Heights University Hospital

All Charges

Charge

Type

Setting

Price

INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES

Facility

$27,413.97

Service Code	APR-DRG 1762
Min. Negotiated Rate	$26,570.34
Max. Negotiated Rate	$27,413.97
Rate for Payer: Aetna Better Health Medicaid	$26,570.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,101.75
Rate for Payer: Wellpoint Medicaid Managed Care	$27,413.97

INSERTION STENT BILLIARY

Facility

$3,503.40

Service Code	HCPCS 47555
Hospital Charge Code	5100504
Hospital Revenue Code	361
Min. Negotiated Rate	$525.51
Max. Negotiated Rate	$525.51
Rate for Payer: Qualcare PPO/HMO/WC	$525.51

INSERTION STENT BILLIARY

Facility

$3,503.40

Service Code	HCPCS 47555
Hospital Charge Code	5100504
Hospital Revenue Code	361
Min. Negotiated Rate	$455.44
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$1,051.02
Rate for Payer: Aetna Medicare Advantage	$1,051.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$893.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$893.37
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	$893.37
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.44
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.51
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INSERT IUD

Facility

$6,866.80

Service Code	HCPCS 58300
Hospital Charge Code	16001006
Hospital Revenue Code	360
Min. Negotiated Rate	$892.68
Max. Negotiated Rate	$3,433.40
Rate for Payer: Aetna Commercial	$2,060.04
Rate for Payer: Aetna Medicare Advantage	$2,060.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.03
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	$1,751.03
Rate for Payer: Cigna Commercial	$3,433.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$892.68
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,030.02
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSERT IUD

Facility

$6,866.80

Service Code	HCPCS 58300
Hospital Charge Code	16001006
Hospital Revenue Code	360
Min. Negotiated Rate	$1,030.02
Max. Negotiated Rate	$1,030.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,030.02

INSERT IVC FILTER

Facility

$13,353.00

Service Code	HCPCS 37191
Hospital Charge Code	366837191
Hospital Revenue Code	361
Min. Negotiated Rate	$1,735.89
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$4,005.90
Rate for Payer: Aetna Medicare Advantage	$4,005.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,405.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,405.01
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	$3,405.01
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.89
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.95
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

INSERT IVC FILTER

Facility

$13,353.00

Service Code	HCPCS 37191
Hospital Charge Code	7411127
Hospital Revenue Code	361
Min. Negotiated Rate	$1,735.89
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$4,005.90
Rate for Payer: Aetna Medicare Advantage	$4,005.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,405.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,405.01
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	$3,405.01
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,735.89
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.95
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

INSERT IVC FILTER

Facility

$13,353.00

Service Code	HCPCS 37191
Hospital Charge Code	366837191
Hospital Revenue Code	361
Min. Negotiated Rate	$2,002.95
Max. Negotiated Rate	$2,002.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.95

INSERT IVC FILTER

Facility

$13,353.00

Service Code	HCPCS 37191
Hospital Charge Code	7411127
Hospital Revenue Code	361
Min. Negotiated Rate	$2,002.95
Max. Negotiated Rate	$2,002.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,002.95

INSERT KNEE 3D SIZE 8 10MM

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270692262
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$1,875.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

INSERT KNEE 3D SIZE 8 10MM

Facility

$7,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270692262
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.50
Max. Negotiated Rate	$3,875.00
Rate for Payer: Aetna Commercial	$2,325.00
Rate for Payer: Aetna Medicare Advantage	$2,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.25
Rate for Payer: Cigna Commercial	$3,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.50

INSERT LOCKING

Facility

$550.00

Hospital Charge Code	270640258
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

INSERT LOCKING

Facility

$550.00

Hospital Charge Code	270640258
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

INSERT MESH/PELVIC FLR ADDON

Facility

$7,795.00

Service Code	HCPCS 57267
Hospital Charge Code	1600000434
Hospital Revenue Code	360
Min. Negotiated Rate	$1,169.25
Max. Negotiated Rate	$1,169.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,169.25

INSERT MESH/PELVIC FLR ADDON

Facility

$7,795.00

Service Code	HCPCS 57267
Hospital Charge Code	1600000434
Hospital Revenue Code	360
Min. Negotiated Rate	$236.35
Max. Negotiated Rate	$2,338.50
Rate for Payer: Aetna Commercial	$2,338.50
Rate for Payer: Aetna Medicare Advantage	$2,338.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,987.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,987.72
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	$1,987.72
Rate for Payer: Cigna Commercial	$236.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,013.35
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,169.25
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSERT MULTI-COMP PENIS PROS

Facility

$94,816.00

Service Code	HCPCS 54405
Hospital Charge Code	16000168
Hospital Revenue Code	360
Min. Negotiated Rate	$14,222.40
Max. Negotiated Rate	$14,222.40
Rate for Payer: Qualcare PPO/HMO/WC	$14,222.40

INSERT MULTI-COMP PENIS PROS

Facility

$94,816.00

Service Code	HCPCS 54405
Hospital Charge Code	16000168
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$49,357.08
Rate for Payer: Aetna Commercial	$28,444.80
Rate for Payer: Aetna Medicare Advantage	$28,444.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,178.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,178.08
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	$24,178.08
Rate for Payer: Cigna Commercial	$49,357.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,326.08
Rate for Payer: Oxford Commercial	$10,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$14,222.40
Rate for Payer: UnitedHealthcare Commercial	$11,456.00

INSERT NG TUBE

Facility

$889.60

Service Code	HCPCS 43752
Hospital Charge Code	2500262
Hospital Revenue Code	750
Min. Negotiated Rate	$133.44
Max. Negotiated Rate	$133.44
Rate for Payer: Qualcare PPO/HMO/WC	$133.44

INSERT NG TUBE

Facility

$889.60

Service Code	HCPCS 43752
Hospital Charge Code	2500262
Hospital Revenue Code	750
Min. Negotiated Rate	$115.65
Max. Negotiated Rate	$1,686.00
Rate for Payer: Aetna Commercial	$266.88
Rate for Payer: Aetna Medicare Advantage	$266.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.85
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.65
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$133.44
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

INSERT NON TUNNEL CV CATH

Facility

$18,533.40

Service Code	HCPCS 36556
Hospital Charge Code	1600000414
Hospital Revenue Code	360
Min. Negotiated Rate	$2,780.01
Max. Negotiated Rate	$2,780.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,780.01

INSERT NON TUNNEL CV CATH

Facility

$18,533.40

Service Code	HCPCS 36556
Hospital Charge Code	1600000414
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$5,560.02
Rate for Payer: Aetna Medicare Advantage	$5,560.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,726.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,726.02
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	$4,726.02
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,409.34
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,780.01
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

INSERT OM BIPOLAR LONG 900751

Facility

$463.25

Hospital Charge Code	270600262
Hospital Revenue Code	272
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

INSERT OM BIPOLAR LONG 900751

Facility

$463.25

Hospital Charge Code	270600262
Hospital Revenue Code	272
Min. Negotiated Rate	$60.22
Max. Negotiated Rate	$231.62
Rate for Payer: Aetna Commercial	$138.97
Rate for Payer: Aetna Medicare Advantage	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.13
Rate for Payer: Cigna Commercial	$231.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: Oxford Commercial	$231.62
Rate for Payer: Qualcare PPO/HMO/WC	$69.49
Rate for Payer: UnitedHealthcare Commercial	$231.62

INSERT OM BIPOLAR MACRO 900761

Facility

$463.25

Hospital Charge Code	270600261
Hospital Revenue Code	272
Min. Negotiated Rate	$60.22
Max. Negotiated Rate	$231.62
Rate for Payer: Aetna Commercial	$138.97
Rate for Payer: Aetna Medicare Advantage	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.13
Rate for Payer: Cigna Commercial	$231.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.22
Rate for Payer: Oxford Commercial	$231.62
Rate for Payer: Qualcare PPO/HMO/WC	$69.49
Rate for Payer: UnitedHealthcare Commercial	$231.62

INSERT OM BIPOLAR MACRO 900761

Facility

$463.25

Hospital Charge Code	270600261
Hospital Revenue Code	272
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

Know your out-of-pocket cost for care.

All Charges