Heights University Hospital

All Charges

Charge

Type

Setting

Price

DEVICE INFLATION LEVEEN

Facility

$209.95

Hospital Charge Code	270645619C
Hospital Revenue Code	272
Min. Negotiated Rate	$31.49
Max. Negotiated Rate	$31.49
Rate for Payer: Qualcare PPO/HMO/WC	$31.49

DEVICE INFLATION PRESTO

Facility

$170.00

Hospital Charge Code	270695684
Hospital Revenue Code	272
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$85.00

DEVICE INFLATION PRESTO

Facility

$170.00

Hospital Charge Code	270695684
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

DEVICEINTERBDYFUSIONFORTLINK

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694166
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$4,942.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

DEVICEINTERBDYFUSIONFORTLINK

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694166
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

DEVICE KPN KYPHOPAK FX F05A

Facility

$552.75

Hospital Charge Code	270629407
Hospital Revenue Code	272
Min. Negotiated Rate	$82.91
Max. Negotiated Rate	$82.91
Rate for Payer: Qualcare PPO/HMO/WC	$82.91

DEVICE KPN KYPHOPAK FX F05A

Facility

$750.00

Hospital Charge Code	270629407V
Hospital Revenue Code	270
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

DEVICE KPN KYPHOPAK FX F05A

Facility

$750.00

Hospital Charge Code	270629407V
Hospital Revenue Code	270
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

DEVICE KPN KYPHOPAK FX F05A

Facility

$552.75

Hospital Charge Code	270629407
Hospital Revenue Code	272
Min. Negotiated Rate	$71.86
Max. Negotiated Rate	$276.38
Rate for Payer: Aetna Commercial	$165.82
Rate for Payer: Aetna Medicare Advantage	$165.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.95
Rate for Payer: Cigna Commercial	$276.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.86
Rate for Payer: Oxford Commercial	$276.38
Rate for Payer: Qualcare PPO/HMO/WC	$82.91
Rate for Payer: UnitedHealthcare Commercial	$276.38

DEVICE LOCKING BX CAP SYST

Facility

$46.13

Hospital Charge Code	270650916
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

DEVICE LOCKING BX CAP SYST

Facility

$46.13

Hospital Charge Code	270650916
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$23.07
Rate for Payer: Aetna Commercial	$13.84
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$23.07
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$23.07

DEVICE LOOP LIGATING MAJ-254

Facility

$161.65

Hospital Charge Code	270618994
Hospital Revenue Code	272
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

DEVICE LOOP LIGATING MAJ-254

Facility

$161.65

Hospital Charge Code	270618994
Hospital Revenue Code	272
Min. Negotiated Rate	$21.01
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$48.49
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.01
Rate for Payer: Oxford Commercial	$80.83
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Commercial	$80.83

DEVICE MCV CAPIO SUTR 831-135

Facility

$3,844.00

Hospital Charge Code	270621602
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$1,922.00
Rate for Payer: Aetna Commercial	$1,153.20
Rate for Payer: Aetna Medicare Advantage	$1,153.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$980.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$980.22
Rate for Payer: Cigna Commercial	$1,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

DEVICE MCV CAPIO SUTR 831-135

Facility

$3,844.00

Hospital Charge Code	270621602
Hospital Revenue Code	278
Min. Negotiated Rate	$576.60
Max. Negotiated Rate	$930.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$768.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$930.25
Rate for Payer: Qualcare PPO/HMO/WC	$576.60

DEVICE MCV LOCK BILIARY 4527

Facility

$59.25

Hospital Charge Code	270627942
Hospital Revenue Code	272
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$8.89
Rate for Payer: Qualcare PPO/HMO/WC	$8.89

DEVICE MCV LOCK BILIARY 4527

Facility

$59.25

Hospital Charge Code	270627942
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$29.62
Rate for Payer: Aetna Commercial	$17.77
Rate for Payer: Aetna Medicare Advantage	$17.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.11
Rate for Payer: Cigna Commercial	$29.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.70
Rate for Payer: Oxford Commercial	$29.62
Rate for Payer: Qualcare PPO/HMO/WC	$8.89
Rate for Payer: UnitedHealthcare Commercial	$29.62

DEVICE MM COMPCT INFLAT IN4125

Facility

$185.65

Hospital Charge Code	270623750
Hospital Revenue Code	272
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$92.83
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$92.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.13
Rate for Payer: Oxford Commercial	$92.83
Rate for Payer: Qualcare PPO/HMO/WC	$27.85
Rate for Payer: UnitedHealthcare Commercial	$92.83

DEVICE MM COMPCT INFLAT IN4125

Facility

$185.65

Hospital Charge Code	270623750
Hospital Revenue Code	272
Min. Negotiated Rate	$27.85
Max. Negotiated Rate	$27.85
Rate for Payer: Qualcare PPO/HMO/WC	$27.85

DEVICE MYOSURE POLYP REMOVAL

Facility

$7,190.10

Hospital Charge Code	270662592
Hospital Revenue Code	272
Min. Negotiated Rate	$934.71
Max. Negotiated Rate	$3,595.05
Rate for Payer: Aetna Commercial	$2,157.03
Rate for Payer: Aetna Medicare Advantage	$2,157.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,833.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,833.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,833.48
Rate for Payer: Cigna Commercial	$3,595.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.71
Rate for Payer: Oxford Commercial	$3,595.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.52
Rate for Payer: UnitedHealthcare Commercial	$3,595.05

DEVICE MYOSURE POLYP REMOVAL

Facility

$7,190.10

Hospital Charge Code	270662592
Hospital Revenue Code	272
Min. Negotiated Rate	$1,078.52
Max. Negotiated Rate	$1,078.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,078.52

DEVICE NEEDLE LOCK ******

Facility

$2.00

Hospital Charge Code	8003253
Hospital Revenue Code	264
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

DEVICE NEEDLE LOCK ******

Facility

$2.00

Hospital Charge Code	8003253
Hospital Revenue Code	264
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

DEVICE NEEDLE LOCK***

Facility

$1.00

Hospital Charge Code	270301279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

DEVICE NEEDLE LOCK***

Facility

$1.00

Hospital Charge Code	270301279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.50

Know your out-of-pocket cost for care.

All Charges