Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELECTRODE TP PAC 5F 647308556P

Facility

$668.00

Hospital Charge Code	270634587
Hospital Revenue Code	272
Min. Negotiated Rate	$100.20
Max. Negotiated Rate	$100.20
Rate for Payer: Qualcare PPO/HMO/WC	$100.20

ELECTRODE TRIGGER FLEX

Facility

$2,975.00

Hospital Charge Code	270670841
Hospital Revenue Code	272
Min. Negotiated Rate	$386.75
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.75
Rate for Payer: Oxford Commercial	$1,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$446.25
Rate for Payer: UnitedHealthcare Commercial	$1,487.50

ELECTRODE TRIGGER FLEX

Facility

$2,975.00

Hospital Charge Code	270670841
Hospital Revenue Code	272
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$446.25
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

ELECTRODE VAPR S50 50DEG

Facility

$1,560.00

Hospital Charge Code	270640024
Hospital Revenue Code	272
Min. Negotiated Rate	$202.80
Max. Negotiated Rate	$780.00
Rate for Payer: Aetna Commercial	$468.00
Rate for Payer: Aetna Medicare Advantage	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.80
Rate for Payer: Cigna Commercial	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.80
Rate for Payer: Oxford Commercial	$780.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.00
Rate for Payer: UnitedHealthcare Commercial	$780.00

ELECTRODE VAPR S50 50DEG

Facility

$1,560.00

Hospital Charge Code	270640024
Hospital Revenue Code	272
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$234.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

ELECTRODE VAPR S90 4.0mm 90deg

Facility

$1,230.00

Hospital Charge Code	270636213
Hospital Revenue Code	272
Min. Negotiated Rate	$184.50
Max. Negotiated Rate	$184.50
Rate for Payer: Qualcare PPO/HMO/WC	$184.50

ELECTRODE VAPR S90 4.0mm 90deg

Facility

$1,230.00

Hospital Charge Code	270636213
Hospital Revenue Code	272
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$615.00
Rate for Payer: Aetna Commercial	$369.00
Rate for Payer: Aetna Medicare Advantage	$369.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$313.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$313.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$313.65
Rate for Payer: Cigna Commercial	$615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.90
Rate for Payer: Oxford Commercial	$615.00
Rate for Payer: Qualcare PPO/HMO/WC	$184.50
Rate for Payer: UnitedHealthcare Commercial	$615.00

ELECTRODE VL DISP LS1100

Facility

$1,824.00

Hospital Charge Code	270623967
Hospital Revenue Code	272
Min. Negotiated Rate	$237.12
Max. Negotiated Rate	$912.00
Rate for Payer: Aetna Commercial	$547.20
Rate for Payer: Aetna Medicare Advantage	$547.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$465.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$465.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$465.12
Rate for Payer: Cigna Commercial	$912.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.12
Rate for Payer: Oxford Commercial	$912.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.60
Rate for Payer: UnitedHealthcare Commercial	$912.00

ELECTRODE VL DISP LS1100

Facility

$1,824.00

Hospital Charge Code	270623967
Hospital Revenue Code	272
Min. Negotiated Rate	$273.60
Max. Negotiated Rate	$273.60
Rate for Payer: Qualcare PPO/HMO/WC	$273.60

ELECTRODE VL EXTD LS3111

Facility

$965.60

Hospital Charge Code	270623966
Hospital Revenue Code	272
Min. Negotiated Rate	$125.53
Max. Negotiated Rate	$482.80
Rate for Payer: Aetna Commercial	$289.68
Rate for Payer: Aetna Medicare Advantage	$289.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.23
Rate for Payer: Cigna Commercial	$482.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.53
Rate for Payer: Oxford Commercial	$482.80
Rate for Payer: Qualcare PPO/HMO/WC	$144.84
Rate for Payer: UnitedHealthcare Commercial	$482.80

ELECTRODE VL EXTD LS3111

Facility

$965.60

Hospital Charge Code	270623966
Hospital Revenue Code	272
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$144.84
Rate for Payer: Qualcare PPO/HMO/WC	$144.84

ELECTRODE VL MAX LS3091

Facility

$912.20

Hospital Charge Code	270623963
Hospital Revenue Code	272
Min. Negotiated Rate	$118.59
Max. Negotiated Rate	$456.10
Rate for Payer: Aetna Commercial	$273.66
Rate for Payer: Aetna Medicare Advantage	$273.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.61
Rate for Payer: Cigna Commercial	$456.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.59
Rate for Payer: Oxford Commercial	$456.10
Rate for Payer: Qualcare PPO/HMO/WC	$136.83
Rate for Payer: UnitedHealthcare Commercial	$456.10

ELECTRODE VL MAX LS3091

Facility

$912.20

Hospital Charge Code	270623963
Hospital Revenue Code	272
Min. Negotiated Rate	$136.83
Max. Negotiated Rate	$136.83
Rate for Payer: Qualcare PPO/HMO/WC	$136.83

ELECTRODE VL STD LS2071

Facility

$912.20

Hospital Charge Code	270623964
Hospital Revenue Code	272
Min. Negotiated Rate	$118.59
Max. Negotiated Rate	$456.10
Rate for Payer: Aetna Commercial	$273.66
Rate for Payer: Aetna Medicare Advantage	$273.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.61
Rate for Payer: Cigna Commercial	$456.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.59
Rate for Payer: Oxford Commercial	$456.10
Rate for Payer: Qualcare PPO/HMO/WC	$136.83
Rate for Payer: UnitedHealthcare Commercial	$456.10

ELECTRODE VL STD LS2071

Facility

$912.20

Hospital Charge Code	270623964
Hospital Revenue Code	272
Min. Negotiated Rate	$136.83
Max. Negotiated Rate	$136.83
Rate for Payer: Qualcare PPO/HMO/WC	$136.83

ELECTRODE W/BALL TIP 8FR

Facility

$253.00

Hospital Charge Code	270330918
Hospital Revenue Code	272
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.89
Rate for Payer: Oxford Commercial	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$126.50

ELECTRODE W/BALL TIP 8FR

Facility

$253.00

Hospital Charge Code	270330918
Hospital Revenue Code	272
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

ELECTRODE WIDE LOOP

Facility

$58.00

Hospital Charge Code	270605214
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

ELECTRODE WIDE LOOP

Facility

$58.00

Hospital Charge Code	270605214
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$29.00

ELECTRODE WIDE LOOP ******

Facility

$58.00

Hospital Charge Code	1608132
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

ELECTRODE WIDE LOOP ******

Facility

$58.00

Hospital Charge Code	1608132
Hospital Revenue Code	272
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$29.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$29.00

ELECTROENCEPHALOGRAM AWAKE/DRO

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	36540006
Hospital Revenue Code	740
Min. Negotiated Rate	$193.83
Max. Negotiated Rate	$3,847.00
Rate for Payer: Aetna Commercial	$447.30
Rate for Payer: Aetna Medicare Advantage	$447.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.20
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.83
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$223.65
Rate for Payer: UnitedHealthcare Commercial	$3,847.00

ELECTROENCEPHALOGRAM AWAKE/DRO

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	36540006
Hospital Revenue Code	740
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$223.65
Rate for Payer: Qualcare PPO/HMO/WC	$223.65

ELECTROHYDRAULLIC LITH PROBE

Facility

$5,775.00

Hospital Charge Code	270652097
Hospital Revenue Code	272
Min. Negotiated Rate	$750.75
Max. Negotiated Rate	$2,887.50
Rate for Payer: Aetna Commercial	$1,732.50
Rate for Payer: Aetna Medicare Advantage	$1,732.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,472.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,472.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,472.62
Rate for Payer: Cigna Commercial	$2,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.75
Rate for Payer: Oxford Commercial	$2,887.50
Rate for Payer: Qualcare PPO/HMO/WC	$866.25
Rate for Payer: UnitedHealthcare Commercial	$2,887.50

ELECTROHYDRAULLIC LITH PROBE

Facility

$5,775.00

Hospital Charge Code	270652097
Hospital Revenue Code	272
Min. Negotiated Rate	$866.25
Max. Negotiated Rate	$866.25
Rate for Payer: Qualcare PPO/HMO/WC	$866.25

Know your out-of-pocket cost for care.

All Charges