Heights University Hospital

All Charges

Charge

Type

Setting

Price

ST PR GPS6FR6x40mSERB650640120

Facility

$7,192.00

Hospital Charge Code	270636673V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,078.80
Max. Negotiated Rate	$1,740.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,438.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,740.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.80

ST PRO10/7x30 135cSECX10730135

Facility

$11,250.00

Hospital Charge Code	270638656V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$3,375.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

ST PRO10/7x30 135cSECX10730135

Facility

$8,400.00

Service Code	HCPCS C1876
Hospital Charge Code	270638656C
Hospital Revenue Code	761
Min. Negotiated Rate	$1,092.00
Max. Negotiated Rate	$4,200.00
Rate for Payer: Aetna Commercial	$2,520.00
Rate for Payer: Aetna Medicare Advantage	$2,520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,142.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,142.00
Rate for Payer: Cigna Commercial	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.00
Rate for Payer: Oxford Commercial	$4,200.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00
Rate for Payer: UnitedHealthcare Commercial	$4,200.00

ST PRO10/7x30 135cSECX10730135

Facility

$11,250.00

Hospital Charge Code	270638656V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$2,722.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

ST PRO10/7x30 135cSECX10730135

Facility

$8,400.00

Service Code	HCPCS C1876
Hospital Charge Code	270638656C
Hospital Revenue Code	761
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$1,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,260.00

ST PROMU RX 3.0X15M 100954115B

Facility

$10,250.00

Hospital Charge Code	270642316C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMU RX 3.0X15M 100954115B

Facility

$10,250.00

Hospital Charge Code	270642316C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMU RX 3.0X18M 100954118B

Facility

$10,250.00

Hospital Charge Code	270642256C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMU RX 3.0X18M 100954118B

Facility

$10,250.00

Hospital Charge Code	270642256C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMUS RX 2.5X8M 100953908B

Facility

$10,250.00

Hospital Charge Code	270641918C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMUS RX 2.5X8M 100953908B

Facility

$10,250.00

Hospital Charge Code	270641918C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMUS RX 3.0X8M 100954108B

Facility

$10,250.00

Hospital Charge Code	270642314C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

ST PROMUS RX 3.0X8M 100954108B

Facility

$10,250.00

Hospital Charge Code	270642314C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STRAIGHT ATTACHMENT ARM

Facility

$643.75

Hospital Charge Code	270702325
Hospital Revenue Code	278
Min. Negotiated Rate	$96.56
Max. Negotiated Rate	$155.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.79
Rate for Payer: Qualcare PPO/HMO/WC	$96.56

STRAIGHT ATTACHMENT ARM

Facility

$643.75

Hospital Charge Code	270702325
Hospital Revenue Code	278
Min. Negotiated Rate	$96.56
Max. Negotiated Rate	$321.88
Rate for Payer: Aetna Commercial	$193.12
Rate for Payer: Aetna Medicare Advantage	$193.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.16
Rate for Payer: Cigna Commercial	$321.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.79
Rate for Payer: Qualcare PPO/HMO/WC	$96.56

STRAIGHT C/D STRUT

Facility

$3,340.00

Hospital Charge Code	270656963
Hospital Revenue Code	278
Min. Negotiated Rate	$501.00
Max. Negotiated Rate	$808.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: Qualcare PPO/HMO/WC	$501.00

STRAIGHT C/D STRUT

Facility

$3,340.00

Hospital Charge Code	270656963
Hospital Revenue Code	278
Min. Negotiated Rate	$501.00
Max. Negotiated Rate	$1,670.00
Rate for Payer: Aetna Commercial	$1,002.00
Rate for Payer: Aetna Medicare Advantage	$1,002.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$851.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$668.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$851.70
Rate for Payer: Cigna Commercial	$1,670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$808.28
Rate for Payer: Qualcare PPO/HMO/WC	$501.00

STRAIGHT NDL SPLIT CANNULA

Facility

$487.00

Hospital Charge Code	270339439
Hospital Revenue Code	272
Min. Negotiated Rate	$73.05
Max. Negotiated Rate	$73.05
Rate for Payer: Qualcare PPO/HMO/WC	$73.05

STRAIGHT NDL SPLIT CANNULA

Facility

$487.00

Hospital Charge Code	270339439
Hospital Revenue Code	272
Min. Negotiated Rate	$63.31
Max. Negotiated Rate	$243.50
Rate for Payer: Aetna Commercial	$146.10
Rate for Payer: Aetna Medicare Advantage	$146.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.19
Rate for Payer: Cigna Commercial	$243.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.31
Rate for Payer: Oxford Commercial	$243.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.05
Rate for Payer: UnitedHealthcare Commercial	$243.50

STRAIGHT PLATE

Facility

$3,250.00

Hospital Charge Code	270657980
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$975.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

STRAIGHT PLATE

Facility

$3,250.00

Hospital Charge Code	270657980
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

Straight Shank Drill Bit 1.5mm

Facility

$275.00

Hospital Charge Code	270685137
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

Straight Shank Drill Bit 1.5mm

Facility

$275.00

Hospital Charge Code	270685137
Hospital Revenue Code	272
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$137.50

Straight Shank Drill Bit 2.0 m

Facility

$275.00

Hospital Charge Code	270685138
Hospital Revenue Code	272
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

Straight Shank Drill Bit 2.0 m

Facility

$275.00

Hospital Charge Code	270685138
Hospital Revenue Code	272
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Oxford Commercial	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: UnitedHealthcare Commercial	$137.50

Know your out-of-pocket cost for care.

All Charges