Heights University Hospital

All Charges

Charge

Type

Setting

Price

KNOTLESS FIBERTAK BICEPS IMPL

Facility

$5,098.50

Service Code	HCPCS C1765
Hospital Charge Code	270705651
Hospital Revenue Code	278
Min. Negotiated Rate	$764.77
Max. Negotiated Rate	$1,233.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: Qualcare PPO/HMO/WC	$764.77

KNOTLESS FIBERTAK BICEPS IMPL

Facility

$5,098.50

Service Code	HCPCS C1765
Hospital Charge Code	270705651
Hospital Revenue Code	278
Min. Negotiated Rate	$764.77
Max. Negotiated Rate	$2,549.25
Rate for Payer: Aetna Commercial	$1,529.55
Rate for Payer: Aetna Medicare Advantage	$1,529.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,019.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.12
Rate for Payer: Cigna Commercial	$2,549.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.84
Rate for Payer: Qualcare PPO/HMO/WC	$764.77

KNOTLESS FIBERTAK DISP KIT

Facility

$1,375.00

Hospital Charge Code	270695227
Hospital Revenue Code	272
Min. Negotiated Rate	$178.75
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$412.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.75
Rate for Payer: Oxford Commercial	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$687.50

KNOTLESS FIBERTAK DISP KIT

Facility

$1,375.00

Hospital Charge Code	270695227
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

KNOTLESS SUTURETAK 3.0MM

Facility

$2,703.00

Hospital Charge Code	270702503
Hospital Revenue Code	278
Min. Negotiated Rate	$405.45
Max. Negotiated Rate	$654.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.13
Rate for Payer: Qualcare PPO/HMO/WC	$405.45

KNOTLESS SUTURETAK 3.0MM

Facility

$2,703.00

Hospital Charge Code	270702503
Hospital Revenue Code	278
Min. Negotiated Rate	$405.45
Max. Negotiated Rate	$1,351.50
Rate for Payer: Aetna Commercial	$810.90
Rate for Payer: Aetna Medicare Advantage	$810.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$689.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$689.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$689.26
Rate for Payer: Cigna Commercial	$1,351.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$654.13
Rate for Payer: Qualcare PPO/HMO/WC	$405.45

KNOT OUSHER/CUTTER

Facility

$281.00

Hospital Charge Code	270335941
Hospital Revenue Code	272
Min. Negotiated Rate	$42.15
Max. Negotiated Rate	$42.15
Rate for Payer: Qualcare PPO/HMO/WC	$42.15

KNOT OUSHER/CUTTER

Facility

$281.00

Hospital Charge Code	270335941
Hospital Revenue Code	272
Min. Negotiated Rate	$36.53
Max. Negotiated Rate	$140.50
Rate for Payer: Aetna Commercial	$84.30
Rate for Payer: Aetna Medicare Advantage	$84.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.66
Rate for Payer: Cigna Commercial	$140.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.53
Rate for Payer: Oxford Commercial	$140.50
Rate for Payer: Qualcare PPO/HMO/WC	$42.15
Rate for Payer: UnitedHealthcare Commercial	$140.50

KNOT PUSHER CUTTER

Facility

$1,100.00

Service Code	HCPCS A4649
Hospital Charge Code	270694780
Hospital Revenue Code	272
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$330.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.00
Rate for Payer: Oxford Commercial	$550.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$550.00

KNOT PUSHER CUTTER

Facility

$1,100.00

Service Code	HCPCS A4649
Hospital Charge Code	270694780
Hospital Revenue Code	272
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

KNOT PUSHER ENDO SLIDE 38CM

Facility

$54.57

Hospital Charge Code	270665013
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$27.29
Rate for Payer: Aetna Commercial	$16.37
Rate for Payer: Aetna Medicare Advantage	$16.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.92
Rate for Payer: Cigna Commercial	$27.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.09
Rate for Payer: Oxford Commercial	$27.29
Rate for Payer: Qualcare PPO/HMO/WC	$8.19
Rate for Payer: UnitedHealthcare Commercial	$27.29

KNOT PUSHER ENDO SLIDE 38CM

Facility

$54.57

Hospital Charge Code	270665013
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$8.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.19

KNOT PUSHER REDSAY LG 5.0 29CM

Facility

$2,650.80

Hospital Charge Code	270698341
Hospital Revenue Code	272
Min. Negotiated Rate	$344.60
Max. Negotiated Rate	$1,325.40
Rate for Payer: Aetna Commercial	$795.24
Rate for Payer: Aetna Medicare Advantage	$795.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.95
Rate for Payer: Cigna Commercial	$1,325.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.60
Rate for Payer: Oxford Commercial	$1,325.40
Rate for Payer: Qualcare PPO/HMO/WC	$397.62
Rate for Payer: UnitedHealthcare Commercial	$1,325.40

KNOT PUSHER REDSAY LG 5.0 29CM

Facility

$2,650.80

Hospital Charge Code	270698341
Hospital Revenue Code	272
Min. Negotiated Rate	$397.62
Max. Negotiated Rate	$397.62
Rate for Payer: Qualcare PPO/HMO/WC	$397.62

KNOT PUSHER/SUTURE CUTTER

Facility

$625.00

Hospital Charge Code	270675822
Hospital Revenue Code	270
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

KNOT PUSHER/SUTURE CUTTER

Facility

$625.00

Hospital Charge Code	270675822
Hospital Revenue Code	270
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.25
Rate for Payer: Oxford Commercial	$312.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$312.50

KNOT PUSHER/SUTURE CUT W PORT

Facility

$1,137.70

Hospital Charge Code	270702601
Hospital Revenue Code	279
Min. Negotiated Rate	$170.66
Max. Negotiated Rate	$170.66
Rate for Payer: Qualcare PPO/HMO/WC	$170.66

KNOT PUSHER/SUTURE CUT W PORT

Facility

$1,137.70

Hospital Charge Code	270702601
Hospital Revenue Code	279
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$568.85
Rate for Payer: Aetna Commercial	$341.31
Rate for Payer: Aetna Medicare Advantage	$341.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.11
Rate for Payer: Cigna Commercial	$568.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.90
Rate for Payer: Oxford Commercial	$568.85
Rate for Payer: Qualcare PPO/HMO/WC	$170.66
Rate for Payer: UnitedHealthcare Commercial	$568.85

KNOT PUSTER CUTTER STRAIGHT

Facility

$710.70

Hospital Charge Code	270646585
Hospital Revenue Code	272
Min. Negotiated Rate	$106.61
Max. Negotiated Rate	$106.61
Rate for Payer: Qualcare PPO/HMO/WC	$106.61

KNOT PUSTER CUTTER STRAIGHT

Facility

$710.70

Hospital Charge Code	270646585
Hospital Revenue Code	272
Min. Negotiated Rate	$92.39
Max. Negotiated Rate	$355.35
Rate for Payer: Aetna Commercial	$213.21
Rate for Payer: Aetna Medicare Advantage	$213.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.23
Rate for Payer: Cigna Commercial	$355.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.39
Rate for Payer: Oxford Commercial	$355.35
Rate for Payer: Qualcare PPO/HMO/WC	$106.61
Rate for Payer: UnitedHealthcare Commercial	$355.35

KNOWLES PIN

Facility

$372.00

Hospital Charge Code	270335010
Hospital Revenue Code	278
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.02
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

KNOWLES PIN

Facility

$372.00

Hospital Charge Code	270335010
Hospital Revenue Code	278
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$90.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.02
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

KOBYGARD DISP.BLADE

Facility

$232.00

Hospital Charge Code	270339451
Hospital Revenue Code	272
Min. Negotiated Rate	$34.80
Max. Negotiated Rate	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$34.80

KOBYGARD DISP.BLADE

Facility

$232.00

Hospital Charge Code	270339451
Hospital Revenue Code	272
Min. Negotiated Rate	$30.16
Max. Negotiated Rate	$116.00
Rate for Payer: Aetna Commercial	$69.60
Rate for Payer: Aetna Medicare Advantage	$69.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.16
Rate for Payer: Cigna Commercial	$116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$116.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.80
Rate for Payer: UnitedHealthcare Commercial	$116.00

KOGENATE FS (FACTOR 8) 100 IU/

Facility

$8.91

Service Code	HCPCS J7192
Hospital Charge Code	606394263
Hospital Revenue Code	636
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$2.67
Rate for Payer: Aetna Commercial	$2.67
Rate for Payer: Aetna Medicare Advantage	$2.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

Know your out-of-pocket cost for care.

All Charges