Heights University Hospital

All Charges

Charge

Type

Setting

Price

CLIP HEMO LOK MLK LARGE

Facility

$261.28

Hospital Charge Code	270619751
Hospital Revenue Code	272
Min. Negotiated Rate	$33.97
Max. Negotiated Rate	$130.64
Rate for Payer: Aetna Commercial	$78.38
Rate for Payer: Aetna Medicare Advantage	$78.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.63
Rate for Payer: Cigna Commercial	$130.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.97
Rate for Payer: Oxford Commercial	$130.64
Rate for Payer: Qualcare PPO/HMO/WC	$39.19
Rate for Payer: UnitedHealthcare Commercial	$130.64

CLIP INSTRUMENT ENDO CLINCH II

Facility

$1,066.58

Hospital Charge Code	270670510
Hospital Revenue Code	272
Min. Negotiated Rate	$159.99
Max. Negotiated Rate	$159.99
Rate for Payer: Qualcare PPO/HMO/WC	$159.99

CLIP INSTRUMENT ENDO CLINCH II

Facility

$1,066.58

Hospital Charge Code	270670510
Hospital Revenue Code	272
Min. Negotiated Rate	$138.66
Max. Negotiated Rate	$533.29
Rate for Payer: Aetna Commercial	$319.97
Rate for Payer: Aetna Medicare Advantage	$319.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.98
Rate for Payer: Cigna Commercial	$533.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.66
Rate for Payer: Oxford Commercial	$533.29
Rate for Payer: Qualcare PPO/HMO/WC	$159.99
Rate for Payer: UnitedHealthcare Commercial	$533.29

CLIP IRRIGATION EMAX 2

Facility

$280.00

Hospital Charge Code	270668484
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

CLIP IRRIGATION EMAX 2

Facility

$280.00

Hospital Charge Code	270668484
Hospital Revenue Code	272
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$84.00
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$140.00

CLIP LIGATING 2200 MEDIUM

Facility

$59.35

Hospital Charge Code	270673283
Hospital Revenue Code	272
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$8.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.90

CLIP LIGATING 2200 MEDIUM

Facility

$59.35

Hospital Charge Code	270673283
Hospital Revenue Code	272
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$29.68
Rate for Payer: Aetna Commercial	$17.80
Rate for Payer: Aetna Medicare Advantage	$17.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.13
Rate for Payer: Cigna Commercial	$29.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Oxford Commercial	$29.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.90
Rate for Payer: UnitedHealthcare Commercial	$29.68

CLIP LIGATING MED/6/BX

Facility

$20.10

Hospital Charge Code	270661328
Hospital Revenue Code	272
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$10.05
Rate for Payer: Aetna Commercial	$6.03
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.13
Rate for Payer: Cigna Commercial	$10.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.61
Rate for Payer: Oxford Commercial	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.02
Rate for Payer: UnitedHealthcare Commercial	$10.05

CLIP LIGATING MED/6/BX

Facility

$20.10

Hospital Charge Code	270661328
Hospital Revenue Code	272
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.02

CLIP LIGAT RESOLUTION 360ULTRA

Facility

$1,127.50

Service Code	HCPCS L8699
Hospital Charge Code	270692937
Hospital Revenue Code	278
Min. Negotiated Rate	$169.12
Max. Negotiated Rate	$272.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.86
Rate for Payer: Qualcare PPO/HMO/WC	$169.12

CLIP LIGAT RESOLUTION 360ULTRA

Facility

$1,127.50

Service Code	HCPCS L8699
Hospital Charge Code	270692937
Hospital Revenue Code	278
Min. Negotiated Rate	$169.12
Max. Negotiated Rate	$563.75
Rate for Payer: Aetna Commercial	$338.25
Rate for Payer: Aetna Medicare Advantage	$338.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.51
Rate for Payer: Cigna Commercial	$563.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.86
Rate for Payer: Qualcare PPO/HMO/WC	$169.12

CLIP OLYMPUS ENDO HX600-090

Facility

$76.85

Hospital Charge Code	270618133
Hospital Revenue Code	270
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

CLIP OLYMPUS ENDO HX600-090

Facility

$76.85

Hospital Charge Code	270618133
Hospital Revenue Code	270
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$23.05
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.99
Rate for Payer: Oxford Commercial	$38.42
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$38.42

CLIP OLYMPUS ENDO HX600-135

Facility

$76.85

Hospital Charge Code	270618134
Hospital Revenue Code	270
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$23.05
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.99
Rate for Payer: Oxford Commercial	$38.42
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$38.42

CLIP OLYMPUS ENDO HX600-135

Facility

$76.85

Hospital Charge Code	270618134
Hospital Revenue Code	270
Min. Negotiated Rate	$11.53
Max. Negotiated Rate	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.53

CLIPPER CORD CLAMP REMOVR 9441

Facility

$119.25

Hospital Charge Code	270600468
Hospital Revenue Code	272
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$59.62
Rate for Payer: Aetna Commercial	$35.77
Rate for Payer: Aetna Medicare Advantage	$35.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.50
Rate for Payer: Oxford Commercial	$59.62
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$59.62

CLIPPER CORD CLAMP REMOVR 9441

Facility

$119.25

Hospital Charge Code	270600468
Hospital Revenue Code	272
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

CLIPPER PREP DISP

Facility

$13.13

Hospital Charge Code	270649373
Hospital Revenue Code	272
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$6.57
Rate for Payer: Aetna Commercial	$3.94
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.35
Rate for Payer: Cigna Commercial	$6.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.71
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.97
Rate for Payer: UnitedHealthcare Commercial	$6.57

CLIPPER PREP DISP

Facility

$13.13

Hospital Charge Code	270649373
Hospital Revenue Code	272
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$1.97
Rate for Payer: Qualcare PPO/HMO/WC	$1.97

CLIPPER SURGICAL HANDLE

Facility

$182.90

Hospital Charge Code	270651870
Hospital Revenue Code	272
Min. Negotiated Rate	$27.43
Max. Negotiated Rate	$27.43
Rate for Payer: Qualcare PPO/HMO/WC	$27.43

CLIPPER SURGICAL HANDLE

Facility

$182.90

Hospital Charge Code	270651870
Hospital Revenue Code	272
Min. Negotiated Rate	$23.78
Max. Negotiated Rate	$91.45
Rate for Payer: Aetna Commercial	$54.87
Rate for Payer: Aetna Medicare Advantage	$54.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.64
Rate for Payer: Cigna Commercial	$91.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.78
Rate for Payer: Oxford Commercial	$91.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.43
Rate for Payer: UnitedHealthcare Commercial	$91.45

CLIP PLACEMENT PERCUTANEOUS

Facility

$867.00

Hospital Charge Code	75190115
Hospital Revenue Code	361
Min. Negotiated Rate	$130.05
Max. Negotiated Rate	$130.05
Rate for Payer: Qualcare PPO/HMO/WC	$130.05

CLIP PLACEMENT PERCUTANEOUS

Facility

$867.00

Hospital Charge Code	75190115
Hospital Revenue Code	361
Min. Negotiated Rate	$112.71
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$260.10
Rate for Payer: Aetna Medicare Advantage	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$221.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$221.09
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	$221.09
Rate for Payer: Cigna Commercial	$433.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.71
Rate for Payer: Qualcare PPO/HMO/WC	$130.05

CLIP RESOLUTION M00522612

Facility

$800.00

Hospital Charge Code	270635097
Hospital Revenue Code	272
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

CLIP RESOLUTION M00522612

Facility

$800.00

Hospital Charge Code	270635097
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

Know your out-of-pocket cost for care.

All Charges