Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRIVER INS F.A.S.T. 2.0mFPD2.0

Facility

$134.00

Hospital Charge Code	270635667
Hospital Revenue Code	272
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$20.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

DRIVER INS F.A.S.T. 2.0mFPD2.0

Facility

$134.00

Hospital Charge Code	270635667
Hospital Revenue Code	272
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$67.00
Rate for Payer: Aetna Commercial	$40.20
Rate for Payer: Aetna Medicare Advantage	$40.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.17
Rate for Payer: Cigna Commercial	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Oxford Commercial	$67.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.10
Rate for Payer: UnitedHealthcare Commercial	$67.00

DRIVER MDTP

Facility

$360.00

Hospital Charge Code	270661761
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

DRIVER MDTP

Facility

$360.00

Hospital Charge Code	270661761
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

DRIVER MSP T6

Facility

$1,395.00

Hospital Charge Code	270696760
Hospital Revenue Code	272
Min. Negotiated Rate	$181.35
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$418.50
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.35
Rate for Payer: Oxford Commercial	$697.50
Rate for Payer: Qualcare PPO/HMO/WC	$209.25
Rate for Payer: UnitedHealthcare Commercial	$697.50

DRIVER MSP T6

Facility

$1,395.00

Hospital Charge Code	270696760
Hospital Revenue Code	272
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$209.25
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

DRIVER QUICK CONNECT 20MM

Facility

$2,500.00

Hospital Charge Code	270684773
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

DRIVER QUICK CONNECT 20MM

Facility

$2,500.00

Hospital Charge Code	270684773
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

DRIVER SHAFT T7 HEXALOBE

Facility

$1,425.00

Hospital Charge Code	270690957
Hospital Revenue Code	272
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Oxford Commercial	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Commercial	$712.50

DRIVER SHAFT T7 HEXALOBE

Facility

$1,425.00

Hospital Charge Code	270690957
Hospital Revenue Code	272
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

DRIVER SHAFT T8 HEXALOBE CANN

Facility

$975.00

Hospital Charge Code	270690958
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

DRIVER SHAFT T8 HEXALOBE CANN

Facility

$975.00

Hospital Charge Code	270690958
Hospital Revenue Code	272
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

DRIVER SHAFT T8 HEXLOBE CANN

Facility

$790.00

Hospital Charge Code	270690956
Hospital Revenue Code	272
Min. Negotiated Rate	$102.70
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$237.00
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.70
Rate for Payer: Oxford Commercial	$395.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Commercial	$395.00

DRIVER SHAFT T8 HEXLOBE CANN

Facility

$790.00

Hospital Charge Code	270690956
Hospital Revenue Code	272
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$118.50
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

DRIVER STEP HEX 2/3.5 mm

Facility

$645.00

Hospital Charge Code	270680474
Hospital Revenue Code	272
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

DRIVER STEP HEX 2/3.5 mm

Facility

$645.00

Hospital Charge Code	270680474
Hospital Revenue Code	272
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$322.50
Rate for Payer: Aetna Commercial	$193.50
Rate for Payer: Aetna Medicare Advantage	$193.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.47
Rate for Payer: Cigna Commercial	$322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.85
Rate for Payer: Oxford Commercial	$322.50
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Commercial	$322.50

DRIVER TIP 2.5mm X 6in HT2502

Facility

$300.00

Hospital Charge Code	270638669
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

DRIVER TIP 2.5mm X 6in HT2502

Facility

$300.00

Hospital Charge Code	270638669
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

DRIVER TORQUE T6 MSP STERILE

Facility

$1,080.00

Hospital Charge Code	270688569
Hospital Revenue Code	272
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

DRIVER TORQUE T6 MSP STERILE

Facility

$1,080.00

Hospital Charge Code	270688569
Hospital Revenue Code	272
Min. Negotiated Rate	$140.40
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$324.00
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.40
Rate for Payer: Oxford Commercial	$540.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Commercial	$540.00

DRIVER UNIVERSAL QC T-20

Facility

$360.00

Hospital Charge Code	270679707
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

DRIVER UNIVERSAL QC T-20

Facility

$360.00

Hospital Charge Code	270679707
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

DRIVER UNIVERSAL QUICK CONNECT

Facility

$603.00

Hospital Charge Code	270661790
Hospital Revenue Code	272
Min. Negotiated Rate	$78.39
Max. Negotiated Rate	$301.50
Rate for Payer: Aetna Commercial	$180.90
Rate for Payer: Aetna Medicare Advantage	$180.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.76
Rate for Payer: Cigna Commercial	$301.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.39
Rate for Payer: Oxford Commercial	$301.50
Rate for Payer: Qualcare PPO/HMO/WC	$90.45
Rate for Payer: UnitedHealthcare Commercial	$301.50

DRIVER UNIVERSAL QUICK CONNECT

Facility

$603.00

Hospital Charge Code	270661790
Hospital Revenue Code	272
Min. Negotiated Rate	$90.45
Max. Negotiated Rate	$90.45
Rate for Payer: Qualcare PPO/HMO/WC	$90.45

DRIVE SHAFT SEAL RIA

Facility

$89.25

Hospital Charge Code	270671815
Hospital Revenue Code	272
Min. Negotiated Rate	$11.60
Max. Negotiated Rate	$44.62
Rate for Payer: Aetna Commercial	$26.77
Rate for Payer: Aetna Medicare Advantage	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.76
Rate for Payer: Cigna Commercial	$44.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.60
Rate for Payer: Oxford Commercial	$44.62
Rate for Payer: Qualcare PPO/HMO/WC	$13.39
Rate for Payer: UnitedHealthcare Commercial	$44.62

Know your out-of-pocket cost for care.

All Charges