Heights University Hospital

All Charges

Charge

Type

Setting

Price

LAP HANDSWITCH ELECTRODE

Facility

$600.00

Hospital Charge Code	270335111
Hospital Revenue Code	272
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$300.00

LAPIDUS 3.5MMX24MM SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688235
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

LAPIDUS 3.5MMX24MM SCREW

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688235
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$414.00
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

LAPIDUS PLATE LEFT

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687468
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$2,700.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

LAPIDUS PLATE LEFT

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687468
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

LAP ILEO/JEJUNO-STOMY

Facility

$130,620.30

Service Code	HCPCS 44187
Hospital Charge Code	1600000266
Hospital Revenue Code	360
Min. Negotiated Rate	$19,593.04
Max. Negotiated Rate	$19,593.04
Rate for Payer: Qualcare PPO/HMO/WC	$19,593.04

LAP ILEO/JEJUNO-STOMY

Facility

$130,620.30

Service Code	HCPCS 44187
Hospital Charge Code	1600000266
Hospital Revenue Code	360
Min. Negotiated Rate	$1,123.27
Max. Negotiated Rate	$39,186.09
Rate for Payer: Aetna Commercial	$39,186.09
Rate for Payer: Aetna Medicare Advantage	$39,186.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,308.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,308.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,308.18
Rate for Payer: Cigna Commercial	$1,123.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,980.64
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$19,593.04
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

LAP INC HERNIA REPAIR RECUR

Facility

$63,727.20

Service Code	HCPCS 49656
Hospital Charge Code	1600000445
Hospital Revenue Code	360
Min. Negotiated Rate	$9,559.08
Max. Negotiated Rate	$9,559.08
Rate for Payer: Qualcare PPO/HMO/WC	$9,559.08

LAP INC HERNIA REPAIR RECUR

Facility

$63,727.20

Service Code	HCPCS 49656
Hospital Charge Code	1600000445
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$31,863.60
Rate for Payer: Aetna Commercial	$19,118.16
Rate for Payer: Aetna Medicare Advantage	$19,118.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,250.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,250.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,250.44
Rate for Payer: Cigna Commercial	$31,863.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,284.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,559.08

LAP INC HERN RECUR COMP

Facility

$39,439.32

Service Code	HCPCS 49657
Hospital Charge Code	16000994
Hospital Revenue Code	360
Min. Negotiated Rate	$5,915.90
Max. Negotiated Rate	$5,915.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90

LAP INC HERN RECUR COMP

Facility

$39,439.32

Service Code	HCPCS 49657
Hospital Charge Code	16000994
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$19,719.66
Rate for Payer: Aetna Commercial	$11,831.80
Rate for Payer: Aetna Medicare Advantage	$11,831.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,057.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,057.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,057.03
Rate for Payer: Cigna Commercial	$19,719.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,127.11
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90

LAP ING HERNIA REPAIR INIT--RT

Facility

$43,334.60

Service Code	HCPCS 49650
Hospital Charge Code	16000646
Hospital Revenue Code	360
Min. Negotiated Rate	$6,500.19
Max. Negotiated Rate	$6,500.19
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19

LAP ING HERNIA REPAIR INIT--RT

Facility

$43,334.60

Service Code	HCPCS 49650
Hospital Charge Code	16000646
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$13,000.38
Rate for Payer: Aetna Medicare Advantage	$13,000.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,050.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,050.32
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,633.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,500.19
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAP ING HERNIA REPAIR RECUR RT

Facility

$44,604.55

Service Code	HCPCS 49651
Hospital Charge Code	1600000328
Hospital Revenue Code	360
Min. Negotiated Rate	$6,690.68
Max. Negotiated Rate	$6,690.68
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.68

LAP ING HERNIA REPAIR RECUR RT

Facility

$44,604.55

Service Code	HCPCS 49651
Hospital Charge Code	1600000328
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$13,381.36
Rate for Payer: Aetna Medicare Advantage	$13,381.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,374.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,374.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,374.16
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,798.59
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.68
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAP INSERTION PERM IP CATH

Facility

$34,812.50

Service Code	HCPCS 49324
Hospital Charge Code	16000988
Hospital Revenue Code	360
Min. Negotiated Rate	$5,221.88
Max. Negotiated Rate	$5,221.88
Rate for Payer: Qualcare PPO/HMO/WC	$5,221.88

LAP INSERTION PERM IP CATH

Facility

$34,812.50

Service Code	HCPCS 49324
Hospital Charge Code	16000988
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$10,443.75
Rate for Payer: Aetna Medicare Advantage	$10,443.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,877.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,877.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,877.19
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,525.62
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,221.88
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LAP INSUFFLATOR TUBE/FILTER

Facility

$300.00

Hospital Charge Code	270335094
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

LAP INSUFFLATOR TUBE/FILTER

Facility

$300.00

Hospital Charge Code	270335094
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

LAPIPLASTY 2.7MM 16/18MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699092
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,042.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

LAPIPLASTY 2.7MM 16/18MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270699092
Hospital Revenue Code	278
Min. Negotiated Rate	$521.25
Max. Negotiated Rate	$840.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25

LAPIPLASTY BIPLANAR SYSTEM 1

Facility

$19,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693836
Hospital Revenue Code	278
Min. Negotiated Rate	$2,921.25
Max. Negotiated Rate	$4,712.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,712.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,921.25

LAPIPLASTY BIPLANAR SYSTEM 1

Facility

$19,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693836
Hospital Revenue Code	278
Min. Negotiated Rate	$2,921.25
Max. Negotiated Rate	$9,737.50
Rate for Payer: Aetna Commercial	$5,842.50
Rate for Payer: Aetna Medicare Advantage	$5,842.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,966.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,966.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,966.12
Rate for Payer: Cigna Commercial	$9,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,712.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,921.25

LAPIPLASTY KIT SK341-SD211-SD2

Facility

$19,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697469
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

LAPIPLASTY KIT SK341-SD211-SD2

Facility

$19,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697469
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

Know your out-of-pocket cost for care.

All Charges