Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPLIT BLOOD UNIT

Facility

$1,255.00

Hospital Charge Code	38471157
Hospital Revenue Code	390
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$188.25
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

SPLIT BLOOD UNIT

Facility

$1,255.00

Hospital Charge Code	38471157
Hospital Revenue Code	390
Min. Negotiated Rate	$163.15
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$376.50
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.15
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$188.25
Rate for Payer: UnitedHealthcare Commercial	$756.00

SPLIT SHEET TIBURON

Facility

$23.95

Hospital Charge Code	270665839
Hospital Revenue Code	270
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$11.97
Rate for Payer: Aetna Commercial	$7.18
Rate for Payer: Aetna Medicare Advantage	$7.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.11
Rate for Payer: Cigna Commercial	$11.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.11
Rate for Payer: Oxford Commercial	$11.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.59
Rate for Payer: UnitedHealthcare Commercial	$11.97

SPLIT SHEET TIBURON

Facility

$23.95

Hospital Charge Code	270665839
Hospital Revenue Code	270
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$3.59

SPLITTING OF BLOOD

Facility

$296.00

Service Code	HCPCS 86985
Hospital Charge Code	38471153
Hospital Revenue Code	309
Min. Negotiated Rate	$14.62
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$88.80
Rate for Payer: Aetna Medicare Advantage	$88.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.48
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

SPLITTING OF BLOOD

Facility

$296.00

Service Code	HCPCS 86985
Hospital Charge Code	38471153
Hospital Revenue Code	309
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$44.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

SP MODIFY VOICE PROSTHESIS***

Facility

$241.00

Service Code	HCPCS 92507
Hospital Charge Code	9100110
Hospital Revenue Code	440
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$36.15
Rate for Payer: Qualcare PPO/HMO/WC	$36.15

SP MODIFY VOICE PROSTHESIS***

Facility

$241.00

Service Code	HCPCS 92507
Hospital Charge Code	9100110
Hospital Revenue Code	440
Min. Negotiated Rate	$11.27
Max. Negotiated Rate	$686.00
Rate for Payer: Aetna Commercial	$72.30
Rate for Payer: Aetna Medicare Advantage	$72.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$84.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.33
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.15
Rate for Payer: UnitedHealthcare Commercial	$686.00

S. PNEUMONIAE AG LA

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	39900222
Hospital Revenue Code	302
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.39
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
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	$42.28
Rate for Payer: Cigna Commercial	$11.54
Rate for Payer: Cigna Medicare Advantage	$5.77
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
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	$11.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.23
Rate for Payer: Wellcare Medicare Advantage	$11.54

S. PNEUMONIAE AG LA

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	39900222
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SPN FSN WO DECMPR CERV BELW C2

Facility

$47,548.90

Service Code	HCPCS 22554
Hospital Charge Code	16000607
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

SPN FSN WO DECMPR CERV BELW C2

Facility

$47,548.90

Service Code	HCPCS 22554
Hospital Charge Code	16000607
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

SPN FUSE&RMV CRV BLW C2,EA ADL

Facility

$47,548.90

Service Code	HCPCS 22552
Hospital Charge Code	1620002
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

SPN FUSE&RMV CRV BLW C2,EA ADL

Facility

$47,548.90

Service Code	HCPCS 22552
Hospital Charge Code	1620002
Hospital Revenue Code	360
Min. Negotiated Rate	$382.54
Max. Negotiated Rate	$14,264.67
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$382.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

SPN FUSE&RMV CRV BLW C2,EA ADL

Facility

$47,548.90

Service Code	HCPCS 22552
Hospital Charge Code	16000606
Hospital Revenue Code	360
Min. Negotiated Rate	$7,132.34
Max. Negotiated Rate	$7,132.34
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34

SPN FUSE&RMV CRV BLW C2,EA ADL

Facility

$47,548.90

Service Code	HCPCS 22552
Hospital Charge Code	16000606
Hospital Revenue Code	360
Min. Negotiated Rate	$382.54
Max. Negotiated Rate	$14,264.67
Rate for Payer: Aetna Commercial	$14,264.67
Rate for Payer: Aetna Medicare Advantage	$14,264.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,124.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,124.97
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	$12,124.97
Rate for Payer: Cigna Commercial	$382.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,181.36
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,132.34
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

SPNG FIL COP BONE VOID11031010

Facility

$9,218.75

Hospital Charge Code	270639515
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.81
Max. Negotiated Rate	$4,609.38
Rate for Payer: Aetna Commercial	$2,765.62
Rate for Payer: Aetna Medicare Advantage	$2,765.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,350.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,350.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,843.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,350.78
Rate for Payer: Cigna Commercial	$4,609.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,230.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,382.81

SPNG FIL COP BONE VOID11031010

Facility

$9,218.75

Hospital Charge Code	270639515
Hospital Revenue Code	278
Min. Negotiated Rate	$1,382.81
Max. Negotiated Rate	$2,230.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,843.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,230.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,382.81

SPO2 CABLE

Facility

$945.00

Hospital Charge Code	270663011
Hospital Revenue Code	270
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.85
Rate for Payer: Oxford Commercial	$472.50
Rate for Payer: Qualcare PPO/HMO/WC	$141.75
Rate for Payer: UnitedHealthcare Commercial	$472.50

SPO2 CABLE

Facility

$945.00

Hospital Charge Code	270663011
Hospital Revenue Code	270
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$141.75
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SPONGE 3 PLY 2X2 N/STER

Facility

$0.02

Hospital Charge Code	270649003
Hospital Revenue Code	270
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare Advantage	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.01
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$0.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.01

SPONGE 3 PLY 2X2 N/STER

Facility

$0.02

Hospital Charge Code	270649003
Hospital Revenue Code	270
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SPONGE 3 PLY 4X4 N/STER

Facility

$0.05

Hospital Charge Code	270649004
Hospital Revenue Code	272
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: Aetna Commercial	$0.02
Rate for Payer: Aetna Medicare Advantage	$0.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.01
Rate for Payer: Cigna Commercial	$0.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.01
Rate for Payer: Oxford Commercial	$0.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.01
Rate for Payer: UnitedHealthcare Commercial	$0.03

SPONGE 3 PLY 4X4 N/STER

Facility

$0.05

Hospital Charge Code	270649004
Hospital Revenue Code	272
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.01

SPONGE BATH HOMECRAFT A722-8

Facility

$16.85

Hospital Charge Code	270611386
Hospital Revenue Code	279
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

Know your out-of-pocket cost for care.

All Charges