Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXTRACTOR S9 BROKEN 4MM DISP

Facility

$1,700.00

Hospital Charge Code	270696268
Hospital Revenue Code	272
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$510.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$850.00

EXTRACTOR S9 BROKEN 4MM DISP

Facility

$1,700.00

Hospital Charge Code	270696268
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

EXTRACTOR S9 STRIPPED 2MM DISP

Facility

$1,700.00

Hospital Charge Code	270696263
Hospital Revenue Code	272
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$510.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$850.00

EXTRACTOR S9 STRIPPED 2MM DISP

Facility

$1,700.00

Hospital Charge Code	270696263
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

EXTRACTOR S9 STRIPPED 4MM DISP

Facility

$1,700.00

Hospital Charge Code	270696264
Hospital Revenue Code	272
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$510.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$850.00

EXTRACTOR S9 STRIPPED 4MM DISP

Facility

$1,700.00

Hospital Charge Code	270696264
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

EXTRACTOR SCREW 6MM SINGLE USE

Facility

$1,700.00

Hospital Charge Code	270695327
Hospital Revenue Code	272
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

EXTRACTOR SCREW 6MM SINGLE USE

Facility

$1,700.00

Hospital Charge Code	270695327
Hospital Revenue Code	272
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$510.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$850.00

EXTRACTOR SCREW STRIPPED 7 MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270688296
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

EXTRACTOR SCREW STRIPPED 7 MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270688296
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$775.00
Rate for Payer: Aetna Commercial	$465.00
Rate for Payer: Aetna Medicare Advantage	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.25
Rate for Payer: Cigna Commercial	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

EXTRACTOR STAPLE

Facility

$5.00

Hospital Charge Code	270014130
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

EXTRACTOR STAPLE

Facility

$5.00

Hospital Charge Code	270014130
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

EXTRACTOR STAPLE******

Facility

$54.00

Hospital Charge Code	8001539
Hospital Revenue Code	279
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

EXTRACTOR STAPLE******

Facility

$54.00

Hospital Charge Code	8001539
Hospital Revenue Code	279
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Commercial	$27.00

EXTRACTOR STAPLE**********

Facility

$4.99

Hospital Charge Code	270014030
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

EXTRACTOR STAPLE**********

Facility

$4.99

Hospital Charge Code	270014030
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

EXTRACTOR STONE 18 EBL-18-200

Facility

$588.00

Hospital Charge Code	270608987
Hospital Revenue Code	272
Min. Negotiated Rate	$76.44
Max. Negotiated Rate	$294.00
Rate for Payer: Aetna Commercial	$176.40
Rate for Payer: Aetna Medicare Advantage	$176.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.94
Rate for Payer: Cigna Commercial	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.44
Rate for Payer: Oxford Commercial	$294.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.20
Rate for Payer: UnitedHealthcare Commercial	$294.00

EXTRACTOR STONE 18 EBL-18-200

Facility

$588.00

Hospital Charge Code	270608987
Hospital Revenue Code	272
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$88.20
Rate for Payer: Qualcare PPO/HMO/WC	$88.20

EXTRACTOR STONE ATLAS WIRE 3FR

Facility

$1,100.00

Hospital Charge Code	270660562
Hospital Revenue Code	272
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$330.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$550.00

EXTRACTOR STONE ATLAS WIRE 3FR

Facility

$1,100.00

Hospital Charge Code	270660562
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

EXTRACTOR STONE BSKT 7F MSB3X6

Facility

$1,552.85

Hospital Charge Code	270600991
Hospital Revenue Code	272
Min. Negotiated Rate	$232.93
Max. Negotiated Rate	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$232.93

EXTRACTOR STONE BSKT 7F MSB3X6

Facility

$1,552.85

Hospital Charge Code	270600991
Hospital Revenue Code	272
Min. Negotiated Rate	$201.87
Max. Negotiated Rate	$776.42
Rate for Payer: Aetna Commercial	$465.86
Rate for Payer: Aetna Medicare Advantage	$465.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.98
Rate for Payer: Cigna Commercial	$776.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.87
Rate for Payer: Oxford Commercial	$776.42
Rate for Payer: Qualcare PPO/HMO/WC	$232.93
Rate for Payer: UnitedHealthcare Commercial	$776.42

EXTRACTOR STONE CAPTURA 2.5FR

Facility

$883.05

Hospital Charge Code	270658544
Hospital Revenue Code	272
Min. Negotiated Rate	$132.46
Max. Negotiated Rate	$132.46
Rate for Payer: Qualcare PPO/HMO/WC	$132.46

EXTRACTOR STONE CAPTURA 2.5FR

Facility

$883.05

Hospital Charge Code	270658544
Hospital Revenue Code	272
Min. Negotiated Rate	$114.80
Max. Negotiated Rate	$441.52
Rate for Payer: Aetna Commercial	$264.92
Rate for Payer: Aetna Medicare Advantage	$264.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.18
Rate for Payer: Cigna Commercial	$441.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.80
Rate for Payer: Oxford Commercial	$441.52
Rate for Payer: Qualcare PPO/HMO/WC	$132.46
Rate for Payer: UnitedHealthcare Commercial	$441.52

EXTRACTOR STONE HEL S 4.5

Facility

$864.85

Hospital Charge Code	270605391
Hospital Revenue Code	272
Min. Negotiated Rate	$129.73
Max. Negotiated Rate	$129.73
Rate for Payer: Qualcare PPO/HMO/WC	$129.73

Know your out-of-pocket cost for care.

All Charges