Heights University Hospital

All Charges

Charge

Type

Setting

Price

SURITAL/1GM

Facility

$28.00

Hospital Charge Code	60633941
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

SUSCEPTIBILITY STUDIES ENZIME

Facility

$33.00

Service Code	HCPCS 87085
Hospital Charge Code	38477038
Hospital Revenue Code	306
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

SUSCEPTIBILITY STUDIES ENZIME

Facility

$33.00

Service Code	HCPCS 87085
Hospital Charge Code	38477038
Hospital Revenue Code	306
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

SUSCEPTIBILITY STUDIES MLC

Facility

$73.00

Service Code	HCPCS 87187
Hospital Charge Code	38477071
Hospital Revenue Code	309
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

SUSCEPTIBILITY STUDIES MLC

Facility

$73.00

Service Code	HCPCS 87187
Hospital Charge Code	38477071
Hospital Revenue Code	309
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$147.18
Rate for Payer: Aetna Commercial	$130.15
Rate for Payer: Aetna Medicare Advantage	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.18
Rate for Payer: Cigna Commercial	$40.17
Rate for Payer: Cigna Medicare Advantage	$20.09
Rate for Payer: Clover Medicare Advantage	$38.16
Rate for Payer: EmblemHealth Commercial	$120.51
Rate for Payer: Humana Medicare Advantage	$41.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$42.58
Rate for Payer: Wellcare Medicare Advantage	$40.17

SUSCEPTIBILITY STUD MACROBROTH

Facility

$47.00

Service Code	HCPCS 87188
Hospital Charge Code	38477049
Hospital Revenue Code	309
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

SUSCEPTIBILITY STUD MACROBROTH

Facility

$47.00

Service Code	HCPCS 87188
Hospital Charge Code	38477049
Hospital Revenue Code	309
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.51
Rate for Payer: Aetna Medicare Advantage	$6.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.33
Rate for Payer: Cigna Commercial	$6.64
Rate for Payer: Cigna Medicare Advantage	$3.32
Rate for Payer: Clover Medicare Advantage	$6.31
Rate for Payer: EmblemHealth Commercial	$19.92
Rate for Payer: Humana Medicare Advantage	$6.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.04
Rate for Payer: Wellcare Medicare Advantage	$6.64

SUSCEPTIBILTY AGAR DILUTION

Facility

$390.00

Service Code	HCPCS 87181
Hospital Charge Code	38477037
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SUSCEPTIBILTY AGAR DILUTION

Facility

$390.00

Service Code	HCPCS 87181
Hospital Charge Code	38477037
Hospital Revenue Code	309
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.39
Rate for Payer: Aetna Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.40
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
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	$4.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.04
Rate for Payer: Wellcare Medicare Advantage	$4.75

SUSCEPTYEASTCOMPPNL(BRONFLUID)

Facility

$623.18

Service Code	HCPCS 87186
Hospital Charge Code	401387186
Hospital Revenue Code	306
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.03
Rate for Payer: Aetna Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.69
Rate for Payer: Cigna Commercial	$8.65
Rate for Payer: Cigna Medicare Advantage	$4.33
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.48
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.17
Rate for Payer: Wellcare Medicare Advantage	$8.65

SUSCEPTYEASTCOMPPNL(BRONFLUID)

Facility

$623.18

Service Code	HCPCS 87186
Hospital Charge Code	401387186
Hospital Revenue Code	306
Min. Negotiated Rate	$93.48
Max. Negotiated Rate	$93.48
Rate for Payer: Qualcare PPO/HMO/WC	$93.48

SUSPEND BOWEL W/PROSTHESIS

Facility

$21,202.60

Service Code	HCPCS 44700
Hospital Charge Code	1600000651
Hospital Revenue Code	360
Min. Negotiated Rate	$3,180.39
Max. Negotiated Rate	$3,180.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.39

SUSPEND BOWEL W/PROSTHESIS

Facility

$21,202.60

Service Code	HCPCS 44700
Hospital Charge Code	1600000651
Hospital Revenue Code	360
Min. Negotiated Rate	$998.43
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$6,360.78
Rate for Payer: Aetna Medicare Advantage	$6,360.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,406.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,406.66
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	$5,406.66
Rate for Payer: Cigna Commercial	$998.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,756.34
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.39
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

SUSPENDERS ATTACHED W/SNAPS

Facility

$270.00

Hospital Charge Code	270667069
Hospital Revenue Code	270
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$135.00

SUSPENDERS ATTACHED W/SNAPS

Facility

$270.00

Hospital Charge Code	270667069
Hospital Revenue Code	270
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

SUSPENSORY 0-2 W/STRAP LARGE

Facility

$43.40

Hospital Charge Code	270651066
Hospital Revenue Code	270
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$6.51
Rate for Payer: Qualcare PPO/HMO/WC	$6.51

SUSPENSORY 0-2 W/STRAP LARGE

Facility

$43.40

Hospital Charge Code	270651066
Hospital Revenue Code	270
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$21.70
Rate for Payer: Aetna Commercial	$13.02
Rate for Payer: Aetna Medicare Advantage	$13.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.07
Rate for Payer: Cigna Commercial	$21.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.64
Rate for Payer: Oxford Commercial	$21.70
Rate for Payer: Qualcare PPO/HMO/WC	$6.51
Rate for Payer: UnitedHealthcare Commercial	$21.70

SUSPENSORY W/STRAP MEDIUM

Facility

$38.25

Hospital Charge Code	270649813
Hospital Revenue Code	270
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$5.74
Rate for Payer: Qualcare PPO/HMO/WC	$5.74

SUSPENSORY W/STRAP MEDIUM

Facility

$38.25

Hospital Charge Code	270649813
Hospital Revenue Code	270
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$19.12
Rate for Payer: Aetna Commercial	$11.47
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.75
Rate for Payer: Cigna Commercial	$19.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.97
Rate for Payer: Oxford Commercial	$19.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.74
Rate for Payer: UnitedHealthcare Commercial	$19.12

SUSPENSORY W/STRAP XL

Facility

$49.55

Hospital Charge Code	270650254
Hospital Revenue Code	272
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$7.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.43

SUSPENSORY W/STRAP XL

Facility

$49.55

Hospital Charge Code	270650254
Hospital Revenue Code	272
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$24.77
Rate for Payer: Aetna Commercial	$14.87
Rate for Payer: Aetna Medicare Advantage	$14.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.64
Rate for Payer: Cigna Commercial	$24.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.44
Rate for Payer: Oxford Commercial	$24.77
Rate for Payer: Qualcare PPO/HMO/WC	$7.43
Rate for Payer: UnitedHealthcare Commercial	$24.77

SUSPENSORY - X-LARGE *********

Facility

$15.00

Hospital Charge Code	8001620
Hospital Revenue Code	279
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

SUSPENSORY - X-LARGE *********

Facility

$15.00

Hospital Charge Code	8001620
Hospital Revenue Code	279
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

SUT ANCHR OSSIOFIB 4.75 BB TP2

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270700793
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SUT ANCHR OSSIOFIB 4.75 BB TP2

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270700793
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

Know your out-of-pocket cost for care.

All Charges