Heights University Hospital

All Charges

Charge

Type

Setting

Price

GLOVE SURG GAMMEX WHITE SX 7.5

Facility

$7.70

Hospital Charge Code	270060940
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

GLOVE SURG GAMMEX WHITE SX 7.5

Facility

$7.70

Hospital Charge Code	270060940
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

GLOVE SURG NEOPRENE P/F SZ 6.5

Facility

$6.54

Hospital Charge Code	270649554
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna Medicare Advantage	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.67
Rate for Payer: Cigna Commercial	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.85
Rate for Payer: Oxford Commercial	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$3.27

GLOVE SURG NEOPRENE P/F SZ 6.5

Facility

$6.54

Hospital Charge Code	270649554
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

GLOVE SURG NEOPRENE P/F SZ 7.5

Facility

$6.54

Hospital Charge Code	270649556
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna Medicare Advantage	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.67
Rate for Payer: Cigna Commercial	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.85
Rate for Payer: Oxford Commercial	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$3.27

GLOVE SURG NEOPRENE P/F SZ 7.5

Facility

$6.54

Hospital Charge Code	270649556
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

GLOVE SURG ORTHO STRL SZ 8.0

Facility

$67.93

Hospital Charge Code	270655993
Hospital Revenue Code	272
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$33.97
Rate for Payer: Aetna Commercial	$20.38
Rate for Payer: Aetna Medicare Advantage	$20.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.32
Rate for Payer: Cigna Commercial	$33.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.83
Rate for Payer: Oxford Commercial	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$10.19
Rate for Payer: UnitedHealthcare Commercial	$33.97

GLOVE SURG ORTHO STRL SZ 8.0

Facility

$67.93

Hospital Charge Code	270655993
Hospital Revenue Code	272
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$10.19
Rate for Payer: Qualcare PPO/HMO/WC	$10.19

GLOVE SURG ORTHO STRL SZ 8.5

Facility

$13.59

Hospital Charge Code	270655994
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.79
Rate for Payer: Aetna Commercial	$4.08
Rate for Payer: Aetna Medicare Advantage	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.47
Rate for Payer: Cigna Commercial	$6.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$6.79

GLOVE SURG ORTHO STRL SZ 8.5

Facility

$13.59

Hospital Charge Code	270655994
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

GLOVE SURG PROTEXIS SZ 6.5

Facility

$8.17

Hospital Charge Code	27060925
Hospital Revenue Code	270
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$2.45
Rate for Payer: Aetna Medicare Advantage	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.06
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$4.08

GLOVE SURG PROTEXIS SZ 6.5

Facility

$8.17

Hospital Charge Code	27060925
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

GLOVE SURG PROTEXIS SZ 7

Facility

$8.17

Hospital Charge Code	27060930
Hospital Revenue Code	270
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$2.45
Rate for Payer: Aetna Medicare Advantage	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.06
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$4.08

GLOVE SURG PROTEXIS SZ 7

Facility

$8.17

Hospital Charge Code	27060930
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

GLOVE SURG PROTEXIS SZ 7.5

Facility

$7.93

Hospital Charge Code	27060935
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

GLOVE SURG PROTEXIS SZ 7.5

Facility

$7.93

Hospital Charge Code	27060935
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.96
Rate for Payer: Aetna Commercial	$2.38
Rate for Payer: Aetna Medicare Advantage	$2.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.02
Rate for Payer: Cigna Commercial	$3.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.96

GLOVE SURG PROTEXIS SZ 8

Facility

$7.93

Hospital Charge Code	27060940
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.96
Rate for Payer: Aetna Commercial	$2.38
Rate for Payer: Aetna Medicare Advantage	$2.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.02
Rate for Payer: Cigna Commercial	$3.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.96

GLOVE SURG PROTEXIS SZ 8

Facility

$7.93

Hospital Charge Code	27060940
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

GLOVE SURG PROTEXIS SZ 8.5

Facility

$8.17

Hospital Charge Code	27060945
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

GLOVE SURG PROTEXIS SZ 8.5

Facility

$8.17

Hospital Charge Code	27060945
Hospital Revenue Code	270
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$2.45
Rate for Payer: Aetna Medicare Advantage	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.06
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$4.08

GLOVE SURG PROTEXIS SZ 9

Facility

$8.17

Hospital Charge Code	270649568
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

GLOVE SURG PROTEXIS SZ 9

Facility

$8.17

Hospital Charge Code	270649568
Hospital Revenue Code	270
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$4.08
Rate for Payer: Aetna Commercial	$2.45
Rate for Payer: Aetna Medicare Advantage	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.08
Rate for Payer: Cigna Commercial	$4.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.06
Rate for Payer: Oxford Commercial	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$4.08

GLOVE SURG SENSICARE SZ 6.5

Facility

$8.95

Hospital Charge Code	270060925C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$4.47

GLOVE SURG SENSICARE SZ 6.5

Facility

$8.95

Hospital Charge Code	270060925C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

GLOVE SURG SENSICARE SZ 7.5

Facility

$8.94

Hospital Charge Code	270060935C
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

Know your out-of-pocket cost for care.

All Charges