Heights University Hospital

All Charges

Charge

Type

Setting

Price

KIT RAPR-ROUND SM/MED 32-46

Facility

$655.00

Hospital Charge Code	270660604
Hospital Revenue Code	272
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$98.25
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

KIT RAPR-ROUND SM/MED 32-46

Facility

$655.00

Hospital Charge Code	270660604
Hospital Revenue Code	272
Min. Negotiated Rate	$85.15
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$196.50
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.15
Rate for Payer: Oxford Commercial	$327.50
Rate for Payer: Qualcare PPO/HMO/WC	$98.25
Rate for Payer: UnitedHealthcare Commercial	$327.50

KIT READY CARE BALLARD 121

Facility

$33.65

Hospital Charge Code	270600636
Hospital Revenue Code	272
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$10.10
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.37
Rate for Payer: Oxford Commercial	$16.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Commercial	$16.82

KIT READY CARE BALLARD 121

Facility

$33.65

Hospital Charge Code	270600636
Hospital Revenue Code	272
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

KIT REAMER MINIBUNION

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690786
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$272.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

KIT REAMER MINIBUNION

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270690786
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$337.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.25
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209C
Hospital Revenue Code	278
Min. Negotiated Rate	$245.72
Max. Negotiated Rate	$819.08
Rate for Payer: Aetna Commercial	$491.44
Rate for Payer: Aetna Medicare Advantage	$491.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$417.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$417.73
Rate for Payer: Cigna Commercial	$819.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: Qualcare PPO/HMO/WC	$245.72

KIT RENEGADE HI FLOW 150/10

Facility

$1,799.20

Hospital Charge Code	270645209
Hospital Revenue Code	278
Min. Negotiated Rate	$269.88
Max. Negotiated Rate	$899.60
Rate for Payer: Aetna Commercial	$539.76
Rate for Payer: Aetna Medicare Advantage	$539.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$458.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$458.80
Rate for Payer: Cigna Commercial	$899.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.41
Rate for Payer: Qualcare PPO/HMO/WC	$269.88

KIT RENEGADE HI FLOW 150/10

Facility

$1,799.20

Hospital Charge Code	270645209
Hospital Revenue Code	278
Min. Negotiated Rate	$269.88
Max. Negotiated Rate	$435.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$359.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$435.41
Rate for Payer: Qualcare PPO/HMO/WC	$269.88

KIT RENEGADE HI FLOW 150/10

Facility

$1,638.15

Service Code	HCPCS C1887
Hospital Charge Code	270645209C
Hospital Revenue Code	278
Min. Negotiated Rate	$245.72
Max. Negotiated Rate	$396.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$327.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.43
Rate for Payer: Qualcare PPO/HMO/WC	$245.72

KIT RENEGADE HI FLOW 35

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$1,227.85
Rate for Payer: Aetna Commercial	$736.71
Rate for Payer: Aetna Medicare Advantage	$736.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.20
Rate for Payer: Cigna Commercial	$1,227.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465C
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$1,227.85
Rate for Payer: Aetna Commercial	$736.71
Rate for Payer: Aetna Medicare Advantage	$736.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.20
Rate for Payer: Cigna Commercial	$1,227.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,455.70

Service Code	HCPCS C1887
Hospital Charge Code	270630465C
Hospital Revenue Code	278
Min. Negotiated Rate	$368.36
Max. Negotiated Rate	$594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$491.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$594.28
Rate for Payer: Qualcare PPO/HMO/WC	$368.36

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,995.00

Hospital Charge Code	270630465V
Hospital Revenue Code	278
Min. Negotiated Rate	$449.25
Max. Negotiated Rate	$724.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$599.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.79
Rate for Payer: Qualcare PPO/HMO/WC	$449.25

KIT RENEGADE HI FLOW 35 18-302

Facility

$2,995.00

Hospital Charge Code	270630465V
Hospital Revenue Code	278
Min. Negotiated Rate	$449.25
Max. Negotiated Rate	$1,497.50
Rate for Payer: Aetna Commercial	$898.50
Rate for Payer: Aetna Medicare Advantage	$898.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$763.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$763.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$599.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$763.73
Rate for Payer: Cigna Commercial	$1,497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$724.79
Rate for Payer: Qualcare PPO/HMO/WC	$449.25

KIT REPAIR HICKM 10FR 0601750

Facility

$744.00

Hospital Charge Code	270603374
Hospital Revenue Code	272
Min. Negotiated Rate	$96.72
Max. Negotiated Rate	$372.00
Rate for Payer: Aetna Commercial	$223.20
Rate for Payer: Aetna Medicare Advantage	$223.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.72
Rate for Payer: Cigna Commercial	$372.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.72
Rate for Payer: Oxford Commercial	$372.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.60
Rate for Payer: UnitedHealthcare Commercial	$372.00

KIT REPAIR HICKM 10FR 0601750

Facility

$744.00

Hospital Charge Code	270603374
Hospital Revenue Code	272
Min. Negotiated Rate	$111.60
Max. Negotiated Rate	$111.60
Rate for Payer: Qualcare PPO/HMO/WC	$111.60

KIT REPAIR HICKM RD CP 0601690

Facility

$514.45

Hospital Charge Code	270603372
Hospital Revenue Code	272
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$257.23
Rate for Payer: Aetna Commercial	$154.34
Rate for Payer: Aetna Medicare Advantage	$154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.18
Rate for Payer: Cigna Commercial	$257.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.88
Rate for Payer: Oxford Commercial	$257.23
Rate for Payer: Qualcare PPO/HMO/WC	$77.17
Rate for Payer: UnitedHealthcare Commercial	$257.23

KIT REPAIR HICKM RD CP 0601690

Facility

$514.45

Hospital Charge Code	270603372
Hospital Revenue Code	272
Min. Negotiated Rate	$77.17
Max. Negotiated Rate	$77.17
Rate for Payer: Qualcare PPO/HMO/WC	$77.17

KIT REPAIR HICKM WT CP 0601680

Facility

$514.45

Hospital Charge Code	270603373
Hospital Revenue Code	272
Min. Negotiated Rate	$66.88
Max. Negotiated Rate	$257.23
Rate for Payer: Aetna Commercial	$154.34
Rate for Payer: Aetna Medicare Advantage	$154.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.18
Rate for Payer: Cigna Commercial	$257.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.88
Rate for Payer: Oxford Commercial	$257.23
Rate for Payer: Qualcare PPO/HMO/WC	$77.17
Rate for Payer: UnitedHealthcare Commercial	$257.23

KIT REPAIR HICKM WT CP 0601680

Facility

$514.45

Hospital Charge Code	270603373
Hospital Revenue Code	272
Min. Negotiated Rate	$77.17
Max. Negotiated Rate	$77.17
Rate for Payer: Qualcare PPO/HMO/WC	$77.17

KIT REPAIR LIGAMENT 2.0

Facility

$7,475.00

Hospital Charge Code	270688256
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 REPAIR LIGAMENT 2.0

Facility

$7,475.00

Hospital Charge Code	270688256
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 RESORABLE MIN BEAD

Facility

$3,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270645042
Hospital Revenue Code	278
Min. Negotiated Rate	$523.50
Max. Negotiated Rate	$844.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$698.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$844.58
Rate for Payer: Qualcare PPO/HMO/WC	$523.50

Know your out-of-pocket cost for care.

All Charges