Heights University Hospital

All Charges

Charge

Type

Setting

Price

GOLD PROBE ARGON COAGULATOR

Facility

$443.00

Hospital Charge Code	270334803
Hospital Revenue Code	272
Min. Negotiated Rate	$57.59
Max. Negotiated Rate	$221.50
Rate for Payer: Aetna Commercial	$132.90
Rate for Payer: Aetna Medicare Advantage	$132.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.97
Rate for Payer: Cigna Commercial	$221.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.59
Rate for Payer: Oxford Commercial	$221.50
Rate for Payer: Qualcare PPO/HMO/WC	$66.45
Rate for Payer: UnitedHealthcare Commercial	$221.50

GOLD PROBE ARGON COAGULATOR

Facility

$443.00

Hospital Charge Code	270334803
Hospital Revenue Code	272
Min. Negotiated Rate	$66.45
Max. Negotiated Rate	$66.45
Rate for Payer: Qualcare PPO/HMO/WC	$66.45

GOLYTELY 1 GAL

Facility

$53.80

Hospital Charge Code	6007330
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

GOLYTELY 1 GAL

Facility

$53.80

Hospital Charge Code	6007330
Hospital Revenue Code	251
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$16.14
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.99
Rate for Payer: Oxford Commercial	$26.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$26.90

GOMCO Suction Machine

Facility

$63.25

Hospital Charge Code	2708001521
Hospital Revenue Code	279
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$18.98
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$31.62
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$31.62

GOMCO Suction Machine

Facility

$63.25

Hospital Charge Code	2708001521
Hospital Revenue Code	279
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

GONADORELIN HYDROCH100MCG

Facility

$324.00

Hospital Charge Code	60632968
Hospital Revenue Code	636
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$97.20
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.41
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

GONADORELIN HYDROCH100MCG

Facility

$324.00

Hospital Charge Code	60632968
Hospital Revenue Code	636
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$78.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.41
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

GONIO LENS

Facility

$300.00

Hospital Charge Code	270687726
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

GONIO LENS

Facility

$300.00

Hospital Charge Code	270687726
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

GONIOSOL OPHTH

Facility

$84.00

Hospital Charge Code	60635032
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

GONIOSOL OPHTH

Facility

$84.00

Hospital Charge Code	60635032
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

GOODWIRE ASAHI PROWATER 180CM

Facility

$2,250.00

Hospital Charge Code	270636741C
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

GOODWIRE ASAHI PROWATER 180CM

Facility

$2,250.00

Hospital Charge Code	270636741C
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

GORE ACUSEAL VASCULAR GRAFT

Facility

$7,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270679633
Hospital Revenue Code	278
Min. Negotiated Rate	$1,124.25
Max. Negotiated Rate	$3,747.50
Rate for Payer: Aetna Commercial	$2,248.50
Rate for Payer: Aetna Medicare Advantage	$2,248.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,911.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,911.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,499.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,911.22
Rate for Payer: Cigna Commercial	$3,747.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,813.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,124.25

GORE ACUSEAL VASCULAR GRAFT

Facility

$7,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270679633
Hospital Revenue Code	278
Min. Negotiated Rate	$1,124.25
Max. Negotiated Rate	$1,813.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,499.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,813.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,124.25

GORETEX DUALMESH BIO 75-96SQ C

Facility

$128.00

Hospital Charge Code	270335386
Hospital Revenue Code	278
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

GORETEX DUALMESH BIO 75-96SQ C

Facility

$128.00

Hospital Charge Code	270335386
Hospital Revenue Code	278
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$64.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

GOUGE BMT 8MM DISP 423876

Facility

$1,556.85

Hospital Charge Code	270615810
Hospital Revenue Code	272
Min. Negotiated Rate	$202.39
Max. Negotiated Rate	$778.42
Rate for Payer: Aetna Commercial	$467.06
Rate for Payer: Aetna Medicare Advantage	$467.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.00
Rate for Payer: Cigna Commercial	$778.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.39
Rate for Payer: Oxford Commercial	$778.42
Rate for Payer: Qualcare PPO/HMO/WC	$233.53
Rate for Payer: UnitedHealthcare Commercial	$778.42

GOUGE BMT 8MM DISP 423876

Facility

$1,556.85

Hospital Charge Code	270615810
Hospital Revenue Code	272
Min. Negotiated Rate	$233.53
Max. Negotiated Rate	$233.53
Rate for Payer: Qualcare PPO/HMO/WC	$233.53

GOWN BAIR PAWS STD

Facility

$62.69

Hospital Charge Code	270649747
Hospital Revenue Code	272
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.40

GOWN BAIR PAWS STD

Facility

$62.69

Hospital Charge Code	270649747
Hospital Revenue Code	272
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$31.34
Rate for Payer: Aetna Commercial	$18.81
Rate for Payer: Aetna Medicare Advantage	$18.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.99
Rate for Payer: Cigna Commercial	$31.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.15
Rate for Payer: Oxford Commercial	$31.34
Rate for Payer: Qualcare PPO/HMO/WC	$9.40
Rate for Payer: UnitedHealthcare Commercial	$31.34

GOWN BAIR PAWS XL

Facility

$77.05

Hospital Charge Code	270649746
Hospital Revenue Code	272
Min. Negotiated Rate	$11.56
Max. Negotiated Rate	$11.56
Rate for Payer: Qualcare PPO/HMO/WC	$11.56

GOWN BAIR PAWS XL

Facility

$77.05

Hospital Charge Code	270649746
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

GOWN NON REINFORCED XL

Facility

$12.64

Hospital Charge Code	270649518
Hospital Revenue Code	270
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

Know your out-of-pocket cost for care.

All Charges