Heights University Hospital

All Charges

Charge

Type

Setting

Price

APPLICATOR ENDOSCOP SUGICEL

Facility

$104.00

Hospital Charge Code	270688737
Hospital Revenue Code	272
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$52.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$52.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$52.00

APPLICATOR FLEXIBLE 45 CM TIP

Facility

$319.70

Hospital Charge Code	270689526
Hospital Revenue Code	272
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$47.95
Rate for Payer: Qualcare PPO/HMO/WC	$47.95

APPLICATOR FLEXIBLE 45 CM TIP

Facility

$319.70

Hospital Charge Code	270689526
Hospital Revenue Code	272
Min. Negotiated Rate	$41.56
Max. Negotiated Rate	$159.85
Rate for Payer: Aetna Commercial	$95.91
Rate for Payer: Aetna Medicare Advantage	$95.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.52
Rate for Payer: Cigna Commercial	$159.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.56
Rate for Payer: Oxford Commercial	$159.85
Rate for Payer: Qualcare PPO/HMO/WC	$47.95
Rate for Payer: UnitedHealthcare Commercial	$159.85

APPLICATOR FLEXTIP RIGID 38 CM

Facility

$207.50

Hospital Charge Code	270687376
Hospital Revenue Code	272
Min. Negotiated Rate	$26.98
Max. Negotiated Rate	$103.75
Rate for Payer: Aetna Commercial	$62.25
Rate for Payer: Aetna Medicare Advantage	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.91
Rate for Payer: Cigna Commercial	$103.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.98
Rate for Payer: Oxford Commercial	$103.75
Rate for Payer: Qualcare PPO/HMO/WC	$31.12
Rate for Payer: UnitedHealthcare Commercial	$103.75

APPLICATOR FLEXTIP RIGID 38 CM

Facility

$207.50

Hospital Charge Code	270687376
Hospital Revenue Code	272
Min. Negotiated Rate	$31.12
Max. Negotiated Rate	$31.12
Rate for Payer: Qualcare PPO/HMO/WC	$31.12

APPLICATOR FLEXTIP XL ARISTA

Facility

$71.50

Hospital Charge Code	270687375
Hospital Revenue Code	272
Min. Negotiated Rate	$9.29
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$21.45
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.29
Rate for Payer: Oxford Commercial	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Commercial	$35.75

APPLICATOR FLEXTIP XL ARISTA

Facility

$71.50

Hospital Charge Code	270687375
Hospital Revenue Code	272
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$10.72
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

APPLICATOR PROCTOSCOPE

Facility

$0.51

Hospital Charge Code	270651081
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.08

APPLICATOR PROCTOSCOPE

Facility

$0.51

Hospital Charge Code	270651081
Hospital Revenue Code	270
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.26
Rate for Payer: Aetna Commercial	$0.15
Rate for Payer: Aetna Medicare Advantage	$0.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.13
Rate for Payer: Cigna Commercial	$0.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.07
Rate for Payer: Oxford Commercial	$0.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.08
Rate for Payer: UnitedHealthcare Commercial	$0.26

APPLICATOR PROGEL EXTED 6

Facility

$300.00

Hospital Charge Code	270678576
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

APPLICATOR PROGEL EXTED 6

Facility

$300.00

Hospital Charge Code	270678576
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

APPLICATORS SILVER NITRATE***

Facility

$11.00

Hospital Charge Code	8002610
Hospital Revenue Code	279
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

APPLICATORS SILVER NITRATE***

Facility

$11.00

Hospital Charge Code	8002610
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

APPLICATOR SURGIFLO

Facility

$257.87

Hospital Charge Code	270688803
Hospital Revenue Code	272
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Qualcare PPO/HMO/WC	$38.68

APPLICATOR SURGIFLO

Facility

$257.87

Hospital Charge Code	270688803
Hospital Revenue Code	272
Min. Negotiated Rate	$33.52
Max. Negotiated Rate	$128.94
Rate for Payer: Aetna Commercial	$77.36
Rate for Payer: Aetna Medicare Advantage	$77.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.76
Rate for Payer: Cigna Commercial	$128.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.52
Rate for Payer: Oxford Commercial	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$38.68
Rate for Payer: UnitedHealthcare Commercial	$128.94

APPLICATOR ULTRAMIST

Facility

$270.00

Hospital Charge Code	270677093
Hospital Revenue Code	270
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

APPLICATOR ULTRAMIST

Facility

$270.00

Hospital Charge Code	270677093
Hospital Revenue Code	270
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$135.00

APPLIC SHORT ARM SPLINT STATIC

Facility

$348.85

Service Code	HCPCS 29125
Hospital Charge Code	2500372
Hospital Revenue Code	761
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$104.66
Rate for Payer: Aetna Medicare Advantage	$104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.96
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.35
Rate for Payer: Oxford Commercial	$174.43
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Commercial	$174.43

APPLIC SHORT ARM SPLINT STATIC

Facility

$348.85

Service Code	HCPCS 29125
Hospital Charge Code	2500372
Hospital Revenue Code	761
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

APPLIC SHORT LEG SPLINT CF FT

Facility

$348.85

Service Code	HCPCS 29515
Hospital Charge Code	2500371
Hospital Revenue Code	761
Min. Negotiated Rate	$45.35
Max. Negotiated Rate	$386.97
Rate for Payer: Aetna Commercial	$104.66
Rate for Payer: Aetna Medicare Advantage	$104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.96
Rate for Payer: Cigna Commercial	$386.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.35
Rate for Payer: Oxford Commercial	$174.43
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Commercial	$174.43

APPLIC SHORT LEG SPLINT CF FT

Facility

$348.85

Service Code	HCPCS 29515
Hospital Charge Code	2500371
Hospital Revenue Code	761
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

APPLIER CLIP 10mm LAP CA090

Facility

$340.00

Hospital Charge Code	270642077
Hospital Revenue Code	272
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

APPLIER CLIP 10mm LAP CA090

Facility

$340.00

Hospital Charge Code	270642077
Hospital Revenue Code	272
Min. Negotiated Rate	$44.20
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$170.00

APPLIER CLIP VCS LG 132907

Facility

$1,293.65

Hospital Charge Code	270600136
Hospital Revenue Code	272
Min. Negotiated Rate	$168.17
Max. Negotiated Rate	$646.83
Rate for Payer: Aetna Commercial	$388.10
Rate for Payer: Aetna Medicare Advantage	$388.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$329.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$329.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$329.88
Rate for Payer: Cigna Commercial	$646.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.17
Rate for Payer: Oxford Commercial	$646.83
Rate for Payer: Qualcare PPO/HMO/WC	$194.05
Rate for Payer: UnitedHealthcare Commercial	$646.83

APPLIER CLIP VCS LG 132907

Facility

$1,293.65

Hospital Charge Code	270600136
Hospital Revenue Code	272
Min. Negotiated Rate	$194.05
Max. Negotiated Rate	$194.05
Rate for Payer: Qualcare PPO/HMO/WC	$194.05

Know your out-of-pocket cost for care.

All Charges