Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEAD XL DELTA BIOLOX 32MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270683290
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

HEAD ZIM FEM 22 3.0 8018-22-30

Facility

$3,371.25

Hospital Charge Code	270616842
Hospital Revenue Code	278
Min. Negotiated Rate	$505.69
Max. Negotiated Rate	$1,685.62
Rate for Payer: Aetna Commercial	$1,011.38
Rate for Payer: Aetna Medicare Advantage	$1,011.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$859.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$859.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$674.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$859.67
Rate for Payer: Cigna Commercial	$1,685.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$815.84
Rate for Payer: Qualcare PPO/HMO/WC	$505.69

HEAD ZIM FEM 22 3.0 8018-22-30

Facility

$3,371.25

Hospital Charge Code	270616842
Hospital Revenue Code	278
Min. Negotiated Rate	$505.69
Max. Negotiated Rate	$815.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$674.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$815.84
Rate for Payer: Qualcare PPO/HMO/WC	$505.69

HEAD ZIM FEM 22MM 8018-22-02

Facility

$3,275.25

Hospital Charge Code	270616591
Hospital Revenue Code	278
Min. Negotiated Rate	$491.29
Max. Negotiated Rate	$792.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.61
Rate for Payer: Qualcare PPO/HMO/WC	$491.29

HEAD ZIM FEM 22MM 8018-22-02

Facility

$3,275.25

Hospital Charge Code	270616591
Hospital Revenue Code	278
Min. Negotiated Rate	$491.29
Max. Negotiated Rate	$1,637.62
Rate for Payer: Aetna Commercial	$982.58
Rate for Payer: Aetna Medicare Advantage	$982.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.19
Rate for Payer: Cigna Commercial	$1,637.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.61
Rate for Payer: Qualcare PPO/HMO/WC	$491.29

HEAD ZIM FEM 22MM MED 9026-22

Facility

$3,490.45

Hospital Charge Code	270605859
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$1,745.22
Rate for Payer: Aetna Commercial	$1,047.13
Rate for Payer: Aetna Medicare Advantage	$1,047.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.06
Rate for Payer: Cigna Commercial	$1,745.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 22MM MED 9026-22

Facility

$3,490.45

Hospital Charge Code	270605859
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$844.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM 8018-28-01

Facility

$3,277.65

Hospital Charge Code	270613460
Hospital Revenue Code	278
Min. Negotiated Rate	$491.65
Max. Negotiated Rate	$793.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.19
Rate for Payer: Qualcare PPO/HMO/WC	$491.65

HEAD ZIM FEM 28MM 8018-28-01

Facility

$3,277.65

Hospital Charge Code	270613460
Hospital Revenue Code	278
Min. Negotiated Rate	$491.65
Max. Negotiated Rate	$1,638.83
Rate for Payer: Aetna Commercial	$983.29
Rate for Payer: Aetna Medicare Advantage	$983.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$835.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$835.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$655.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$835.80
Rate for Payer: Cigna Commercial	$1,638.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$793.19
Rate for Payer: Qualcare PPO/HMO/WC	$491.65

HEAD ZIM FEM 28MM 8018-28-02

Facility

$3,490.45

Hospital Charge Code	270609818
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$844.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM 8018-28-02

Facility

$3,490.45

Hospital Charge Code	270609818
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$1,745.22
Rate for Payer: Aetna Commercial	$1,047.13
Rate for Payer: Aetna Medicare Advantage	$1,047.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.06
Rate for Payer: Cigna Commercial	$1,745.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM 8018-28-04

Facility

$3,490.45

Hospital Charge Code	270608929
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$1,745.22
Rate for Payer: Aetna Commercial	$1,047.13
Rate for Payer: Aetna Medicare Advantage	$1,047.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$890.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$890.06
Rate for Payer: Cigna Commercial	$1,745.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM 8018-28-04

Facility

$3,490.45

Hospital Charge Code	270608929
Hospital Revenue Code	278
Min. Negotiated Rate	$523.57
Max. Negotiated Rate	$844.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.69
Rate for Payer: Qualcare PPO/HMO/WC	$523.57

HEAD ZIM FEM 28MM SHT 9026-28

Facility

$3,642.45

Hospital Charge Code	270606985
Hospital Revenue Code	278
Min. Negotiated Rate	$546.37
Max. Negotiated Rate	$881.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$728.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.47
Rate for Payer: Qualcare PPO/HMO/WC	$546.37

HEAD ZIM FEM 28MM SHT 9026-28

Facility

$3,642.45

Hospital Charge Code	270606985
Hospital Revenue Code	278
Min. Negotiated Rate	$546.37
Max. Negotiated Rate	$1,821.22
Rate for Payer: Aetna Commercial	$1,092.73
Rate for Payer: Aetna Medicare Advantage	$1,092.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$928.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$728.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$928.82
Rate for Payer: Cigna Commercial	$1,821.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$881.47
Rate for Payer: Qualcare PPO/HMO/WC	$546.37

HEAD ZIM FEM 29MM 9026-29

Facility

$3,412.85

Hospital Charge Code	270605479
Hospital Revenue Code	278
Min. Negotiated Rate	$511.93
Max. Negotiated Rate	$825.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: Qualcare PPO/HMO/WC	$511.93

HEAD ZIM FEM 29MM 9026-29

Facility

$3,412.85

Hospital Charge Code	270605479
Hospital Revenue Code	278
Min. Negotiated Rate	$511.93
Max. Negotiated Rate	$1,706.42
Rate for Payer: Aetna Commercial	$1,023.86
Rate for Payer: Aetna Medicare Advantage	$1,023.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$682.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.28
Rate for Payer: Cigna Commercial	$1,706.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$825.91
Rate for Payer: Qualcare PPO/HMO/WC	$511.93

HEAD ZIM FEM 9026-28

Facility

$3,487.25

Hospital Charge Code	270607080
Hospital Revenue Code	278
Min. Negotiated Rate	$523.09
Max. Negotiated Rate	$843.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$697.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$843.91
Rate for Payer: Qualcare PPO/HMO/WC	$523.09

HEAD ZIM FEM 9026-28

Facility

$3,487.25

Hospital Charge Code	270607080
Hospital Revenue Code	278
Min. Negotiated Rate	$523.09
Max. Negotiated Rate	$1,743.62
Rate for Payer: Aetna Commercial	$1,046.17
Rate for Payer: Aetna Medicare Advantage	$1,046.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$889.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$889.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$697.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$889.25
Rate for Payer: Cigna Commercial	$1,743.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$843.91
Rate for Payer: Qualcare PPO/HMO/WC	$523.09

HEAD ZIM HUM 13 4065-44

Facility

$5,725.65

Hospital Charge Code	270613410
Hospital Revenue Code	278
Min. Negotiated Rate	$858.85
Max. Negotiated Rate	$2,862.82
Rate for Payer: Aetna Commercial	$1,717.69
Rate for Payer: Aetna Medicare Advantage	$1,717.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,460.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,460.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,460.04
Rate for Payer: Cigna Commercial	$2,862.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.61
Rate for Payer: Qualcare PPO/HMO/WC	$858.85

HEAD ZIM HUM 13 4065-44

Facility

$5,725.65

Hospital Charge Code	270613410
Hospital Revenue Code	278
Min. Negotiated Rate	$858.85
Max. Negotiated Rate	$1,385.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,145.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,385.61
Rate for Payer: Qualcare PPO/HMO/WC	$858.85

HEAD ZIM HUM 14 26 4065-49

Facility

$3,084.85

Hospital Charge Code	270621877
Hospital Revenue Code	278
Min. Negotiated Rate	$462.73
Max. Negotiated Rate	$746.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$746.53
Rate for Payer: Qualcare PPO/HMO/WC	$462.73

HEAD ZIM HUM 14 26 4065-49

Facility

$3,084.85

Hospital Charge Code	270621877
Hospital Revenue Code	278
Min. Negotiated Rate	$462.73
Max. Negotiated Rate	$1,542.42
Rate for Payer: Aetna Commercial	$925.46
Rate for Payer: Aetna Medicare Advantage	$925.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.64
Rate for Payer: Cigna Commercial	$1,542.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$746.53
Rate for Payer: Qualcare PPO/HMO/WC	$462.73

HEAD ZIM HUM 14 4065-48

Facility

$4,332.85

Hospital Charge Code	270611154
Hospital Revenue Code	278
Min. Negotiated Rate	$649.93
Max. Negotiated Rate	$2,166.43
Rate for Payer: Aetna Commercial	$1,299.86
Rate for Payer: Aetna Medicare Advantage	$1,299.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.88
Rate for Payer: Cigna Commercial	$2,166.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,048.55
Rate for Payer: Qualcare PPO/HMO/WC	$649.93

HEAD ZIM HUM 14 4065-48

Facility

$4,332.85

Hospital Charge Code	270611154
Hospital Revenue Code	278
Min. Negotiated Rate	$649.93
Max. Negotiated Rate	$1,048.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,048.55
Rate for Payer: Qualcare PPO/HMO/WC	$649.93

Know your out-of-pocket cost for care.

All Charges