Heights University Hospital

All Charges

Charge

Type

Setting

Price

JOINT SURVEY SNGL VIEW-TC

Facility

$153.15

Service Code	HCPCS 77077TC
Hospital Charge Code	85000285
Hospital Revenue Code	320
Min. Negotiated Rate	$22.97
Max. Negotiated Rate	$22.97
Rate for Payer: Qualcare PPO/HMO/WC	$22.97

JOINT UNIVERSAL FOR TWO TUBES

Facility

$3,380.45

Service Code	HCPCS C1776
Hospital Charge Code	270639891
Hospital Revenue Code	278
Min. Negotiated Rate	$507.07
Max. Negotiated Rate	$1,690.22
Rate for Payer: Aetna Commercial	$1,014.13
Rate for Payer: Aetna Medicare Advantage	$1,014.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$862.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$862.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$862.01
Rate for Payer: Cigna Commercial	$1,690.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.07
Rate for Payer: Qualcare PPO/HMO/WC	$507.07

JOINT UNIVERSAL FOR TWO TUBES

Facility

$3,380.45

Service Code	HCPCS C1776
Hospital Charge Code	270639891
Hospital Revenue Code	278
Min. Negotiated Rate	$507.07
Max. Negotiated Rate	$818.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.07
Rate for Payer: Qualcare PPO/HMO/WC	$507.07

JOYSTICK REDUCTION 2.8MM

Facility

$318.25

Hospital Charge Code	270678309
Hospital Revenue Code	272
Min. Negotiated Rate	$41.37
Max. Negotiated Rate	$159.12
Rate for Payer: Aetna Commercial	$95.47
Rate for Payer: Aetna Medicare Advantage	$95.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.15
Rate for Payer: Cigna Commercial	$159.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.37
Rate for Payer: Oxford Commercial	$159.12
Rate for Payer: Qualcare PPO/HMO/WC	$47.74
Rate for Payer: UnitedHealthcare Commercial	$159.12

JOYSTICK REDUCTION 2.8MM

Facility

$318.25

Hospital Charge Code	270678309
Hospital Revenue Code	272
Min. Negotiated Rate	$47.74
Max. Negotiated Rate	$47.74
Rate for Payer: Qualcare PPO/HMO/WC	$47.74

JOYSTICK REDUCTION 5.0 MM

Facility

$1,591.35

Service Code	HCPCS C1713
Hospital Charge Code	270680137
Hospital Revenue Code	278
Min. Negotiated Rate	$238.70
Max. Negotiated Rate	$385.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.11
Rate for Payer: Qualcare PPO/HMO/WC	$238.70

JOYSTICK REDUCTION 5.0 MM

Facility

$1,591.35

Service Code	HCPCS C1713
Hospital Charge Code	270680137
Hospital Revenue Code	278
Min. Negotiated Rate	$238.70
Max. Negotiated Rate	$795.67
Rate for Payer: Aetna Commercial	$477.40
Rate for Payer: Aetna Medicare Advantage	$477.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.79
Rate for Payer: Cigna Commercial	$795.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.11
Rate for Payer: Qualcare PPO/HMO/WC	$238.70

JOYSTICK REDUCTION 6.5MM

Facility

$1,545.55

Hospital Charge Code	270677510
Hospital Revenue Code	272
Min. Negotiated Rate	$200.92
Max. Negotiated Rate	$772.77
Rate for Payer: Aetna Commercial	$463.67
Rate for Payer: Aetna Medicare Advantage	$463.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$394.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$394.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$394.12
Rate for Payer: Cigna Commercial	$772.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.92
Rate for Payer: Oxford Commercial	$772.77
Rate for Payer: Qualcare PPO/HMO/WC	$231.83
Rate for Payer: UnitedHealthcare Commercial	$772.77

JOYSTICK REDUCTION 6.5MM

Facility

$1,545.55

Hospital Charge Code	270677510
Hospital Revenue Code	272
Min. Negotiated Rate	$231.83
Max. Negotiated Rate	$231.83
Rate for Payer: Qualcare PPO/HMO/WC	$231.83

JUGGERKNOT 2.0 DISP KIT

Facility

$2,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681525
Hospital Revenue Code	278
Min. Negotiated Rate	$397.50
Max. Negotiated Rate	$1,325.00
Rate for Payer: Aetna Commercial	$795.00
Rate for Payer: Aetna Medicare Advantage	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.75
Rate for Payer: Cigna Commercial	$1,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.30
Rate for Payer: Qualcare PPO/HMO/WC	$397.50

JUGGERKNOT 2.0 DISP KIT

Facility

$2,650.00

Service Code	HCPCS C1713
Hospital Charge Code	270681525
Hospital Revenue Code	278
Min. Negotiated Rate	$397.50
Max. Negotiated Rate	$641.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.30
Rate for Payer: Qualcare PPO/HMO/WC	$397.50

JUGS OMNI W/SPECIMEN CAP

Facility

$131.25

Hospital Charge Code	270666017
Hospital Revenue Code	270
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

JUGS OMNI W/SPECIMEN CAP

Facility

$131.25

Hospital Charge Code	270666017
Hospital Revenue Code	270
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$39.38
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$65.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$65.62

JUMBO BIOSPY FORCEPS

Facility

$35.00

Hospital Charge Code	270701121
Hospital Revenue Code	272
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$10.50
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$17.50

JUMBO BIOSPY FORCEPS

Facility

$35.00

Hospital Charge Code	270701121
Hospital Revenue Code	272
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

JUMBO FORCEPS

Facility

$116.00

Hospital Charge Code	270325681
Hospital Revenue Code	272
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$58.00
Rate for Payer: Aetna Commercial	$34.80
Rate for Payer: Aetna Medicare Advantage	$34.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.58
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$58.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$58.00

JUMBO FORCEPS

Facility

$116.00

Hospital Charge Code	270325681
Hospital Revenue Code	272
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

JUMPSTART KIT 4x4

Facility

$125.00

Hospital Charge Code	270676731
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

JUMPSTART KIT 4x4

Facility

$125.00

Hospital Charge Code	270676731
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

JURGAN BABY PIN BALL 0.9MM

Facility

$175.00

Hospital Charge Code	270673129
Hospital Revenue Code	272
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$87.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$87.50

JURGAN BABY PIN BALL 0.9MM

Facility

$175.00

Hospital Charge Code	270673129
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

JUVENO FEM HIPSYS SZ 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270703609
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

JUVENO FEM HIPSYS SZ 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270703609
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

KACTUSH.5x4.25P.5x4.25 1156602

Facility

$980.00

Hospital Charge Code	270639232
Hospital Revenue Code	272
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$147.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

KACTUSH.5x4.25P.5x4.25 1156602

Facility

$980.00

Hospital Charge Code	270639232
Hospital Revenue Code	272
Min. Negotiated Rate	$127.40
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$294.00
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.40
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Commercial	$490.00

Know your out-of-pocket cost for care.

All Charges