Heights University Hospital

All Charges

Charge

Type

Setting

Price

LAP TIP 2MM X 30CM & TUBESET

Facility

$6,000.00

Hospital Charge Code	270691645
Hospital Revenue Code	272
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$780.00
Rate for Payer: Oxford Commercial	$3,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Commercial	$3,000.00

LAP TIP 2MM X 30CM & TUBESET

Facility

$6,000.00

Hospital Charge Code	270691645
Hospital Revenue Code	272
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

LAP TX ECT PREG WO SALPIN/OOPH

Facility

$43,334.60

Service Code	HCPCS 59150
Hospital Charge Code	1600000429
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 TX ECT PREG WO SALPIN/OOPH

Facility

$43,334.60

Service Code	HCPCS 59150
Hospital Charge Code	1600000429
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 TX ECT PREG,W SALPIN/OOPHO

Facility

$44,604.40

Service Code	HCPCS 59151
Hospital Charge Code	1600000488
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$13,381.32
Rate for Payer: Aetna Medicare Advantage	$13,381.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,374.12
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	$11,374.12
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,798.57
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAP TX ECT PREG,W SALPIN/OOPHO

Facility

$44,604.40

Service Code	HCPCS 59151
Hospital Charge Code	1600000488
Hospital Revenue Code	360
Min. Negotiated Rate	$6,690.66
Max. Negotiated Rate	$6,690.66
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66

LAP TY ABS SUTURE CLIP APPLIER

Facility

$162.70

Hospital Charge Code	270685306
Hospital Revenue Code	272
Min. Negotiated Rate	$24.41
Max. Negotiated Rate	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$24.41

LAP TY ABS SUTURE CLIP APPLIER

Facility

$162.70

Hospital Charge Code	270685306
Hospital Revenue Code	272
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$81.35
Rate for Payer: Aetna Commercial	$48.81
Rate for Payer: Aetna Medicare Advantage	$48.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.49
Rate for Payer: Cigna Commercial	$81.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.15
Rate for Payer: Oxford Commercial	$81.35
Rate for Payer: Qualcare PPO/HMO/WC	$24.41
Rate for Payer: UnitedHealthcare Commercial	$81.35

LAP VENT/ABD HERNIA REPAIR

Facility

$66,282.45

Service Code	HCPCS 49652
Hospital Charge Code	16000647
Hospital Revenue Code	360
Min. Negotiated Rate	$9,942.37
Max. Negotiated Rate	$9,942.37
Rate for Payer: Qualcare PPO/HMO/WC	$9,942.37

LAP VENT/ABD HERNIA REPAIR

Facility

$66,282.45

Service Code	HCPCS 49652
Hospital Charge Code	16000647
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$33,141.22
Rate for Payer: Aetna Commercial	$19,884.74
Rate for Payer: Aetna Medicare Advantage	$19,884.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,902.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,902.02
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	$16,902.02
Rate for Payer: Cigna Commercial	$33,141.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,616.72
Rate for Payer: Qualcare PPO/HMO/WC	$9,942.37

LAP W DESTRUCTIONS OF OVIDUCT

Facility

$58,549.97

Service Code	HCPCS 58670
Hospital Charge Code	1600000317
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,564.99
Rate for Payer: Aetna Commercial	$17,564.99
Rate for Payer: Aetna Medicare Advantage	$17,564.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,930.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,930.24
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	$14,930.24
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,611.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAP W DESTRUCTIONS OF OVIDUCT

Facility

$58,549.97

Service Code	HCPCS 58670
Hospital Charge Code	1600000317
Hospital Revenue Code	360
Min. Negotiated Rate	$8,782.50
Max. Negotiated Rate	$8,782.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50

LAP W/EXC DESTR OVARY PELVIC W

Facility

$58,549.97

Service Code	HCPCS 58662
Hospital Charge Code	16000765
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,564.99
Rate for Payer: Aetna Commercial	$17,564.99
Rate for Payer: Aetna Medicare Advantage	$17,564.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,930.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,930.24
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	$14,930.24
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,611.50
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAP W/EXC DESTR OVARY PELVIC W

Facility

$58,549.97

Service Code	HCPCS 58662
Hospital Charge Code	16000765
Hospital Revenue Code	360
Min. Negotiated Rate	$8,782.50
Max. Negotiated Rate	$8,782.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,782.50

LAP,W REM ADNEXAL STRUCTURES

Facility

$44,604.40

Service Code	HCPCS 58661
Hospital Charge Code	16001009
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$14,396.79
Rate for Payer: Aetna Commercial	$13,381.32
Rate for Payer: Aetna Medicare Advantage	$13,381.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,374.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,374.12
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	$11,374.12
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,798.57
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

LAP,W REM ADNEXAL STRUCTURES

Facility

$44,604.40

Service Code	HCPCS 58661
Hospital Charge Code	16001009
Hospital Revenue Code	360
Min. Negotiated Rate	$6,690.66
Max. Negotiated Rate	$6,690.66
Rate for Payer: Qualcare PPO/HMO/WC	$6,690.66

LARGE CAP BIOPSY ALLIGATOR

Facility

$24.75

Hospital Charge Code	270700337
Hospital Revenue Code	272
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$7.42
Rate for Payer: Aetna Medicare Advantage	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.31
Rate for Payer: Cigna Commercial	$12.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.22
Rate for Payer: Oxford Commercial	$12.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.71
Rate for Payer: UnitedHealthcare Commercial	$12.38

LARGE CAP BIOPSY ALLIGATOR

Facility

$24.75

Hospital Charge Code	270700337
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$3.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

LARGE ID PLAQUE CLEAR

Facility

$30.15

Hospital Charge Code	270665602
Hospital Revenue Code	270
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$15.07
Rate for Payer: Aetna Commercial	$9.04
Rate for Payer: Aetna Medicare Advantage	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.69
Rate for Payer: Cigna Commercial	$15.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.92
Rate for Payer: Oxford Commercial	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$4.52
Rate for Payer: UnitedHealthcare Commercial	$15.07

LARGE ID PLAQUE CLEAR

Facility

$30.15

Hospital Charge Code	270665602
Hospital Revenue Code	270
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$4.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.52

LARGE PHASIX PLUG WITH PATCH

Facility

$2,925.00

Service Code	HCPCS C1781
Hospital Charge Code	270683932
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$1,462.50
Rate for Payer: Aetna Commercial	$877.50
Rate for Payer: Aetna Medicare Advantage	$877.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$745.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$745.88
Rate for Payer: Cigna Commercial	$1,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

LARGE PHASIX PLUG WITH PATCH

Facility

$2,925.00

Service Code	HCPCS C1781
Hospital Charge Code	270683932
Hospital Revenue Code	278
Min. Negotiated Rate	$438.75
Max. Negotiated Rate	$707.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.85
Rate for Payer: Qualcare PPO/HMO/WC	$438.75

LARIAT SNARE

Facility

$75.00

Hospital Charge Code	270669843
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

LARIAT SNARE

Facility

$75.00

Hospital Charge Code	270669843
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

LARYNGECTOMY TUBE 32.7 FR

Facility

$388.00

Hospital Charge Code	270331691
Hospital Revenue Code	272
Min. Negotiated Rate	$58.20
Max. Negotiated Rate	$58.20
Rate for Payer: Qualcare PPO/HMO/WC	$58.20

Know your out-of-pocket cost for care.

All Charges