Heights University Hospital

All Charges

Charge

Type

Setting

Price

INST KIT MICRO SUTURETAK

Facility

$875.00

Hospital Charge Code	270677969
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

INST KIT MICRO SUTURETAK

Facility

$875.00

Hospital Charge Code	270677969
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

INST. KIT,SUPERIOR,GLENOID

Facility

$1,960.00

Hospital Charge Code	270687343
Hospital Revenue Code	272
Min. Negotiated Rate	$254.80
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.80
Rate for Payer: Oxford Commercial	$980.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.00
Rate for Payer: UnitedHealthcare Commercial	$980.00

INST. KIT,SUPERIOR,GLENOID

Facility

$1,960.00

Hospital Charge Code	270687343
Hospital Revenue Code	272
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$294.00
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

INSTRATEK BLADE

Facility

$620.00

Hospital Charge Code	270332654
Hospital Revenue Code	272
Min. Negotiated Rate	$80.60
Max. Negotiated Rate	$310.00
Rate for Payer: Aetna Commercial	$186.00
Rate for Payer: Aetna Medicare Advantage	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.10
Rate for Payer: Cigna Commercial	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.60
Rate for Payer: Oxford Commercial	$310.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00
Rate for Payer: UnitedHealthcare Commercial	$310.00

INSTRATEK BLADE

Facility

$620.00

Hospital Charge Code	270332654
Hospital Revenue Code	272
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.00

INSTRUMENTATION FEE OR 999880

Facility

$1,724.85

Hospital Charge Code	270612029
Hospital Revenue Code	272
Min. Negotiated Rate	$224.23
Max. Negotiated Rate	$862.42
Rate for Payer: Aetna Commercial	$517.46
Rate for Payer: Aetna Medicare Advantage	$517.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.84
Rate for Payer: Cigna Commercial	$862.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.23
Rate for Payer: Oxford Commercial	$862.42
Rate for Payer: Qualcare PPO/HMO/WC	$258.73
Rate for Payer: UnitedHealthcare Commercial	$862.42

INSTRUMENTATION FEE OR 999880

Facility

$1,724.85

Hospital Charge Code	270612029
Hospital Revenue Code	272
Min. Negotiated Rate	$258.73
Max. Negotiated Rate	$258.73
Rate for Payer: Qualcare PPO/HMO/WC	$258.73

INSTRUMENT CANNULA 8MM

Facility

$2,800.00

Hospital Charge Code	270663996
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INSTRUMENT CANNULA 8MM

Facility

$2,800.00

Hospital Charge Code	270663996
Hospital Revenue Code	272
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$1,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,400.00

INSTRUMENT CANNULA, LONG 8MM

Facility

$3,000.00

Hospital Charge Code	270663994
Hospital Revenue Code	272
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00

INSTRUMENT CANNULA, LONG 8MM

Facility

$3,000.00

Hospital Charge Code	270663994
Hospital Revenue Code	272
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

INSTRUMENT KIT PRO-TOE

Facility

$1,135.00

Hospital Charge Code	270661604
Hospital Revenue Code	272
Min. Negotiated Rate	$147.55
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$340.50
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.55
Rate for Payer: Oxford Commercial	$567.50
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Commercial	$567.50

INSTRUMENT KIT PRO-TOE

Facility

$1,135.00

Hospital Charge Code	270661604
Hospital Revenue Code	272
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$170.25
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

INSTRUMENT PRODTECTION TRAY AN

Facility

$151.30

Hospital Charge Code	270667057
Hospital Revenue Code	270
Min. Negotiated Rate	$19.67
Max. Negotiated Rate	$75.65
Rate for Payer: Aetna Commercial	$45.39
Rate for Payer: Aetna Medicare Advantage	$45.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.58
Rate for Payer: Cigna Commercial	$75.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.67
Rate for Payer: Oxford Commercial	$75.65
Rate for Payer: Qualcare PPO/HMO/WC	$22.70
Rate for Payer: UnitedHealthcare Commercial	$75.65

INSTRUMENT PRODTECTION TRAY AN

Facility

$151.30

Hospital Charge Code	270667057
Hospital Revenue Code	270
Min. Negotiated Rate	$22.70
Max. Negotiated Rate	$22.70
Rate for Payer: Qualcare PPO/HMO/WC	$22.70

INSTRUMENT SET SEREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687872
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

INSTRUMENT SET SEREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687872
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

INST SET CALCANEUS

Facility

$4,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270687870
Hospital Revenue Code	278
Min. Negotiated Rate	$663.75
Max. Negotiated Rate	$1,070.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.85
Rate for Payer: Qualcare PPO/HMO/WC	$663.75

INST SET CALCANEUS

Facility

$4,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270687870
Hospital Revenue Code	278
Min. Negotiated Rate	$663.75
Max. Negotiated Rate	$2,212.50
Rate for Payer: Aetna Commercial	$1,327.50
Rate for Payer: Aetna Medicare Advantage	$1,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,128.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,128.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,128.38
Rate for Payer: Cigna Commercial	$2,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.85
Rate for Payer: Qualcare PPO/HMO/WC	$663.75

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	366849418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,183.22
Max. Negotiated Rate	$2,183.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	321049418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	321049418
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	411049418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,183.22
Max. Negotiated Rate	$2,183.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22

INS TUN INT PERIT CATH

Facility

$8,972.00

Service Code	HCPCS 49418
Hospital Charge Code	7411588
Hospital Revenue Code	361
Min. Negotiated Rate	$1,345.80
Max. Negotiated Rate	$1,345.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.80

Know your out-of-pocket cost for care.

All Charges