Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPHINCTEROTOME WC HUIBRG HPC-3

Facility

$649.60

Hospital Charge Code	270623621
Hospital Revenue Code	272
Min. Negotiated Rate	$84.45
Max. Negotiated Rate	$324.80
Rate for Payer: Aetna Commercial	$194.88
Rate for Payer: Aetna Medicare Advantage	$194.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.65
Rate for Payer: Cigna Commercial	$324.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.45
Rate for Payer: Oxford Commercial	$324.80
Rate for Payer: Qualcare PPO/HMO/WC	$97.44
Rate for Payer: UnitedHealthcare Commercial	$324.80

SPHINCTEROTOME WC HUIBRG HPC-3

Facility

$649.60

Hospital Charge Code	270623621
Hospital Revenue Code	272
Min. Negotiated Rate	$97.44
Max. Negotiated Rate	$97.44
Rate for Payer: Qualcare PPO/HMO/WC	$97.44

SPHINCTEROTOMY***

Facility

$383.00

Hospital Charge Code	2300218
Hospital Revenue Code	759
Min. Negotiated Rate	$57.45
Max. Negotiated Rate	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

SPHINCTEROTOMY***

Facility

$383.00

Hospital Charge Code	2300218
Hospital Revenue Code	759
Min. Negotiated Rate	$49.79
Max. Negotiated Rate	$191.50
Rate for Payer: Aetna Commercial	$114.90
Rate for Payer: Aetna Medicare Advantage	$114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.67
Rate for Payer: Cigna Commercial	$191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.79
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

SPHINCTERTMY ANL DIV OF SPH

Facility

$16,685.10

Service Code	HCPCS 46080
Hospital Charge Code	1600000381
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,609.93
Rate for Payer: Aetna Commercial	$5,005.53
Rate for Payer: Aetna Medicare Advantage	$5,005.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,254.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,254.70
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	$4,254.70
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,169.06
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

SPHINCTERTMY ANL DIV OF SPH

Facility

$16,685.10

Service Code	HCPCS 46080
Hospital Charge Code	1600000381
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.76
Max. Negotiated Rate	$2,502.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.76

SPHINCTER URINARY AMS800

Facility

$69,500.00

Service Code	HCPCS C1813
Hospital Charge Code	270700789
Hospital Revenue Code	278
Min. Negotiated Rate	$10,425.00
Max. Negotiated Rate	$34,750.00
Rate for Payer: Aetna Commercial	$20,850.00
Rate for Payer: Aetna Medicare Advantage	$20,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,722.50
Rate for Payer: Cigna Commercial	$34,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,819.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,425.00

SPHINCTER URINARY AMS800

Facility

$69,500.00

Service Code	HCPCS C1813
Hospital Charge Code	270700789
Hospital Revenue Code	278
Min. Negotiated Rate	$10,425.00
Max. Negotiated Rate	$16,819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,819.00
Rate for Payer: Qualcare PPO/HMO/WC	$10,425.00

SPICA THUMB MEDIUM LEFT

Facility

$71.55

Hospital Charge Code	270653979
Hospital Revenue Code	272
Min. Negotiated Rate	$10.73
Max. Negotiated Rate	$10.73
Rate for Payer: Qualcare PPO/HMO/WC	$10.73

SPICA THUMB MEDIUM LEFT

Facility

$71.55

Hospital Charge Code	270653979
Hospital Revenue Code	272
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$35.77
Rate for Payer: Aetna Commercial	$21.46
Rate for Payer: Aetna Medicare Advantage	$21.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.25
Rate for Payer: Cigna Commercial	$35.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.30
Rate for Payer: Oxford Commercial	$35.77
Rate for Payer: Qualcare PPO/HMO/WC	$10.73
Rate for Payer: UnitedHealthcare Commercial	$35.77

SPICA THUMB SMALL LEFT

Facility

$73.65

Hospital Charge Code	270653980
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$22.09
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Oxford Commercial	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$36.83

SPICA THUMB SMALL LEFT

Facility

$73.65

Hospital Charge Code	270653980
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

SPICA THUM MED RIGHT

Facility

$73.65

Hospital Charge Code	270653973
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

SPICA THUM MED RIGHT

Facility

$73.65

Hospital Charge Code	270653973
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$22.09
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Oxford Commercial	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$36.83

SPICA THUM SMALL RIGHT

Facility

$73.65

Hospital Charge Code	270653974
Hospital Revenue Code	272
Min. Negotiated Rate	$9.57
Max. Negotiated Rate	$36.83
Rate for Payer: Aetna Commercial	$22.09
Rate for Payer: Aetna Medicare Advantage	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.78
Rate for Payer: Cigna Commercial	$36.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Oxford Commercial	$36.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$36.83

SPICA THUM SMALL RIGHT

Facility

$73.65

Hospital Charge Code	270653974
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

SPIDER VEINS LEG-30 MINUTES

Facility

$372.00

Service Code	HCPCS 36468
Hospital Charge Code	75190130
Hospital Revenue Code	510
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SPIDER VEINS LEG-30 MINUTES

Facility

$372.00

Service Code	HCPCS 36468
Hospital Charge Code	75190130
Hospital Revenue Code	510
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SPIDER WRIST ACCESSORY

Facility

$3,865.00

Hospital Charge Code	270688366
Hospital Revenue Code	272
Min. Negotiated Rate	$579.75
Max. Negotiated Rate	$579.75
Rate for Payer: Qualcare PPO/HMO/WC	$579.75

SPIDER WRIST ACCESSORY

Facility

$3,865.00

Hospital Charge Code	270688366
Hospital Revenue Code	272
Min. Negotiated Rate	$502.45
Max. Negotiated Rate	$1,932.50
Rate for Payer: Aetna Commercial	$1,159.50
Rate for Payer: Aetna Medicare Advantage	$1,159.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$985.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$985.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$985.58
Rate for Payer: Cigna Commercial	$1,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.45
Rate for Payer: Oxford Commercial	$1,932.50
Rate for Payer: Qualcare PPO/HMO/WC	$579.75
Rate for Payer: UnitedHealthcare Commercial	$1,932.50

SPI FIL WIRE 6.0M SPD2US060320

Facility

$6,000.00

Hospital Charge Code	270638657
Hospital Revenue Code	272
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

SPI FIL WIRE 6.0M SPD2US060320

Facility

$6,000.00

Hospital Charge Code	270638657
Hospital Revenue Code	272
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.00
Rate for Payer: Oxford Commercial	$3,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$3,000.00

SPINA LAMINA 1/2 CRVL

Facility

$23,080.70

Service Code	HCPCS 63001
Hospital Charge Code	16001018
Hospital Revenue Code	360
Min. Negotiated Rate	$3,462.11
Max. Negotiated Rate	$3,462.11
Rate for Payer: Qualcare PPO/HMO/WC	$3,462.11

SPINA LAMINA 1/2 CRVL

Facility

$23,080.70

Service Code	HCPCS 63001
Hospital Charge Code	16001018
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$6,924.21
Rate for Payer: Aetna Medicare Advantage	$6,924.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,885.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,885.58
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	$5,885.58
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,000.49
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,462.11
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

SPINAL BLADE 60

Facility

$2,563.85

Hospital Charge Code	270687792
Hospital Revenue Code	272
Min. Negotiated Rate	$384.58
Max. Negotiated Rate	$384.58
Rate for Payer: Qualcare PPO/HMO/WC	$384.58

Know your out-of-pocket cost for care.

All Charges