.09
Rate for Payer: Cigna Commercial	$10.67
Rate for Payer: Cigna Medicare Advantage	$5.33
Rate for Payer: Clover Medicare Advantage	$10.14
Rate for Payer: EmblemHealth Commercial	$32.01
Rate for Payer: Humana Medicare Advantage	$10.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.34
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.31
Rate for Payer: Wellcare Medicare Advantage	$10.67

SPERM ANTIBODIES

Facility

$75.59

Service Code	HCPCS 89325
Hospital Charge Code	38477075
Hospital Revenue Code	300
Min. Negotiated Rate	$11.34
Max. Negotiated Rate	$11.34
Rate for Payer: Qualcare PPO/HMO/WC	$11.34

SPERM EVAL-CERVICAL MUCUS PEN

Facility

$70.00

Service Code	HCPCS 89330
Hospital Charge Code	38477065
Hospital Revenue Code	300
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

SPERM EVAL-CERVICAL MUCUS PEN

Facility

$70.00

Service Code	HCPCS 89330
Hospital Charge Code	38477065
Hospital Revenue Code	300
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.63
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.03
Rate for Payer: Cigna Commercial	$10.38
Rate for Payer: Cigna Medicare Advantage	$5.19
Rate for Payer: Clover Medicare Advantage	$9.86
Rate for Payer: EmblemHealth Commercial	$31.14
Rate for Payer: Humana Medicare Advantage	$10.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.00
Rate for Payer: Wellcare Medicare Advantage	$10.38

SPERM ISOLATION;COMPLEX PREP

Facility

$218.74

Service Code	HCPCS 89261
Hospital Charge Code	38477186
Hospital Revenue Code	300
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$65.62
Rate for Payer: Aetna Medicare Advantage	$65.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.78
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges