Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSERT DRILL SLEEVE 8.5/2.8MM

Facility

$781.75

Hospital Charge Code	270678289
Hospital Revenue Code	272
Min. Negotiated Rate	$101.63
Max. Negotiated Rate	$390.88
Rate for Payer: Aetna Commercial	$234.53
Rate for Payer: Aetna Medicare Advantage	$234.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.35
Rate for Payer: Cigna Commercial	$390.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.63
Rate for Payer: Oxford Commercial	$390.88
Rate for Payer: Qualcare PPO/HMO/WC	$117.26
Rate for Payer: UnitedHealthcare Commercial	$390.88

INSERT DRUG IMPLANT

Facility

$1,167.00

Service Code	HCPCS 11981
Hospital Charge Code	16000783
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

INSERT DRUG IMPLANT

Facility

$1,167.00

Service Code	HCPCS 11981
Hospital Charge Code	16000783
Hospital Revenue Code	360
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$354.79
Rate for Payer: Aetna Commercial	$350.10
Rate for Payer: Aetna Medicare Advantage	$350.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.58
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.71
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89
Rate for Payer: Wellpoint Medicaid Managed Care	$354.79

INSERT DRUG IMPLANT DEVICE

Facility

$716.00

Service Code	HCPCS 11981
Hospital Charge Code	87502620
Hospital Revenue Code	761
Min. Negotiated Rate	$93.08
Max. Negotiated Rate	$361.89
Rate for Payer: Aetna Better Health Medicaid	$354.79
Rate for Payer: Aetna Commercial	$214.80
Rate for Payer: Aetna Medicare Advantage	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.58
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.08
Rate for Payer: Oxford Commercial	$358.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.40
Rate for Payer: UnitedHealthcare Commercial	$358.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$361.89

INSERT DRUG IMPLANT DEVICE

Facility

$716.00

Service Code	HCPCS 11981
Hospital Charge Code	87502620
Hospital Revenue Code	761
Min. Negotiated Rate	$107.40
Max. Negotiated Rate	$107.40
Rate for Payer: Qualcare PPO/HMO/WC	$107.40

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	7411025
Hospital Revenue Code	480
Min. Negotiated Rate	$282.90
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Better Health Medicaid	$1,861.87
Rate for Payer: Aetna Commercial	$4,532.40
Rate for Payer: Aetna Medicare Advantage	$4,532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,852.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,852.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,852.54
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,964.04
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20
Rate for Payer: UnitedHealthcare Commercial	$1,793.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,899.11

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	366833217
Hospital Revenue Code	480
Min. Negotiated Rate	$282.90
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Better Health Medicaid	$1,861.87
Rate for Payer: Aetna Commercial	$4,532.40
Rate for Payer: Aetna Medicare Advantage	$4,532.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,852.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,852.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,852.54
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,964.04
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20
Rate for Payer: UnitedHealthcare Commercial	$1,793.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,899.11

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	7411025
Hospital Revenue Code	480
Min. Negotiated Rate	$2,266.20
Max. Negotiated Rate	$2,266.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20

INSERT DUAL PM LEADS

Facility

$15,108.00

Service Code	HCPCS 33217
Hospital Charge Code	366833217
Hospital Revenue Code	480
Min. Negotiated Rate	$2,266.20
Max. Negotiated Rate	$2,266.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,266.20

INSERTER BONE SCREW 78353000

Facility

$817.65

Hospital Charge Code	270607867
Hospital Revenue Code	272
Min. Negotiated Rate	$106.29
Max. Negotiated Rate	$408.82
Rate for Payer: Aetna Commercial	$245.29
Rate for Payer: Aetna Medicare Advantage	$245.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.50
Rate for Payer: Cigna Commercial	$408.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.29
Rate for Payer: Oxford Commercial	$408.82
Rate for Payer: Qualcare PPO/HMO/WC	$122.65
Rate for Payer: UnitedHealthcare Commercial	$408.82

INSERTER BONE SCREW 78353000

Facility

$817.65

Hospital Charge Code	270607867
Hospital Revenue Code	272
Min. Negotiated Rate	$122.65
Max. Negotiated Rate	$122.65
Rate for Payer: Qualcare PPO/HMO/WC	$122.65

INSERTER CRUCIFORM 2.4mm

Facility

$2,208.00

Hospital Charge Code	270656614
Hospital Revenue Code	272
Min. Negotiated Rate	$331.20
Max. Negotiated Rate	$331.20
Rate for Payer: Qualcare PPO/HMO/WC	$331.20

INSERTER CRUCIFORM 2.4mm

Facility

$2,208.00

Hospital Charge Code	270656614
Hospital Revenue Code	272
Min. Negotiated Rate	$287.04
Max. Negotiated Rate	$1,104.00
Rate for Payer: Aetna Commercial	$662.40
Rate for Payer: Aetna Medicare Advantage	$662.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$563.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$563.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$563.04
Rate for Payer: Cigna Commercial	$1,104.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.04
Rate for Payer: Oxford Commercial	$1,104.00
Rate for Payer: Qualcare PPO/HMO/WC	$331.20
Rate for Payer: UnitedHealthcare Commercial	$1,104.00

INSERTER HELICAL BLADE

Facility

$5,473.00

Hospital Charge Code	270688249
Hospital Revenue Code	272
Min. Negotiated Rate	$820.95
Max. Negotiated Rate	$820.95
Rate for Payer: Qualcare PPO/HMO/WC	$820.95

INSERTER HELICAL BLADE

Facility

$5,473.00

Hospital Charge Code	270688249
Hospital Revenue Code	272
Min. Negotiated Rate	$711.49
Max. Negotiated Rate	$2,736.50
Rate for Payer: Aetna Commercial	$1,641.90
Rate for Payer: Aetna Medicare Advantage	$1,641.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,395.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,395.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,395.62
Rate for Payer: Cigna Commercial	$2,736.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$711.49
Rate for Payer: Oxford Commercial	$2,736.50
Rate for Payer: Qualcare PPO/HMO/WC	$820.95
Rate for Payer: UnitedHealthcare Commercial	$2,736.50

INSERTER SHAFT F/LAGSCR 225860

Facility

$2,797.50

Hospital Charge Code	270632313
Hospital Revenue Code	272
Min. Negotiated Rate	$363.68
Max. Negotiated Rate	$1,398.75
Rate for Payer: Aetna Commercial	$839.25
Rate for Payer: Aetna Medicare Advantage	$839.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$713.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$713.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$713.36
Rate for Payer: Cigna Commercial	$1,398.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.68
Rate for Payer: Oxford Commercial	$1,398.75
Rate for Payer: Qualcare PPO/HMO/WC	$419.62
Rate for Payer: UnitedHealthcare Commercial	$1,398.75

INSERTER SHAFT F/LAGSCR 225860

Facility

$2,797.50

Hospital Charge Code	270632313
Hospital Revenue Code	272
Min. Negotiated Rate	$419.62
Max. Negotiated Rate	$419.62
Rate for Payer: Qualcare PPO/HMO/WC	$419.62

INSERTER TIP ART SURF 58435201

Facility

$496.00

Hospital Charge Code	270635701
Hospital Revenue Code	272
Min. Negotiated Rate	$64.48
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$148.80
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.48
Rate for Payer: Oxford Commercial	$248.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$248.00

INSERTER TIP ART SURF 58435201

Facility

$496.00

Hospital Charge Code	270635701
Hospital Revenue Code	272
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

INSERTER TIP DEEP LARGE 6MM

Facility

$1,725.00

Hospital Charge Code	270692630
Hospital Revenue Code	272
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

INSERTER TIP DEEP LARGE 6MM

Facility

$1,725.00

Hospital Charge Code	270692630
Hospital Revenue Code	272
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.25
Rate for Payer: Oxford Commercial	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$862.50

INSERTER TIP L/LD H 5MM

Facility

$1,725.00

Hospital Charge Code	270697229
Hospital Revenue Code	272
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

INSERTER TIP L/LD H 5MM

Facility

$1,725.00

Hospital Charge Code	270697229
Hospital Revenue Code	272
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.25
Rate for Payer: Oxford Commercial	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$862.50

INSERTER TIP MED

Facility

$1,725.00

Hospital Charge Code	270693682
Hospital Revenue Code	272
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.25
Rate for Payer: Oxford Commercial	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$862.50

INSERTER TIP MED

Facility

$1,725.00

Hospital Charge Code	270693682
Hospital Revenue Code	272
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

Know your out-of-pocket cost for care.

All Charges