Heights University Hospital

All Charges

Charge

Type

Setting

Price

LASER FIBER LIT PROFLEX 910 M

Facility

$3,175.00

Hospital Charge Code	270682490
Hospital Revenue Code	272
Min. Negotiated Rate	$476.25
Max. Negotiated Rate	$476.25
Rate for Payer: Qualcare PPO/HMO/WC	$476.25

LASER FIBER LIT PROFLEX 910 M

Facility

$3,175.00

Hospital Charge Code	270682490
Hospital Revenue Code	272
Min. Negotiated Rate	$412.75
Max. Negotiated Rate	$1,587.50
Rate for Payer: Aetna Commercial	$952.50
Rate for Payer: Aetna Medicare Advantage	$952.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$809.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$809.62
Rate for Payer: Cigna Commercial	$1,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.75
Rate for Payer: Oxford Commercial	$1,587.50
Rate for Payer: Qualcare PPO/HMO/WC	$476.25
Rate for Payer: UnitedHealthcare Commercial	$1,587.50

LASER FIBER SLIMLINE 550

Facility

$3,215.00

Hospital Charge Code	270670032
Hospital Revenue Code	272
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$482.25
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

LASER FIBER SLIMLINE 550

Facility

$3,215.00

Hospital Charge Code	270670032
Hospital Revenue Code	272
Min. Negotiated Rate	$417.95
Max. Negotiated Rate	$1,607.50
Rate for Payer: Aetna Commercial	$964.50
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.95
Rate for Payer: Oxford Commercial	$1,607.50
Rate for Payer: Qualcare PPO/HMO/WC	$482.25
Rate for Payer: UnitedHealthcare Commercial	$1,607.50

LASER FIBR HLM 400 DUR400DBX

Facility

$2,212.25

Hospital Charge Code	270631441
Hospital Revenue Code	272
Min. Negotiated Rate	$287.59
Max. Negotiated Rate	$1,106.12
Rate for Payer: Aetna Commercial	$663.67
Rate for Payer: Aetna Medicare Advantage	$663.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$564.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$564.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$564.12
Rate for Payer: Cigna Commercial	$1,106.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$287.59
Rate for Payer: Oxford Commercial	$1,106.12
Rate for Payer: Qualcare PPO/HMO/WC	$331.84
Rate for Payer: UnitedHealthcare Commercial	$1,106.12

LASER FIBR HLM 400 DUR400DBX

Facility

$2,212.25

Hospital Charge Code	270631441
Hospital Revenue Code	272
Min. Negotiated Rate	$331.84
Max. Negotiated Rate	$331.84
Rate for Payer: Qualcare PPO/HMO/WC	$331.84

LASER FIBR HOL MIC HF0600DSSMS

Facility

$2,524.70

Hospital Charge Code	270631935
Hospital Revenue Code	272
Min. Negotiated Rate	$378.70
Max. Negotiated Rate	$378.70
Rate for Payer: Qualcare PPO/HMO/WC	$378.70

LASER FIBR HOL MIC HF0600DSSMS

Facility

$2,524.70

Hospital Charge Code	270631935
Hospital Revenue Code	272
Min. Negotiated Rate	$328.21
Max. Negotiated Rate	$1,262.35
Rate for Payer: Cigna Commercial	$1,262.35
Rate for Payer: Aetna Commercial	$757.41
Rate for Payer: Aetna Medicare Advantage	$757.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$643.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$643.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$643.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$328.21
Rate for Payer: Oxford Commercial	$1,262.35
Rate for Payer: Qualcare PPO/HMO/WC	$378.70
Rate for Payer: UnitedHealthcare Commercial	$1,262.35

LASER FIBR HOLM MC HFO200DSSMS

Facility

$1,000.00

Hospital Charge Code	270632539
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

LASER FIBR HOLM MC HFO200DSSMS

Facility

$1,000.00

Hospital Charge Code	270632539
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

LASER GREENLIGHT RENTAL

Facility

$4,250.00

Hospital Charge Code	270645490
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

LASER GREENLIGHT RENTAL

Facility

$4,250.00

Hospital Charge Code	270645490
Hospital Revenue Code	272
Min. Negotiated Rate	$552.50
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,275.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.50
Rate for Payer: Oxford Commercial	$2,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$2,125.00

LASER PRO TOUCH

Facility

$4,750.00

Hospital Charge Code	270662160
Hospital Revenue Code	272
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LASER PRO TOUCH

Facility

$4,750.00

Hospital Charge Code	270662160
Hospital Revenue Code	272
Min. Negotiated Rate	$617.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.50
Rate for Payer: Oxford Commercial	$2,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Commercial	$2,375.00

LASER VAPOZATION OF PROSTATE

Facility

$39,246.20

Service Code	HCPCS 52648
Hospital Charge Code	16000649
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,768.54
Rate for Payer: Aetna Commercial	$11,773.86
Rate for Payer: Aetna Medicare Advantage	$11,773.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,007.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,007.78
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	$10,007.78
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,102.01
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.93
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

LASER VAPOZATION OF PROSTATE

Facility

$39,246.20

Service Code	HCPCS 52648
Hospital Charge Code	16000649
Hospital Revenue Code	360
Min. Negotiated Rate	$5,886.93
Max. Negotiated Rate	$5,886.93
Rate for Payer: Qualcare PPO/HMO/WC	$5,886.93

LASIX/40MG/TAB

Facility

$3.00

Hospital Charge Code	60633271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LASIX/40MG/TAB

Facility

$3.00

Hospital Charge Code	60633271
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

LASIX/80MG/BULK

Facility

$3.00

Hospital Charge Code	60634643
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

LASIX/80MG/BULK

Facility

$3.00

Hospital Charge Code	60634643
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LASIX/80MG/TAB

Facility

$3.00

Hospital Charge Code	60633272
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

LASIX/80MG/TAB

Facility

$3.00

Hospital Charge Code	60633272
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LASSO ATX SUTURE 90 AR4065905

Facility

$967.25

Hospital Charge Code	270627514
Hospital Revenue Code	272
Min. Negotiated Rate	$125.74
Max. Negotiated Rate	$483.62
Rate for Payer: Aetna Commercial	$290.18
Rate for Payer: Aetna Medicare Advantage	$290.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.65
Rate for Payer: Cigna Commercial	$483.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.74
Rate for Payer: Oxford Commercial	$483.62
Rate for Payer: Qualcare PPO/HMO/WC	$145.09
Rate for Payer: UnitedHealthcare Commercial	$483.62

LASSO ATX SUTURE 90 AR4065905

Facility

$967.25

Hospital Charge Code	270627514
Hospital Revenue Code	272
Min. Negotiated Rate	$145.09
Max. Negotiated Rate	$145.09
Rate for Payer: Qualcare PPO/HMO/WC	$145.09

LASSO QUICKPASS CURVE LEFT 45

Facility

$1,145.00

Hospital Charge Code	270667328
Hospital Revenue Code	270
Min. Negotiated Rate	$171.75
Max. Negotiated Rate	$171.75
Rate for Payer: Qualcare PPO/HMO/WC	$171.75

Know your out-of-pocket cost for care.

All Charges