Heights University Hospital

All Charges

Charge

Type

Setting

Price

INTERLOCK 8MM X 20CM

Facility

$2,499.00

Hospital Charge Code	270662971
Hospital Revenue Code	278
Min. Negotiated Rate	$374.85
Max. Negotiated Rate	$604.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.76
Rate for Payer: Qualcare PPO/HMO/WC	$374.85

INTERLOCK 8MM X 20CM

Facility

$2,499.00

Hospital Charge Code	270662971
Hospital Revenue Code	278
Min. Negotiated Rate	$374.85
Max. Negotiated Rate	$1,249.50
Rate for Payer: Aetna Commercial	$749.70
Rate for Payer: Aetna Medicare Advantage	$749.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.25
Rate for Payer: Cigna Commercial	$1,249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$604.76
Rate for Payer: Qualcare PPO/HMO/WC	$374.85

INTERLOCK OCCLUSION SYS

Facility

$2,000.00

Hospital Charge Code	2680390
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

INTERLOCK OCCLUSION SYS

Facility

$2,000.00

Hospital Charge Code	2680390
Hospital Revenue Code	272
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00

INTERLOCK OCCLUSION SYS

Facility

$2,000.00

Hospital Charge Code	7412025
Hospital Revenue Code	272
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00

INTERLOCK OCCLUSION SYS

Facility

$2,000.00

Hospital Charge Code	7412025
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

INTERLOCK OCLUSION SYSTEM 10 M

Facility

$2,697.50

Hospital Charge Code	270679435
Hospital Revenue Code	272
Min. Negotiated Rate	$404.62
Max. Negotiated Rate	$404.62
Rate for Payer: Qualcare PPO/HMO/WC	$404.62

INTERLOCK OCLUSION SYSTEM 10 M

Facility

$2,697.50

Hospital Charge Code	270679435
Hospital Revenue Code	272
Min. Negotiated Rate	$350.68
Max. Negotiated Rate	$1,348.75
Rate for Payer: Aetna Commercial	$809.25
Rate for Payer: Aetna Medicare Advantage	$809.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$687.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$687.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$687.86
Rate for Payer: Cigna Commercial	$1,348.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.68
Rate for Payer: Oxford Commercial	$1,348.75
Rate for Payer: Qualcare PPO/HMO/WC	$404.62
Rate for Payer: UnitedHealthcare Commercial	$1,348.75

INTERLOCK OCLUSION SYSTEM 3MM

Facility

$2,572.50

Hospital Charge Code	270679430
Hospital Revenue Code	272
Min. Negotiated Rate	$334.43
Max. Negotiated Rate	$1,286.25
Rate for Payer: Aetna Commercial	$771.75
Rate for Payer: Aetna Medicare Advantage	$771.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.99
Rate for Payer: Cigna Commercial	$1,286.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.43
Rate for Payer: Oxford Commercial	$1,286.25
Rate for Payer: Qualcare PPO/HMO/WC	$385.88
Rate for Payer: UnitedHealthcare Commercial	$1,286.25

INTERLOCK OCLUSION SYSTEM 3MM

Facility

$2,572.50

Hospital Charge Code	270679430
Hospital Revenue Code	272
Min. Negotiated Rate	$385.88
Max. Negotiated Rate	$385.88
Rate for Payer: Qualcare PPO/HMO/WC	$385.88

INTERLOCK OCLUSION SYSTEM 3MM

Facility

$2,572.50

Hospital Charge Code	270679430O
Hospital Revenue Code	272
Min. Negotiated Rate	$385.88
Max. Negotiated Rate	$385.88
Rate for Payer: Qualcare PPO/HMO/WC	$385.88

INTERLOCK OCLUSION SYSTEM 3MM

Facility

$2,572.50

Hospital Charge Code	270679430O
Hospital Revenue Code	272
Min. Negotiated Rate	$334.43
Max. Negotiated Rate	$1,286.25
Rate for Payer: Aetna Commercial	$771.75
Rate for Payer: Aetna Medicare Advantage	$771.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.99
Rate for Payer: Cigna Commercial	$1,286.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.43
Rate for Payer: Oxford Commercial	$1,286.25
Rate for Payer: Qualcare PPO/HMO/WC	$385.88
Rate for Payer: UnitedHealthcare Commercial	$1,286.25

INTERLOCK OCLUSION SYSTEM 5 MM

Facility

$2,572.50

Hospital Charge Code	270679432
Hospital Revenue Code	272
Min. Negotiated Rate	$385.88
Max. Negotiated Rate	$385.88
Rate for Payer: Qualcare PPO/HMO/WC	$385.88

INTERLOCK OCLUSION SYSTEM 5 MM

Facility

$2,572.50

Hospital Charge Code	270679432
Hospital Revenue Code	272
Min. Negotiated Rate	$334.43
Max. Negotiated Rate	$1,286.25
Rate for Payer: Aetna Commercial	$771.75
Rate for Payer: Aetna Medicare Advantage	$771.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.99
Rate for Payer: Cigna Commercial	$1,286.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.43
Rate for Payer: Oxford Commercial	$1,286.25
Rate for Payer: Qualcare PPO/HMO/WC	$385.88
Rate for Payer: UnitedHealthcare Commercial	$1,286.25

INTERLOCK OCLUSION SYSTEM 6 MM

Facility

$2,572.50

Hospital Charge Code	270679433
Hospital Revenue Code	272
Min. Negotiated Rate	$334.43
Max. Negotiated Rate	$1,286.25
Rate for Payer: Aetna Commercial	$771.75
Rate for Payer: Aetna Medicare Advantage	$771.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$655.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$655.99
Rate for Payer: Cigna Commercial	$1,286.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.43
Rate for Payer: Oxford Commercial	$1,286.25
Rate for Payer: Qualcare PPO/HMO/WC	$385.88
Rate for Payer: UnitedHealthcare Commercial	$1,286.25

INTERLOCK OCLUSION SYSTEM 6 MM

Facility

$2,572.50

Hospital Charge Code	270679433
Hospital Revenue Code	272
Min. Negotiated Rate	$385.88
Max. Negotiated Rate	$385.88
Rate for Payer: Qualcare PPO/HMO/WC	$385.88

INTERLOCK OCLUSION SYSTEM 8 MM

Facility

$1,885.75

Hospital Charge Code	270679434
Hospital Revenue Code	272
Min. Negotiated Rate	$245.15
Max. Negotiated Rate	$942.88
Rate for Payer: Aetna Commercial	$565.73
Rate for Payer: Aetna Medicare Advantage	$565.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.87
Rate for Payer: Cigna Commercial	$942.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.15
Rate for Payer: Oxford Commercial	$942.88
Rate for Payer: Qualcare PPO/HMO/WC	$282.86
Rate for Payer: UnitedHealthcare Commercial	$942.88

INTERLOCK OCLUSION SYSTEM 8 MM

Facility

$1,885.75

Hospital Charge Code	270679434
Hospital Revenue Code	272
Min. Negotiated Rate	$282.86
Max. Negotiated Rate	$282.86
Rate for Payer: Qualcare PPO/HMO/WC	$282.86

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662544
Hospital Revenue Code	278
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,685.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,393.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,685.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662474
Hospital Revenue Code	272
Min. Negotiated Rate	$905.45
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,089.50
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$905.45
Rate for Payer: Oxford Commercial	$3,482.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75
Rate for Payer: UnitedHealthcare Commercial	$3,482.50

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662544
Hospital Revenue Code	278
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$3,482.50
Rate for Payer: Aetna Commercial	$2,089.50
Rate for Payer: Aetna Medicare Advantage	$2,089.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,776.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,776.08
Rate for Payer: Cigna Commercial	$3,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,685.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

INTERNAL BRACE IMPLANT KIT

Facility

$6,965.00

Hospital Charge Code	270662474
Hospital Revenue Code	272
Min. Negotiated Rate	$1,044.75
Max. Negotiated Rate	$1,044.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,044.75

INTERNAL BRACE IMPLANT SYSTEM

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270680614
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$1,792.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

INTERNAL BRACE IMPLANT SYSTEM

Facility

$5,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270680614
Hospital Revenue Code	278
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$1,445.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,445.95
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

INTERP CERV MYELOGRAM

Facility

$2,963.00

Service Code	HCPCS 72240
Hospital Charge Code	84506070
Hospital Revenue Code	320
Min. Negotiated Rate	$444.45
Max. Negotiated Rate	$444.45
Rate for Payer: Qualcare PPO/HMO/WC	$444.45

Know your out-of-pocket cost for care.

All Charges