Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT IN-SITU BENDR CUT 530.521S

Facility

$387.25

Hospital Charge Code	270635021
Hospital Revenue Code	272
Min. Negotiated Rate	$50.34
Max. Negotiated Rate	$193.62
Rate for Payer: Aetna Commercial	$116.17
Rate for Payer: Aetna Medicare Advantage	$116.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.75
Rate for Payer: Cigna Commercial	$193.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.34
Rate for Payer: Oxford Commercial	$193.62
Rate for Payer: Qualcare PPO/HMO/WC	$58.09
Rate for Payer: UnitedHealthcare Commercial	$193.62

KIT IN-SITU BENDR CUT 530.521S

Facility

$387.25

Hospital Charge Code	270635021
Hospital Revenue Code	272
Min. Negotiated Rate	$58.09
Max. Negotiated Rate	$58.09
Rate for Payer: Qualcare PPO/HMO/WC	$58.09

KIT INSTRMT T1 GRT TOE2483KIT1

Facility

$2,455.25

Hospital Charge Code	270611663
Hospital Revenue Code	272
Min. Negotiated Rate	$319.18
Max. Negotiated Rate	$1,227.62
Rate for Payer: Aetna Commercial	$736.58
Rate for Payer: Aetna Medicare Advantage	$736.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.09
Rate for Payer: Cigna Commercial	$1,227.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.18
Rate for Payer: Oxford Commercial	$1,227.62
Rate for Payer: Qualcare PPO/HMO/WC	$368.29
Rate for Payer: UnitedHealthcare Commercial	$1,227.62

KIT INSTRMT T1 GRT TOE2483KIT1

Facility

$2,455.25

Hospital Charge Code	270611663
Hospital Revenue Code	272
Min. Negotiated Rate	$368.29
Max. Negotiated Rate	$368.29
Rate for Payer: Qualcare PPO/HMO/WC	$368.29

KIT INTERNAL BRACE IMPLANT

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270676522
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

KIT INTERNAL BRACE IMPLANT

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270676522
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

KIT INTERNAL BRACE LIS ANC

Facility

$7,475.00

Hospital Charge Code	270684906
Hospital Revenue Code	272
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,121.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

KIT INTERNAL BRACE LIS ANC

Facility

$7,475.00

Hospital Charge Code	270684906
Hospital Revenue Code	272
Min. Negotiated Rate	$971.75
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$971.75
Rate for Payer: Oxford Commercial	$3,737.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25
Rate for Payer: UnitedHealthcare Commercial	$3,737.50

KIT INTRAGASTRIC ORBERA

Facility

$500.00

Hospital Charge Code	270693543
Hospital Revenue Code	272
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

KIT INTRAGASTRIC ORBERA

Facility

$500.00

Hospital Charge Code	270693543
Hospital Revenue Code	272
Min. Negotiated Rate	$65.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$250.00

KIT INTROD BILIARY STENT 3391

Facility

$616.00

Hospital Charge Code	270600935
Hospital Revenue Code	272
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$92.40
Rate for Payer: Qualcare PPO/HMO/WC	$92.40

KIT INTROD BILIARY STENT 3391

Facility

$616.00

Hospital Charge Code	270600935
Hospital Revenue Code	272
Min. Negotiated Rate	$80.08
Max. Negotiated Rate	$308.00
Rate for Payer: Aetna Commercial	$184.80
Rate for Payer: Aetna Medicare Advantage	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.08
Rate for Payer: Cigna Commercial	$308.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.08
Rate for Payer: Oxford Commercial	$308.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.40
Rate for Payer: UnitedHealthcare Commercial	$308.00

KIT INTRODUCER

Facility

$990.35

Hospital Charge Code	270670059
Hospital Revenue Code	272
Min. Negotiated Rate	$128.75
Max. Negotiated Rate	$495.18
Rate for Payer: Aetna Commercial	$297.11
Rate for Payer: Aetna Medicare Advantage	$297.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.54
Rate for Payer: Cigna Commercial	$495.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.75
Rate for Payer: Oxford Commercial	$495.18
Rate for Payer: Qualcare PPO/HMO/WC	$148.55
Rate for Payer: UnitedHealthcare Commercial	$495.18

KIT INTRODUCER

Facility

$990.35

Hospital Charge Code	270670059
Hospital Revenue Code	272
Min. Negotiated Rate	$148.55
Max. Negotiated Rate	$148.55
Rate for Payer: Qualcare PPO/HMO/WC	$148.55

KIT INTRODUCER 10FR

Facility

$180.00

Hospital Charge Code	270605534
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$90.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$90.00

KIT INTRODUCER 10FR

Facility

$180.00

Hospital Charge Code	270605534
Hospital Revenue Code	272
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

KIT INTRODUCER 10FR 405120

Facility

$463.25

Hospital Charge Code	270601161
Hospital Revenue Code	272
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

KIT INTRODUCER 10FR 405120

Facility

$463.25

Hospital Charge Code	270601161
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

KIT INTRODUCER 11FR 405124

Facility

$463.25

Hospital Charge Code	270601160
Hospital Revenue Code	272
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

KIT INTRODUCER 11FR 405124

Facility

$463.25

Hospital Charge Code	270601160
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

KIT INTRODUCER 14FR 405136

Facility

$463.25

Hospital Charge Code	270601154
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

KIT INTRODUCER 14FR 405136

Facility

$463.25

Hospital Charge Code	270601154
Hospital Revenue Code	272
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Qualcare PPO/HMO/WC	$69.49

KIT INTRODUCER 4 FR

Facility

$90.00

Hospital Charge Code	270685421
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

KIT INTRODUCER 4 FR

Facility

$90.00

Hospital Charge Code	270685421
Hospital Revenue Code	272
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

KIT INTRODUCER 9FR 405116

Facility

$307.25

Hospital Charge Code	270616185
Hospital Revenue Code	272
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$46.09
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

Know your out-of-pocket cost for care.

All Charges