Heights University Hospital

All Charges

Charge

Type

Setting

Price

FORCEPS MICRO BLACK DIAMOND

Facility

$1,041.67

Hospital Charge Code	270675210
Hospital Revenue Code	272
Min. Negotiated Rate	$156.25
Max. Negotiated Rate	$156.25
Rate for Payer: Qualcare PPO/HMO/WC	$156.25

FORCEPS MICRO L4 3/8 IN 5 MM C

Facility

$3,117.35

Hospital Charge Code	270683686
Hospital Revenue Code	272
Min. Negotiated Rate	$467.60
Max. Negotiated Rate	$467.60
Rate for Payer: Qualcare PPO/HMO/WC	$467.60

FORCEPS MICRO L4 3/8 IN 5 MM C

Facility

$3,117.35

Hospital Charge Code	270683686
Hospital Revenue Code	272
Min. Negotiated Rate	$405.26
Max. Negotiated Rate	$1,558.67
Rate for Payer: Aetna Commercial	$935.21
Rate for Payer: Aetna Medicare Advantage	$935.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$794.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$794.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$794.92
Rate for Payer: Cigna Commercial	$1,558.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$405.26
Rate for Payer: Oxford Commercial	$1,558.67
Rate for Payer: Qualcare PPO/HMO/WC	$467.60
Rate for Payer: UnitedHealthcare Commercial	$1,558.67

FORCEPS PERIARTIC REDUCT 6.5MM

Facility

$6,600.25

Hospital Charge Code	270677658
Hospital Revenue Code	272
Min. Negotiated Rate	$990.04
Max. Negotiated Rate	$990.04
Rate for Payer: Qualcare PPO/HMO/WC	$990.04

FORCEPS PERIARTIC REDUCT 6.5MM

Facility

$6,600.25

Hospital Charge Code	270677658
Hospital Revenue Code	272
Min. Negotiated Rate	$858.03
Max. Negotiated Rate	$3,300.12
Rate for Payer: Aetna Commercial	$1,980.08
Rate for Payer: Aetna Medicare Advantage	$1,980.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.06
Rate for Payer: Cigna Commercial	$3,300.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$858.03
Rate for Payer: Oxford Commercial	$3,300.12
Rate for Payer: Qualcare PPO/HMO/WC	$990.04
Rate for Payer: UnitedHealthcare Commercial	$3,300.12

FORCEPS RADIAL JAW 160cm

Facility

$87.50

Hospital Charge Code	270650907
Hospital Revenue Code	272
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$43.75
Rate for Payer: Aetna Commercial	$26.25
Rate for Payer: Aetna Medicare Advantage	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.31
Rate for Payer: Cigna Commercial	$43.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.38
Rate for Payer: Oxford Commercial	$43.75
Rate for Payer: Qualcare PPO/HMO/WC	$13.12
Rate for Payer: UnitedHealthcare Commercial	$43.75

FORCEPS RADIAL JAW 160cm

Facility

$87.50

Hospital Charge Code	270650907
Hospital Revenue Code	272
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$13.12
Rate for Payer: Qualcare PPO/HMO/WC	$13.12

FORCEPS RADIAL JAW 3 240cm

Facility

$125.00

Hospital Charge Code	270650908
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

FORCEPS RADIAL JAW 3 240cm

Facility

$125.00

Hospital Charge Code	270650908
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

FORCEPS REDUCTION 130MM

Facility

$852.00

Hospital Charge Code	270668378
Hospital Revenue Code	272
Min. Negotiated Rate	$127.80
Max. Negotiated Rate	$127.80
Rate for Payer: Qualcare PPO/HMO/WC	$127.80

FORCEPS REDUCTION 130MM

Facility

$852.00

Hospital Charge Code	270668378
Hospital Revenue Code	272
Min. Negotiated Rate	$110.76
Max. Negotiated Rate	$426.00
Rate for Payer: Aetna Commercial	$255.60
Rate for Payer: Aetna Medicare Advantage	$255.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.26
Rate for Payer: Cigna Commercial	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.76
Rate for Payer: Oxford Commercial	$426.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.80
Rate for Payer: UnitedHealthcare Commercial	$426.00

FORCEPS REDUCTION LARGE

Facility

$13,253.00

Hospital Charge Code	270649819
Hospital Revenue Code	272
Min. Negotiated Rate	$1,987.95
Max. Negotiated Rate	$1,987.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.95

FORCEPS REDUCTION LARGE

Facility

$13,253.00

Hospital Charge Code	270649819
Hospital Revenue Code	272
Min. Negotiated Rate	$1,722.89
Max. Negotiated Rate	$6,626.50
Rate for Payer: Aetna Commercial	$3,975.90
Rate for Payer: Aetna Medicare Advantage	$3,975.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,379.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,379.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,379.51
Rate for Payer: Cigna Commercial	$6,626.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,722.89
Rate for Payer: Oxford Commercial	$6,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,987.95
Rate for Payer: UnitedHealthcare Commercial	$6,626.50

FORCEPS REDUCT W/POINTS BROAD

Facility

$1,820.00

Hospital Charge Code	270614780
Hospital Revenue Code	272
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$273.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.00

FORCEPS REDUCT W/POINTS BROAD

Facility

$1,820.00

Hospital Charge Code	270614780
Hospital Revenue Code	272
Min. Negotiated Rate	$236.60
Max. Negotiated Rate	$910.00
Rate for Payer: Aetna Commercial	$546.00
Rate for Payer: Aetna Medicare Advantage	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.10
Rate for Payer: Cigna Commercial	$910.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.60
Rate for Payer: Oxford Commercial	$910.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.00
Rate for Payer: UnitedHealthcare Commercial	$910.00

FORCEPS REDUCT W/POINTS NARROW

Facility

$1,874.60

Hospital Charge Code	270607305
Hospital Revenue Code	272
Min. Negotiated Rate	$281.19
Max. Negotiated Rate	$281.19
Rate for Payer: Qualcare PPO/HMO/WC	$281.19

FORCEPS REDUCT W/POINTS NARROW

Facility

$1,874.60

Hospital Charge Code	270607305
Hospital Revenue Code	272
Min. Negotiated Rate	$243.70
Max. Negotiated Rate	$937.30
Rate for Payer: Aetna Commercial	$562.38
Rate for Payer: Aetna Medicare Advantage	$562.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.02
Rate for Payer: Cigna Commercial	$937.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.70
Rate for Payer: Oxford Commercial	$937.30
Rate for Payer: Qualcare PPO/HMO/WC	$281.19
Rate for Payer: UnitedHealthcare Commercial	$937.30

FORCEPS SATIN HALSTEAD 5 CVD

Facility

$39.75

Hospital Charge Code	270657884
Hospital Revenue Code	270
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.96

FORCEPS SATIN HALSTEAD 5 CVD

Facility

$39.75

Hospital Charge Code	270657884
Hospital Revenue Code	270
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$19.88
Rate for Payer: Aetna Commercial	$11.93
Rate for Payer: Aetna Medicare Advantage	$11.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.14
Rate for Payer: Cigna Commercial	$19.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.17
Rate for Payer: Oxford Commercial	$19.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.96
Rate for Payer: UnitedHealthcare Commercial	$19.88

FORCEPS SCREW

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270614770
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

FORCEPS SCREW

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270614770
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

FORCEP STD RADIAL JAW 240CC

Facility

$77.04

Hospital Charge Code	270655593
Hospital Revenue Code	272
Min. Negotiated Rate	$10.02
Max. Negotiated Rate	$38.52
Rate for Payer: Aetna Commercial	$23.11
Rate for Payer: Aetna Medicare Advantage	$23.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.65
Rate for Payer: Cigna Commercial	$38.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.02
Rate for Payer: Oxford Commercial	$38.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.56
Rate for Payer: UnitedHealthcare Commercial	$38.52

FORCEP STD RADIAL JAW 240CC

Facility

$77.04

Hospital Charge Code	270655593
Hospital Revenue Code	272
Min. Negotiated Rate	$11.56
Max. Negotiated Rate	$11.56
Rate for Payer: Qualcare PPO/HMO/WC	$11.56

FORCEP STONE RETRIEV 2.4FR

Facility

$1,586.45

Hospital Charge Code	270601109
Hospital Revenue Code	272
Min. Negotiated Rate	$206.24
Max. Negotiated Rate	$793.23
Rate for Payer: Aetna Commercial	$475.94
Rate for Payer: Aetna Medicare Advantage	$475.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.54
Rate for Payer: Cigna Commercial	$793.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.24
Rate for Payer: Oxford Commercial	$793.23
Rate for Payer: Qualcare PPO/HMO/WC	$237.97
Rate for Payer: UnitedHealthcare Commercial	$793.23

FORCEP STONE RETRIEV 2.4FR

Facility

$1,586.45

Hospital Charge Code	270601109
Hospital Revenue Code	272
Min. Negotiated Rate	$237.97
Max. Negotiated Rate	$237.97
Rate for Payer: Qualcare PPO/HMO/WC	$237.97

Know your out-of-pocket cost for care.

All Charges