Heights University Hospital

All Charges

Charge

Type

Setting

Price

CENTER BLADE

Facility

$465.50

Hospital Charge Code	270665055
Hospital Revenue Code	270
Min. Negotiated Rate	$60.52
Max. Negotiated Rate	$232.75
Rate for Payer: Aetna Commercial	$139.65
Rate for Payer: Aetna Medicare Advantage	$139.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.70
Rate for Payer: Cigna Commercial	$232.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.52
Rate for Payer: Oxford Commercial	$232.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.83
Rate for Payer: UnitedHealthcare Commercial	$232.75

CENTERLINE DIPOSABLE KIT

Facility

$1,000.00

Hospital Charge Code	270662180
Hospital Revenue Code	270
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CENTERLINE DIPOSABLE KIT

Facility

$1,000.00

Hospital Charge Code	270662180
Hospital Revenue Code	270
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CENTER LINE TRAY - RENTAL

Facility

$1,000.00

Hospital Charge Code	270658833
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

CENTER LINE TRAY - RENTAL

Facility

$1,000.00

Hospital Charge Code	270658833
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CENTRAFLEX PLACENT MATRI 2X3CM

Facility

$8,500.00

Service Code	HCPCS C1762
Hospital Charge Code	270698091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

CENTRAFLEX PLACENT MATRI 2X3CM

Facility

$8,500.00

Service Code	HCPCS C1762
Hospital Charge Code	270698091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

CENTRAFLEX PLACENT MATRI 3X3CM

Facility

$12,250.00

Service Code	HCPCS C1762
Hospital Charge Code	270698092
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$3,675.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

CENTRAFLEX PLACENT MATRI 3X3CM

Facility

$12,250.00

Service Code	HCPCS C1762
Hospital Charge Code	270698092
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

CENTRALIZER 13MM

Facility

$525.00

Hospital Charge Code	270667720
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

CENTRALIZER 13MM

Facility

$525.00

Hospital Charge Code	270667720
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

CENTRALIZER BMT 12-162611

Facility

$11,285.00

Hospital Charge Code	270606326
Hospital Revenue Code	278
Min. Negotiated Rate	$1,692.75
Max. Negotiated Rate	$5,642.50
Rate for Payer: Aetna Commercial	$3,385.50
Rate for Payer: Aetna Medicare Advantage	$3,385.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,877.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,877.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,257.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,877.68
Rate for Payer: Cigna Commercial	$5,642.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,730.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,692.75

CENTRALIZER BMT 12-162611

Facility

$11,285.00

Hospital Charge Code	270606326
Hospital Revenue Code	278
Min. Negotiated Rate	$1,692.75
Max. Negotiated Rate	$2,730.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,257.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,730.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,692.75

CENTRALIZER BMT 12-162613

Facility

$3,527.25

Hospital Charge Code	270605407
Hospital Revenue Code	278
Min. Negotiated Rate	$529.09
Max. Negotiated Rate	$1,763.62
Rate for Payer: Aetna Commercial	$1,058.17
Rate for Payer: Aetna Medicare Advantage	$1,058.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$899.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$899.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$705.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$899.45
Rate for Payer: Cigna Commercial	$1,763.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.59
Rate for Payer: Qualcare PPO/HMO/WC	$529.09

CENTRALIZER BMT 12-162613

Facility

$3,527.25

Hospital Charge Code	270605407
Hospital Revenue Code	278
Min. Negotiated Rate	$529.09
Max. Negotiated Rate	$853.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$705.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.59
Rate for Payer: Qualcare PPO/HMO/WC	$529.09

CENTRALIZER BMT 12MM 12-162615

Facility

$8,719.75

Hospital Charge Code	270607973
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.96
Max. Negotiated Rate	$4,359.88
Rate for Payer: Aetna Commercial	$2,615.93
Rate for Payer: Aetna Medicare Advantage	$2,615.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,223.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,223.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,223.54
Rate for Payer: Cigna Commercial	$4,359.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,110.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.96

CENTRALIZER BMT 12MM 12-162615

Facility

$8,719.75

Hospital Charge Code	270607973
Hospital Revenue Code	278
Min. Negotiated Rate	$1,307.96
Max. Negotiated Rate	$2,110.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,743.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,110.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,307.96

CENTRALIZER BMT DI 13MM 162658

Facility

$775.00

Service Code	HCPCS C1776
Hospital Charge Code	270609034
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$187.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CENTRALIZER BMT DI 13MM 162658

Facility

$775.00

Service Code	HCPCS C1776
Hospital Charge Code	270609034
Hospital Revenue Code	278
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$232.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.55
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

CENTRALIZER BMT DI 15MM 162659

Facility

$892.85

Hospital Charge Code	270607974
Hospital Revenue Code	278
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

CENTRALIZER BMT DI 15MM 162659

Facility

$892.85

Hospital Charge Code	270607974
Hospital Revenue Code	278
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$267.86
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

CENTRALIZER BMT DI 162660

Facility

$892.85

Hospital Charge Code	270605340
Hospital Revenue Code	278
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$446.43
Rate for Payer: Aetna Commercial	$267.86
Rate for Payer: Aetna Medicare Advantage	$267.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$446.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

CENTRALIZER BMT DI 162660

Facility

$892.85

Hospital Charge Code	270605340
Hospital Revenue Code	278
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$216.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.07
Rate for Payer: Qualcare PPO/HMO/WC	$133.93

CENTRALIZER BMT DISTAL

Facility

$348.00

Hospital Charge Code	270606327
Hospital Revenue Code	272
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

CENTRALIZER BMT DISTAL

Facility

$348.00

Hospital Charge Code	270606327
Hospital Revenue Code	272
Min. Negotiated Rate	$45.24
Max. Negotiated Rate	$174.00
Rate for Payer: Aetna Commercial	$104.40
Rate for Payer: Aetna Medicare Advantage	$104.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.74
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$174.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Commercial	$174.00

Know your out-of-pocket cost for care.

All Charges