Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT MICKEY GASTRO TUBE 20F 3

Facility

$455.80

Hospital Charge Code	270617889
Hospital Revenue Code	272
Min. Negotiated Rate	$68.37
Max. Negotiated Rate	$68.37
Rate for Payer: Qualcare PPO/HMO/WC	$68.37

KIT MICKEY GASTRO TUBE 20F 3

Facility

$455.80

Hospital Charge Code	270617889
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$227.90
Rate for Payer: Aetna Commercial	$136.74
Rate for Payer: Aetna Medicare Advantage	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.23
Rate for Payer: Cigna Commercial	$227.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.25
Rate for Payer: Oxford Commercial	$227.90
Rate for Payer: Qualcare PPO/HMO/WC	$68.37
Rate for Payer: UnitedHealthcare Commercial	$227.90

KIT MILD DEVICE-MIN IN V

Facility

$12,500.00

Hospital Charge Code	270646012
Hospital Revenue Code	270
Min. Negotiated Rate	$1,625.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,625.00
Rate for Payer: Oxford Commercial	$6,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00
Rate for Payer: UnitedHealthcare Commercial	$6,250.00

KIT MILD DEVICE-MIN IN V

Facility

$12,500.00

Hospital Charge Code	270646012
Hospital Revenue Code	270
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$1,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

KIT MINI TIGHTROPE

Facility

$3,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270667601
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$762.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

KIT MINI TIGHTROPE

Facility

$3,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270667601
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$1,575.00
Rate for Payer: Aetna Commercial	$945.00
Rate for Payer: Aetna Medicare Advantage	$945.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$803.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$803.25
Rate for Payer: Cigna Commercial	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$762.30
Rate for Payer: Qualcare PPO/HMO/WC	$472.50

KIT MIXING SYRINGE 14 CC CAP

Facility

$2,875.00

Hospital Charge Code	270683167
Hospital Revenue Code	272
Min. Negotiated Rate	$373.75
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$862.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.75
Rate for Payer: Oxford Commercial	$1,437.50
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Commercial	$1,437.50

KIT MIXING SYRINGE 14 CC CAP

Facility

$2,875.00

Hospital Charge Code	270683167
Hospital Revenue Code	272
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529S
Hospital Revenue Code	270
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$28.93
Rate for Payer: Aetna Commercial	$17.36
Rate for Payer: Aetna Medicare Advantage	$17.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.75
Rate for Payer: Cigna Commercial	$28.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.52
Rate for Payer: Oxford Commercial	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$8.68
Rate for Payer: UnitedHealthcare Commercial	$28.93

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529
Hospital Revenue Code	270
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$28.93
Rate for Payer: Aetna Commercial	$17.36
Rate for Payer: Aetna Medicare Advantage	$17.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.75
Rate for Payer: Cigna Commercial	$28.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.52
Rate for Payer: Oxford Commercial	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$8.68
Rate for Payer: UnitedHealthcare Commercial	$28.93

KIT MONITORING W/TRANSDUCER

Facility

$34.80

Hospital Charge Code	270657529N
Hospital Revenue Code	270
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$17.40
Rate for Payer: Aetna Commercial	$10.44
Rate for Payer: Aetna Medicare Advantage	$10.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.87
Rate for Payer: Cigna Commercial	$17.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.22
Rate for Payer: UnitedHealthcare Commercial	$17.40

KIT MONITORING W/TRANSDUCER

Facility

$34.80

Hospital Charge Code	270657529N
Hospital Revenue Code	270
Min. Negotiated Rate	$5.22
Max. Negotiated Rate	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.22

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529S
Hospital Revenue Code	270
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$8.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.68

KIT MONITORING W/TRANSDUCER

Facility

$57.85

Hospital Charge Code	270657529
Hospital Revenue Code	270
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$8.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.68

KIT MSP METATARSAL SHORTENING

Facility

$5,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688567
Hospital Revenue Code	278
Min. Negotiated Rate	$870.00
Max. Negotiated Rate	$2,900.00
Rate for Payer: Aetna Commercial	$1,740.00
Rate for Payer: Aetna Medicare Advantage	$1,740.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,479.00
Rate for Payer: Cigna Commercial	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,403.60
Rate for Payer: Qualcare PPO/HMO/WC	$870.00

KIT MSP METATARSAL SHORTENING

Facility

$5,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270688567
Hospital Revenue Code	278
Min. Negotiated Rate	$870.00
Max. Negotiated Rate	$1,403.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,403.60
Rate for Payer: Qualcare PPO/HMO/WC	$870.00

KIT NAIL IM VALOR LT 10X250MM

Facility

$16,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270700406
Hospital Revenue Code	278
Min. Negotiated Rate	$2,430.75
Max. Negotiated Rate	$3,921.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,921.61
Rate for Payer: Qualcare PPO/HMO/WC	$2,430.75

KIT NAIL IM VALOR LT 10X250MM

Facility

$16,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270700406
Hospital Revenue Code	278
Min. Negotiated Rate	$2,430.75
Max. Negotiated Rate	$8,102.50
Rate for Payer: Aetna Commercial	$4,861.50
Rate for Payer: Aetna Medicare Advantage	$4,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,132.27
Rate for Payer: Cigna Commercial	$8,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,921.61
Rate for Payer: Qualcare PPO/HMO/WC	$2,430.75

KIT NAIL LONG R1.5 TI LEFT

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270672766
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.16
Max. Negotiated Rate	$3,160.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16

KIT NAIL LONG R1.5 TI LEFT

Facility

$13,061.10

Service Code	HCPCS C1713
Hospital Charge Code	270672766
Hospital Revenue Code	278
Min. Negotiated Rate	$1,959.16
Max. Negotiated Rate	$6,530.55
Rate for Payer: Aetna Commercial	$3,918.33
Rate for Payer: Aetna Medicare Advantage	$3,918.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,612.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,330.58
Rate for Payer: Cigna Commercial	$6,530.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,160.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,959.16

KIT NAIL TI 10X170MM 125 DEG

Facility

$12,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270647251
Hospital Revenue Code	278
Min. Negotiated Rate	$1,818.75
Max. Negotiated Rate	$2,934.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75

KIT NAIL TI 10X170MM 125 DEG

Facility

$12,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270647251
Hospital Revenue Code	278
Min. Negotiated Rate	$1,818.75
Max. Negotiated Rate	$6,062.50
Rate for Payer: Aetna Commercial	$3,637.50
Rate for Payer: Aetna Medicare Advantage	$3,637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,091.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,091.88
Rate for Payer: Cigna Commercial	$6,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,934.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,818.75

KIT NAIL Ti LONG 1.5 RIGHT

Facility

$16,175.00

Hospital Charge Code	270648350
Hospital Revenue Code	278
Min. Negotiated Rate	$2,426.25
Max. Negotiated Rate	$3,914.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,914.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,426.25

KIT NAIL Ti LONG 1.5 RIGHT

Facility

$16,175.00

Hospital Charge Code	270648350
Hospital Revenue Code	278
Min. Negotiated Rate	$2,426.25
Max. Negotiated Rate	$8,087.50
Rate for Payer: Aetna Commercial	$4,852.50
Rate for Payer: Aetna Medicare Advantage	$4,852.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,124.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,124.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,124.62
Rate for Payer: Cigna Commercial	$8,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,914.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,426.25

KIT NANONEEDLE HIGHFLOW 125MM

Facility

$960.00

Service Code	HCPCS A4649
Hospital Charge Code	270699065
Hospital Revenue Code	272
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$144.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

Know your out-of-pocket cost for care.

All Charges