Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE LEEP BALL 3MM 900161

Facility

$110.10

Hospital Charge Code	270608103
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$55.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.52
Rate for Payer: Aetna Commercial	$33.03
Rate for Payer: Aetna Medicare Advantage	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$55.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.31
Rate for Payer: Oxford Commercial	$55.05
Rate for Payer: UnitedHealthcare Commercial	$55.05

ELECTRODE LEEP BALL 3MM 900161

Facility

$110.10

Hospital Charge Code	270608103
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$16.52

ELECTRODE LEEP BALL 5MM 900163

Facility

$110.10

Hospital Charge Code	270608102
Hospital Revenue Code	272
Min. Negotiated Rate	$16.52
Max. Negotiated Rate	$16.52
Rate for Payer: Qualcare PPO/HMO/WC	$16.52

ELECTRODE LEEP BALL 5MM 900163

Facility

$110.10

Hospital Charge Code	270608102
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$55.05
Rate for Payer: Aetna Commercial	$33.03
Rate for Payer: Aetna Medicare Advantage	$33.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$55.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.31
Rate for Payer: Oxford Commercial	$55.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.52
Rate for Payer: UnitedHealthcare Commercial	$55.05

ELECTRODE LEEP/LLETZ LOOP

Facility

$68.75

Hospital Charge Code	270676782
Hospital Revenue Code	272
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$34.38
Rate for Payer: Aetna Commercial	$20.62
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$34.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.94
Rate for Payer: Oxford Commercial	$34.38
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: UnitedHealthcare Commercial	$34.38

ELECTRODE LEEP/LLETZ LOOP

Facility

$68.75

Hospital Charge Code	270676782
Hospital Revenue Code	272
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

ELECTRODE LETZ LOOP SML YELLOW

Facility

$75.00

Hospital Charge Code	270658132
Hospital Revenue Code	270
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

ELECTRODE LETZ LOOP SML YELLOW

Facility

$75.00

Hospital Charge Code	270658132
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

ELECTRODE LEVEEN COAC 3.0 2622

Facility

$4,340.00

Hospital Charge Code	270633817
Hospital Revenue Code	272
Min. Negotiated Rate	$651.00
Max. Negotiated Rate	$651.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.00

ELECTRODE LEVEEN COAC 3.0 2622

Facility

$4,340.00

Hospital Charge Code	270633817
Hospital Revenue Code	272
Min. Negotiated Rate	$564.20
Max. Negotiated Rate	$2,170.00
Rate for Payer: Aetna Commercial	$1,302.00
Rate for Payer: Aetna Medicare Advantage	$1,302.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,106.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,106.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,106.70
Rate for Payer: Cigna Commercial	$2,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$564.20
Rate for Payer: Oxford Commercial	$2,170.00
Rate for Payer: Qualcare PPO/HMO/WC	$651.00
Rate for Payer: UnitedHealthcare Commercial	$2,170.00

ELECTRODE LEVEEN COACCESS 2.0

Facility

$4,975.00

Hospital Charge Code	270634088
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

ELECTRODE LEVEEN COACCESS 2.0

Facility

$4,975.00

Hospital Charge Code	270634088
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

ELECTRODE LEVEEN COACCESS 4.0

Facility

$10,175.00

Hospital Charge Code	270631815
Hospital Revenue Code	272
Min. Negotiated Rate	$1,526.25
Max. Negotiated Rate	$1,526.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,526.25

ELECTRODE LEVEEN COACCESS 4.0

Facility

$10,175.00

Hospital Charge Code	270631815
Hospital Revenue Code	272
Min. Negotiated Rate	$1,322.75
Max. Negotiated Rate	$5,087.50
Rate for Payer: Aetna Commercial	$3,052.50
Rate for Payer: Aetna Medicare Advantage	$3,052.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,594.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,594.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,594.62
Rate for Payer: Cigna Commercial	$5,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,322.75
Rate for Payer: Oxford Commercial	$5,087.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,526.25
Rate for Payer: UnitedHealthcare Commercial	$5,087.50

ELECTRODE LEVEEN SUPERSLIM 3.0

Facility

$5,555.25

Hospital Charge Code	270636524
Hospital Revenue Code	272
Min. Negotiated Rate	$722.18
Max. Negotiated Rate	$2,777.62
Rate for Payer: Aetna Commercial	$1,666.58
Rate for Payer: Aetna Medicare Advantage	$1,666.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,416.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,416.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,416.59
Rate for Payer: Cigna Commercial	$2,777.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$722.18
Rate for Payer: Oxford Commercial	$2,777.62
Rate for Payer: Qualcare PPO/HMO/WC	$833.29
Rate for Payer: UnitedHealthcare Commercial	$2,777.62

ELECTRODE LEVEEN SUPERSLIM 3.0

Facility

$5,555.25

Hospital Charge Code	270636524
Hospital Revenue Code	272
Min. Negotiated Rate	$833.29
Max. Negotiated Rate	$833.29
Rate for Payer: Qualcare PPO/HMO/WC	$833.29

ELECTRODE LEVEN COAC 3.5 26223

Facility

$6,975.00

Hospital Charge Code	270632723
Hospital Revenue Code	272
Min. Negotiated Rate	$906.75
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$906.75
Rate for Payer: Oxford Commercial	$3,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25
Rate for Payer: UnitedHealthcare Commercial	$3,487.50

ELECTRODE LEVEN COAC 3.5 26223

Facility

$6,975.00

Hospital Charge Code	270632723
Hospital Revenue Code	272
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,046.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

ELECTRODE L HOOK 36CM

Facility

$162.70

Hospital Charge Code	270692089
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

ELECTRODE L HOOK 36CM

Facility

$162.70

Hospital Charge Code	270692089
Hospital Revenue Code	272
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$81.35
Rate for Payer: Aetna Commercial	$48.81
Rate for Payer: Aetna Medicare Advantage	$48.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.15
Rate for Payer: Oxford Commercial	$81.35
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$81.35

ELECTRODE L HOOK 36CM

Facility

$162.72

Hospital Charge Code	270691560
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

ELECTRODE L HOOK 36CM

Facility

$162.72

Hospital Charge Code	270691560
Hospital Revenue Code	272
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$81.36
Rate for Payer: Aetna Commercial	$48.82
Rate for Payer: Aetna Medicare Advantage	$48.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.15
Rate for Payer: Oxford Commercial	$81.36
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$81.36

ELECTRODE L HOOK DISP ******

Facility

$78.00

Hospital Charge Code	1606318
Hospital Revenue Code	279
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$39.00
Rate for Payer: Aetna Commercial	$23.40
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$39.00

ELECTRODE L HOOK DISP ******

Facility

$78.00

Hospital Charge Code	1606318
Hospital Revenue Code	279
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

ELECTRODE LOOP 20x12 DLPW11

Facility

$75.00

Hospital Charge Code	270632344
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

Know your out-of-pocket cost for care.

All Charges