Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT LAP CHOLE CUSTOM 6/ST

Facility

$1,712.05

Hospital Charge Code	270658611
Hospital Revenue Code	272
Min. Negotiated Rate	$222.57
Max. Negotiated Rate	$856.02
Rate for Payer: Aetna Commercial	$513.62
Rate for Payer: Aetna Medicare Advantage	$513.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.57
Rate for Payer: Cigna Commercial	$856.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.57
Rate for Payer: Oxford Commercial	$856.02
Rate for Payer: Qualcare PPO/HMO/WC	$256.81
Rate for Payer: UnitedHealthcare Commercial	$856.02

KIT LATERAL SUPPORT

Facility

$3,250.00

Hospital Charge Code	270703547
Hospital Revenue Code	272
Min. Negotiated Rate	$422.50
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$975.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.50
Rate for Payer: Oxford Commercial	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$1,625.00

KIT LATERAL SUPPORT

Facility

$3,250.00

Hospital Charge Code	270703547
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

KIT LEAD

Facility

$6,950.00

Service Code	HCPCS C1778
Hospital Charge Code	270665617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,042.50
Max. Negotiated Rate	$3,475.00
Rate for Payer: Aetna Commercial	$2,085.00
Rate for Payer: Aetna Medicare Advantage	$2,085.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,772.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,772.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,772.25
Rate for Payer: Cigna Commercial	$3,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,681.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,042.50

KIT LEAD

Facility

$12,800.00

Service Code	HCPCS C1897
Hospital Charge Code	270665899
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$3,097.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

KIT LEAD

Facility

$12,800.00

Service Code	HCPCS C1897
Hospital Charge Code	270665899
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$6,400.00
Rate for Payer: Aetna Commercial	$3,840.00
Rate for Payer: Aetna Medicare Advantage	$3,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,264.00
Rate for Payer: Cigna Commercial	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

KIT LEAD

Facility

$6,950.00

Service Code	HCPCS C1778
Hospital Charge Code	270665617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,042.50
Max. Negotiated Rate	$1,681.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,681.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,042.50

KIT LEAD

Facility

$32,550.00

Service Code	HCPCS C1767
Hospital Charge Code	270663408
Hospital Revenue Code	278
Min. Negotiated Rate	$4,882.50
Max. Negotiated Rate	$16,275.00
Rate for Payer: Aetna Commercial	$9,765.00
Rate for Payer: Aetna Medicare Advantage	$9,765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,300.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,300.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,300.25
Rate for Payer: Cigna Commercial	$16,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,877.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,882.50

KIT LEAD

Facility

$32,550.00

Service Code	HCPCS C1767
Hospital Charge Code	270663408
Hospital Revenue Code	278
Min. Negotiated Rate	$4,882.50
Max. Negotiated Rate	$7,877.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,877.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,882.50

KIT LEAD 3778-45

Facility

$11,950.00

Hospital Charge Code	270639468
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$5,975.00
Rate for Payer: Aetna Commercial	$3,585.00
Rate for Payer: Aetna Medicare Advantage	$3,585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,047.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,047.25
Rate for Payer: Cigna Commercial	$5,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

KIT LEAD 3778-45

Facility

$11,950.00

Hospital Charge Code	270639468
Hospital Revenue Code	278
Min. Negotiated Rate	$1,792.50
Max. Negotiated Rate	$2,891.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,891.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,792.50

KIT LEAD 90 CM LENGTH

Facility

$16,075.00

Service Code	HCPCS C1788
Hospital Charge Code	270672151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,411.25
Max. Negotiated Rate	$3,890.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,890.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,411.25

KIT LEAD 90 CM LENGTH

Facility

$16,075.00

Service Code	HCPCS C1788
Hospital Charge Code	270672151
Hospital Revenue Code	278
Min. Negotiated Rate	$2,411.25
Max. Negotiated Rate	$8,037.50
Rate for Payer: Aetna Commercial	$4,822.50
Rate for Payer: Aetna Medicare Advantage	$4,822.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,099.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,099.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,099.12
Rate for Payer: Cigna Commercial	$8,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,890.15
Rate for Payer: Qualcare PPO/HMO/WC	$2,411.25

KIT LEAD MEDTRONIC

Facility

$11,300.00

Hospital Charge Code	270648828
Hospital Revenue Code	272
Min. Negotiated Rate	$1,469.00
Max. Negotiated Rate	$5,650.00
Rate for Payer: Aetna Commercial	$3,390.00
Rate for Payer: Aetna Medicare Advantage	$3,390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,881.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,881.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,881.50
Rate for Payer: Cigna Commercial	$5,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,469.00
Rate for Payer: Oxford Commercial	$5,650.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,695.00
Rate for Payer: UnitedHealthcare Commercial	$5,650.00

KIT LEAD MEDTRONIC

Facility

$11,300.00

Hospital Charge Code	270648828
Hospital Revenue Code	272
Min. Negotiated Rate	$1,695.00
Max. Negotiated Rate	$1,695.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,695.00

KIT LEAD (MEDTRONIC) 3778-60

Facility

$12,547.50

Hospital Charge Code	270640282
Hospital Revenue Code	278
Min. Negotiated Rate	$1,882.12
Max. Negotiated Rate	$3,036.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,509.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,036.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,882.12

KIT LEAD (MEDTRONIC) 3778-60

Facility

$12,547.50

Hospital Charge Code	270640282
Hospital Revenue Code	278
Min. Negotiated Rate	$1,882.12
Max. Negotiated Rate	$6,273.75
Rate for Payer: Aetna Commercial	$3,764.25
Rate for Payer: Aetna Medicare Advantage	$3,764.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,199.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,199.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,509.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,199.61
Rate for Payer: Cigna Commercial	$6,273.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,036.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,882.12

KIT LEAD NEUROSTIMULAT 5X50CM

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693874
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT LEAD NEUROSTIMULAT 5X50CM

Facility

$2,500.00

Service Code	HCPCS C1778
Hospital Charge Code	270693874
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT LEAD OCTRODE TRIAL 60CML

Facility

$2,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270633761
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT LEAD OCTRODE TRIAL 60CML

Facility

$2,500.00

Service Code	HCPCS C1897
Hospital Charge Code	270633761
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

KIT LMA PEDIATRIC EMERGENCY

Facility

$65.75

Hospital Charge Code	270655290
Hospital Revenue Code	271
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$9.86
Rate for Payer: Qualcare PPO/HMO/WC	$9.86

KIT LMA PEDIATRIC EMERGENCY

Facility

$65.75

Hospital Charge Code	270655290
Hospital Revenue Code	271
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$32.88
Rate for Payer: Aetna Commercial	$19.73
Rate for Payer: Aetna Medicare Advantage	$19.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.77
Rate for Payer: Cigna Commercial	$32.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.55
Rate for Payer: Oxford Commercial	$32.88
Rate for Payer: Qualcare PPO/HMO/WC	$9.86
Rate for Payer: UnitedHealthcare Commercial	$32.88

KIT LONG NAIL R1,TI, LEFT

Facility

$7.55

Hospital Charge Code	270663904
Hospital Revenue Code	278
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

KIT LONG NAIL R1,TI, LEFT

Facility

$7.55

Hospital Charge Code	270663904
Hospital Revenue Code	278
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$3.77
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

Know your out-of-pocket cost for care.

All Charges