Heights University Hospital

All Charges

Charge

Type

Setting

Price

CONVERTOR SURGIPOR 4.5 175005

Facility

$50.45

Hospital Charge Code	270600062
Hospital Revenue Code	272
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

CONVERTOR SURGIPOR 4.5 175005

Facility

$50.45

Hospital Charge Code	270600062
Hospital Revenue Code	272
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

CONVERTOR SURGIPOR 5.5 *****

Facility

$29.00

Hospital Charge Code	1603281
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

CONVERTOR SURGIPOR 5.5 *****

Facility

$29.00

Hospital Charge Code	1603281
Hospital Revenue Code	272
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$14.50
Rate for Payer: Aetna Commercial	$8.70
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.39
Rate for Payer: Cigna Commercial	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.77
Rate for Payer: Oxford Commercial	$14.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$14.50

CONVERTOR SURGP 10.5/15 175018

Facility

$50.45

Hospital Charge Code	270600061
Hospital Revenue Code	272
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

CONVERTOR SURGP 10.5/15 175018

Facility

$50.45

Hospital Charge Code	270600061
Hospital Revenue Code	272
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

CONVERTOR SURGP 5.5/15 175016

Facility

$50.45

Hospital Charge Code	270600059
Hospital Revenue Code	272
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

CONVERTOR SURGP 5.5/15 175016

Facility

$50.45

Hospital Charge Code	270600059
Hospital Revenue Code	272
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

COOLANT TUBING 3318506E

Facility

$175.00

Hospital Charge Code	270639696
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

COOLANT TUBING 3318506E

Facility

$175.00

Hospital Charge Code	270639696
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

COOLCUT TORPEDO 4.2MM 19CM

Facility

$505.00

Hospital Charge Code	270679504
Hospital Revenue Code	272
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

COOLCUT TORPEDO 4.2MM 19CM

Facility

$505.00

Hospital Charge Code	270679504
Hospital Revenue Code	272
Min. Negotiated Rate	$65.65
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.65
Rate for Payer: Oxford Commercial	$252.50
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Commercial	$252.50

COOMBS DIRECT OR INDIRECT***

Facility

$19.00

Service Code	HCPCS 86880
Hospital Charge Code	3000874
Hospital Revenue Code	302
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$140.48
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

COOMBS DIRECT OR INDIRECT***

Facility

$17.00

Hospital Charge Code	3010873
Hospital Revenue Code	302
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$114.00

COOMBS DIRECT OR INDIRECT***

Facility

$19.00

Service Code	HCPCS 86880
Hospital Charge Code	3000874
Hospital Revenue Code	302
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

COOMBS DIRECT OR INDIRECT***

Facility

$17.00

Hospital Charge Code	3010873
Hospital Revenue Code	302
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

COOPER VISION 1/A PAK*********

Facility

$215.00

Hospital Charge Code	1600816
Hospital Revenue Code	272
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

COOPER VISION 1/A PAK*********

Facility

$215.00

Hospital Charge Code	1600816
Hospital Revenue Code	272
Min. Negotiated Rate	$27.95
Max. Negotiated Rate	$107.50
Rate for Payer: Aetna Commercial	$64.50
Rate for Payer: Aetna Medicare Advantage	$64.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.83
Rate for Payer: Cigna Commercial	$107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Oxford Commercial	$107.50
Rate for Payer: Qualcare PPO/HMO/WC	$32.25
Rate for Payer: UnitedHealthcare Commercial	$107.50

COOPER VIS SER 10000 1/APAK***

Facility

$179.00

Hospital Charge Code	1600832
Hospital Revenue Code	272
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

COOPER VIS SER 10000 1/APAK***

Facility

$179.00

Hospital Charge Code	1600832
Hospital Revenue Code	272
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$89.50
Rate for Payer: Aetna Commercial	$53.70
Rate for Payer: Aetna Medicare Advantage	$53.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$89.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.27
Rate for Payer: Oxford Commercial	$89.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
Rate for Payer: UnitedHealthcare Commercial	$89.50

COOPER VIS SER 10000 UNIPAK***

Facility

$301.00

Hospital Charge Code	1600824
Hospital Revenue Code	272
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

COOPER VIS SER 10000 UNIPAK***

Facility

$301.00

Hospital Charge Code	1600824
Hospital Revenue Code	272
Min. Negotiated Rate	$39.13
Max. Negotiated Rate	$150.50
Rate for Payer: Aetna Commercial	$90.30
Rate for Payer: Aetna Medicare Advantage	$90.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.75
Rate for Payer: Cigna Commercial	$150.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.13
Rate for Payer: Oxford Commercial	$150.50
Rate for Payer: Qualcare PPO/HMO/WC	$45.15
Rate for Payer: UnitedHealthcare Commercial	$150.50

COOXIMETERCOMTROL 50X1.7ML

Facility

$7.90

Hospital Charge Code	2709003369
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

COOXIMETERCOMTROL 50X1.7ML

Facility

$7.90

Hospital Charge Code	2709003369
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.95
Rate for Payer: Aetna Commercial	$2.37
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.01
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.95

COPE NEPHROUETERSTOMY 22 F

Facility

$687.45

Hospital Charge Code	270703091
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$343.73
Rate for Payer: Aetna Commercial	$206.24
Rate for Payer: Aetna Medicare Advantage	$206.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.30
Rate for Payer: Cigna Commercial	$343.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

Know your out-of-pocket cost for care.

All Charges