Heights University Hospital

All Charges

Charge

Type

Setting

Price

FORCEPS BIPOLAR

Facility

$1,250.00

Hospital Charge Code	270692669
Hospital Revenue Code	270
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

FORCEPS BIPOLAR

Facility

$1,250.00

Hospital Charge Code	270692669
Hospital Revenue Code	270
Min. Negotiated Rate	$162.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$625.00

FORCEPS BIPOLAR DISP 1.0MM TIP

Facility

$2,196.00

Hospital Charge Code	270692063
Hospital Revenue Code	272
Min. Negotiated Rate	$329.40
Max. Negotiated Rate	$329.40
Rate for Payer: Qualcare PPO/HMO/WC	$329.40

FORCEPS BIPOLAR DISP 1.0MM TIP

Facility

$2,196.00

Hospital Charge Code	270692063
Hospital Revenue Code	272
Min. Negotiated Rate	$285.48
Max. Negotiated Rate	$1,098.00
Rate for Payer: Aetna Commercial	$658.80
Rate for Payer: Aetna Medicare Advantage	$658.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$559.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$559.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$559.98
Rate for Payer: Cigna Commercial	$1,098.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.48
Rate for Payer: Oxford Commercial	$1,098.00
Rate for Payer: Qualcare PPO/HMO/WC	$329.40
Rate for Payer: UnitedHealthcare Commercial	$1,098.00

FORCEPS BIPOLAR NON IRRIGATING

Facility

$2,835.00

Hospital Charge Code	270620022
Hospital Revenue Code	272
Min. Negotiated Rate	$425.25
Max. Negotiated Rate	$425.25
Rate for Payer: Qualcare PPO/HMO/WC	$425.25

FORCEPS BIPOLAR NON IRRIGATING

Facility

$2,835.00

Hospital Charge Code	270620022
Hospital Revenue Code	272
Min. Negotiated Rate	$368.55
Max. Negotiated Rate	$1,417.50
Rate for Payer: Aetna Commercial	$850.50
Rate for Payer: Aetna Medicare Advantage	$850.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$722.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$722.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$722.92
Rate for Payer: Cigna Commercial	$1,417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.55
Rate for Payer: Oxford Commercial	$1,417.50
Rate for Payer: Qualcare PPO/HMO/WC	$425.25
Rate for Payer: UnitedHealthcare Commercial	$1,417.50

FORCEPS BIPOLAR SNGL SITE 5MM

Facility

$1,500.00

Hospital Charge Code	270677925
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

FORCEPS BIPOLAR SNGL SITE 5MM

Facility

$1,500.00

Hospital Charge Code	270677925
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$750.00

FORCEPS BITE SPYGLASS

Facility

$2,580.00

Hospital Charge Code	270664633
Hospital Revenue Code	272
Min. Negotiated Rate	$387.00
Max. Negotiated Rate	$387.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

FORCEPS BITE SPYGLASS

Facility

$2,580.00

Hospital Charge Code	270664633
Hospital Revenue Code	272
Min. Negotiated Rate	$335.40
Max. Negotiated Rate	$1,290.00
Rate for Payer: Aetna Commercial	$774.00
Rate for Payer: Aetna Medicare Advantage	$774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.90
Rate for Payer: Cigna Commercial	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.40
Rate for Payer: Oxford Commercial	$1,290.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00
Rate for Payer: UnitedHealthcare Commercial	$1,290.00

FORCEPS CADIERE

Facility

$10,500.00

Hospital Charge Code	270675536
Hospital Revenue Code	272
Min. Negotiated Rate	$1,365.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,365.00
Rate for Payer: Oxford Commercial	$5,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00
Rate for Payer: UnitedHealthcare Commercial	$5,250.00

FORCEPS CADIERE

Facility

$10,500.00

Hospital Charge Code	270675536
Hospital Revenue Code	272
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$1,575.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

FORCEPS CHILD MAGILL

Facility

$75.00

Hospital Charge Code	270665162
Hospital Revenue Code	270
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

FORCEPS CHILD MAGILL

Facility

$75.00

Hospital Charge Code	270665162
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

FORCEPS GYR 10 15 3015PK

Facility

$1,424.00

Hospital Charge Code	270629602
Hospital Revenue Code	272
Min. Negotiated Rate	$213.60
Max. Negotiated Rate	$213.60
Rate for Payer: Qualcare PPO/HMO/WC	$213.60

FORCEPS GYR 10 15 3015PK

Facility

$1,424.00

Hospital Charge Code	270629602
Hospital Revenue Code	272
Min. Negotiated Rate	$185.12
Max. Negotiated Rate	$712.00
Rate for Payer: Aetna Commercial	$427.20
Rate for Payer: Aetna Medicare Advantage	$427.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.12
Rate for Payer: Cigna Commercial	$712.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.12
Rate for Payer: Oxford Commercial	$712.00
Rate for Payer: Qualcare PPO/HMO/WC	$213.60
Rate for Payer: UnitedHealthcare Commercial	$712.00

FORCEPS HARTMAN ALLIGATOR

Facility

$103.75

Hospital Charge Code	270666969
Hospital Revenue Code	270
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$51.88
Rate for Payer: Aetna Commercial	$31.12
Rate for Payer: Aetna Medicare Advantage	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.46
Rate for Payer: Cigna Commercial	$51.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.49
Rate for Payer: Oxford Commercial	$51.88
Rate for Payer: Qualcare PPO/HMO/WC	$15.56
Rate for Payer: UnitedHealthcare Commercial	$51.88

FORCEPS HARTMAN ALLIGATOR

Facility

$103.75

Hospital Charge Code	270666969
Hospital Revenue Code	270
Min. Negotiated Rate	$15.56
Max. Negotiated Rate	$15.56
Rate for Payer: Qualcare PPO/HMO/WC	$15.56

FORCEP SINGLE USE PULM BIOPSY

Facility

$440.00

Hospital Charge Code	270663359
Hospital Revenue Code	272
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

FORCEP SINGLE USE PULM BIOPSY

Facility

$440.00

Hospital Charge Code	270663359
Hospital Revenue Code	272
Min. Negotiated Rate	$57.20
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.20
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$220.00

FORCEPS INSORB SINGLE PAT 9100

Facility

$495.00

Hospital Charge Code	270639061
Hospital Revenue Code	272
Min. Negotiated Rate	$64.35
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$148.50
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.35
Rate for Payer: Oxford Commercial	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$247.50

FORCEPS INSORB SINGLE PAT 9100

Facility

$495.00

Hospital Charge Code	270639061
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

FORCEPS JUMBO RJ4 1337-20

Facility

$190.00

Hospital Charge Code	270637471
Hospital Revenue Code	272
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$95.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$95.00

FORCEPS JUMBO RJ4 1337-20

Facility

$190.00

Hospital Charge Code	270637471
Hospital Revenue Code	272
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

FORCEPS MICRO BLACK DIAMOND

Facility

$1,041.67

Hospital Charge Code	270675210
Hospital Revenue Code	272
Min. Negotiated Rate	$135.42
Max. Negotiated Rate	$520.84
Rate for Payer: Aetna Commercial	$312.50
Rate for Payer: Aetna Medicare Advantage	$312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.63
Rate for Payer: Cigna Commercial	$520.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.42
Rate for Payer: Oxford Commercial	$520.84
Rate for Payer: Qualcare PPO/HMO/WC	$156.25
Rate for Payer: UnitedHealthcare Commercial	$520.84

Know your out-of-pocket cost for care.

All Charges