Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPRAY KIT 800-0200

Facility

$173.65

Hospital Charge Code	270633003
Hospital Revenue Code	272
Min. Negotiated Rate	$26.05
Max. Negotiated Rate	$26.05
Rate for Payer: Qualcare PPO/HMO/WC	$26.05

SPRAY KIT 800-0200

Facility

$173.65

Hospital Charge Code	270633003
Hospital Revenue Code	272
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$86.83
Rate for Payer: Aetna Commercial	$52.09
Rate for Payer: Aetna Medicare Advantage	$52.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.28
Rate for Payer: Cigna Commercial	$86.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.57
Rate for Payer: Oxford Commercial	$86.83
Rate for Payer: Qualcare PPO/HMO/WC	$26.05
Rate for Payer: UnitedHealthcare Commercial	$86.83

SPRAY NOZLE F/USE W/PANASPRAY

Facility

$90.00

Hospital Charge Code	270665000
Hospital Revenue Code	270
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

SPRAY NOZLE F/USE W/PANASPRAY

Facility

$90.00

Hospital Charge Code	270665000
Hospital Revenue Code	270
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

SPRAY SILICONE

Facility

$170.00

Hospital Charge Code	270650912
Hospital Revenue Code	272
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$85.00

SPRAY SILICONE

Facility

$170.00

Hospital Charge Code	270650912
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

SPRAY TIP 800-0201

Facility

$161.25

Hospital Charge Code	270633004
Hospital Revenue Code	272
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$80.62
Rate for Payer: Aetna Commercial	$48.38
Rate for Payer: Aetna Medicare Advantage	$48.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.12
Rate for Payer: Cigna Commercial	$80.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.96
Rate for Payer: Oxford Commercial	$80.62
Rate for Payer: Qualcare PPO/HMO/WC	$24.19
Rate for Payer: UnitedHealthcare Commercial	$80.62

SPRAY TIP 800-0201

Facility

$161.25

Hospital Charge Code	270633004
Hospital Revenue Code	272
Min. Negotiated Rate	$24.19
Max. Negotiated Rate	$24.19
Rate for Payer: Qualcare PPO/HMO/WC	$24.19

SPRAY TIP APPLICATOR 8000202

Facility

$162.50

Hospital Charge Code	270639017
Hospital Revenue Code	272
Min. Negotiated Rate	$24.38
Max. Negotiated Rate	$24.38
Rate for Payer: Qualcare PPO/HMO/WC	$24.38

SPRAY TIP APPLICATOR 8000202

Facility

$162.50

Hospital Charge Code	270639017
Hospital Revenue Code	272
Min. Negotiated Rate	$21.12
Max. Negotiated Rate	$81.25
Rate for Payer: Aetna Commercial	$48.75
Rate for Payer: Aetna Medicare Advantage	$48.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.44
Rate for Payer: Cigna Commercial	$81.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.12
Rate for Payer: Oxford Commercial	$81.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.38
Rate for Payer: UnitedHealthcare Commercial	$81.25

SPRAY TIP GPS APPLICATOR

Facility

$162.50

Hospital Charge Code	270637656
Hospital Revenue Code	272
Min. Negotiated Rate	$24.38
Max. Negotiated Rate	$24.38
Rate for Payer: Qualcare PPO/HMO/WC	$24.38

SPRAY TIP GPS APPLICATOR

Facility

$162.50

Hospital Charge Code	270637656
Hospital Revenue Code	272
Min. Negotiated Rate	$21.12
Max. Negotiated Rate	$81.25
Rate for Payer: Aetna Commercial	$48.75
Rate for Payer: Aetna Medicare Advantage	$48.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.44
Rate for Payer: Cigna Commercial	$81.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.12
Rate for Payer: Oxford Commercial	$81.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.38
Rate for Payer: UnitedHealthcare Commercial	$81.25

SPRING GUIDE 35/150/FC/TF/3J

Facility

$81.00

Hospital Charge Code	270332044
Hospital Revenue Code	272
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

SPRING GUIDE 35/150/FC/TF/3J

Facility

$81.00

Hospital Charge Code	270332044
Hospital Revenue Code	272
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$24.30
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.53
Rate for Payer: Oxford Commercial	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$40.50

SPRING LOADED NUT

Facility

$211.50

Hospital Charge Code	270656305
Hospital Revenue Code	272
Min. Negotiated Rate	$27.50
Max. Negotiated Rate	$105.75
Rate for Payer: Aetna Commercial	$63.45
Rate for Payer: Aetna Medicare Advantage	$63.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.93
Rate for Payer: Cigna Commercial	$105.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.50
Rate for Payer: Oxford Commercial	$105.75
Rate for Payer: Qualcare PPO/HMO/WC	$31.73
Rate for Payer: UnitedHealthcare Commercial	$105.75

SPRING LOADED NUT

Facility

$211.50

Hospital Charge Code	270656305
Hospital Revenue Code	272
Min. Negotiated Rate	$31.73
Max. Negotiated Rate	$31.73
Rate for Payer: Qualcare PPO/HMO/WC	$31.73

SPRINT ENDURA PNS SYSTEM

Facility

$29,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270703514
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$7,018.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

SPRINT ENDURA PNS SYSTEM

Facility

$29,000.00

Service Code	HCPCS C1778
Hospital Charge Code	270703514
Hospital Revenue Code	278
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$14,500.00
Rate for Payer: Aetna Commercial	$8,700.00
Rate for Payer: Aetna Medicare Advantage	$8,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,395.00
Rate for Payer: Cigna Commercial	$14,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,350.00

SPROTTE SPINAL NEEDLE 22GA

Facility

$157.00

Hospital Charge Code	270332536
Hospital Revenue Code	272
Min. Negotiated Rate	$20.41
Max. Negotiated Rate	$78.50
Rate for Payer: Aetna Commercial	$47.10
Rate for Payer: Aetna Medicare Advantage	$47.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.03
Rate for Payer: Cigna Commercial	$78.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.41
Rate for Payer: Oxford Commercial	$78.50
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$78.50

SPROTTE SPINAL NEEDLE 22GA

Facility

$157.00

Hospital Charge Code	270332536
Hospital Revenue Code	272
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

SPR SHEETH XL 10F LRGE DIAMTER

Facility

$512.05

Hospital Charge Code	270662666
Hospital Revenue Code	270
Min. Negotiated Rate	$76.81
Max. Negotiated Rate	$76.81
Rate for Payer: Qualcare PPO/HMO/WC	$76.81

SPR SHEETH XL 10F LRGE DIAMTER

Facility

$512.05

Hospital Charge Code	270662666
Hospital Revenue Code	270
Min. Negotiated Rate	$66.57
Max. Negotiated Rate	$256.02
Rate for Payer: Aetna Commercial	$153.62
Rate for Payer: Aetna Medicare Advantage	$153.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.57
Rate for Payer: Cigna Commercial	$256.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.57
Rate for Payer: Oxford Commercial	$256.02
Rate for Payer: Qualcare PPO/HMO/WC	$76.81
Rate for Payer: UnitedHealthcare Commercial	$256.02

SP SPEECH APHASIA EVALUATION

Facility

$6,800.00

Service Code	HCPCS 96105
Hospital Charge Code	9001021
Hospital Revenue Code	918
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

SP SPEECH APHASIA EVALUATION

Facility

$6,800.00

Service Code	HCPCS 96105
Hospital Charge Code	9001021
Hospital Revenue Code	918
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$2,040.00
Rate for Payer: Aetna Commercial	$2,040.00
Rate for Payer: Aetna Medicare Advantage	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,734.00
Rate for Payer: Cigna Commercial	$106.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

SP SPEECH EVALUATION

Facility

$2,400.00

Service Code	HCPCS 92523GN
Hospital Charge Code	9000308
Hospital Revenue Code	444
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$720.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

Know your out-of-pocket cost for care.

All Charges