Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

LASSO QUICKPASS RIGHT 25 DEG

Facility

$1,145.00

Hospital Charge Code	270667327
Hospital Revenue Code	270
Min. Negotiated Rate	$148.85
Max. Negotiated Rate	$572.50
Rate for Payer: Aetna Commercial	$343.50
Rate for Payer: Aetna Medicare Advantage	$343.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.98
Rate for Payer: Cigna Commercial	$572.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.85
Rate for Payer: Oxford Commercial	$572.50
Rate for Payer: Qualcare PPO/HMO/WC	$171.75
Rate for Payer: UnitedHealthcare Commercial	$572.50

LASSO QUICKPASS RIGHT 25 DEG

Facility

$1,145.00

Hospital Charge Code	270667327
Hospital Revenue Code	270
Min. Negotiated Rate	$171.75
Max. Negotiated Rate	$171.75
Rate for Payer: Qualcare PPO/HMO/WC	$171.75

LASSO SUTURE 45 DEGREE

Facility

$967.25

Hospital Charge Code	270636100
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 SUTURE 45 DEGREE

Facility

$967.25

Hospital Charge Code	270636100
Hospital Revenue Code	272
Min. Negotiated Rate	$145.09
Max. Negotiated Rate	$145.09
Rate for Payer: Qualcare PPO/HMO/WC	$145.09

LATANOPROST 2.5 ML SOL

Facility

$1,043.59

Service Code	NDC 13830304
Hospital Charge Code	60628089
Hospital Revenue Code	250
Min. Negotiated Rate	$135.67
Max. Negotiated Rate	$521.79
Rate for Payer: Aetna Commercial	$313.08
Rate for Payer: Aetna Medicare Advantage	$313.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$266.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$266.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$266.12
Rate for Payer: Cigna Commercial	$521.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.67
Rate for Payer: Oxford Commercial	$521.79
Rate for Payer: Qualcare PPO/HMO/WC	$156.54
Rate for Payer: UnitedHealthcare Commercial	$521.79

LATANOPROST 2.5 ML SOL

Facility

$1,043.59

Service Code	NDC 13830304
Hospital Charge Code	60628089
Hospital Revenue Code	250
Min. Negotiated Rate	$156.54
Max. Negotiated Rate	$156.54
Rate for Payer: Qualcare PPO/HMO/WC	$156.54

LATERAL ENTRY FEMOR NAIL(10MM)

Facility

$6,645.00

Hospital Charge Code	270656684
Hospital Revenue Code	278
Min. Negotiated Rate	$996.75
Max. Negotiated Rate	$1,608.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.09
Rate for Payer: Qualcare PPO/HMO/WC	$996.75

LATERAL ENTRY FEMOR NAIL(10MM)

Facility

$6,645.00

Hospital Charge Code	270656684
Hospital Revenue Code	278
Min. Negotiated Rate	$996.75
Max. Negotiated Rate	$3,322.50
Rate for Payer: Aetna Commercial	$1,993.50
Rate for Payer: Aetna Medicare Advantage	$1,993.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,694.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,694.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,694.47
Rate for Payer: Cigna Commercial	$3,322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,608.09
Rate for Payer: Qualcare PPO/HMO/WC	$996.75

LATERAL KWIRE

Facility

$1,125.00

Hospital Charge Code	270704025
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

LATERAL KWIRE

Facility

$1,125.00

Hospital Charge Code	270704025
Hospital Revenue Code	272
Min. Negotiated Rate	$146.25
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) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.25
Rate for Payer: Oxford Commercial	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$562.50

LATERAL PATIENT POSITIONER

Facility

$3,250.00

Hospital Charge Code	270703548
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

LATERAL PATIENT POSITIONER

Facility

$3,250.00

Hospital Charge Code	270703548
Hospital Revenue Code	272
Min. Negotiated Rate	$422.50
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$975.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.50
Rate for Payer: Oxford Commercial	$1,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$1,625.00

LATERAL PLATE 30MM

Facility

$16,341.90

Hospital Charge Code	270702310
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.28
Max. Negotiated Rate	$8,170.95
Rate for Payer: Aetna Commercial	$4,902.57
Rate for Payer: Aetna Medicare Advantage	$4,902.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,167.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,268.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,167.18
Rate for Payer: Cigna Commercial	$8,170.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,954.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.28

LATERAL PLATE 30MM

Facility

$16,341.90

Hospital Charge Code	270702310
Hospital Revenue Code	278
Min. Negotiated Rate	$2,451.28
Max. Negotiated Rate	$3,954.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,268.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,954.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,451.28

LATEX SPECIFIC IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3009985
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

LATEX SPECIFIC IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3009985
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

LAT INTERBODY 18X40X10MM 6 DEG

Facility

$21,000.00

Hospital Charge Code	270702451
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$10,500.00
Rate for Payer: Aetna Commercial	$6,300.00
Rate for Payer: Aetna Medicare Advantage	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,355.00
Rate for Payer: Cigna Commercial	$10,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

LAT INTERBODY 18X40X10MM 6 DEG

Facility

$21,000.00

Hospital Charge Code	270702451
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$5,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

LAT INTERBODY 18X50X12 12 DEG

Facility

$21,000.00

Hospital Charge Code	270702452
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$10,500.00
Rate for Payer: Aetna Commercial	$6,300.00
Rate for Payer: Aetna Medicare Advantage	$6,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,355.00
Rate for Payer: Cigna Commercial	$10,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

LAT INTERBODY 18X50X12 12 DEG

Facility

$21,000.00

Hospital Charge Code	270702452
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$5,082.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,082.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,150.00

LAT THOR/LUMB ADDL SEG

Facility

$9,420.05

Service Code	HCPCS 22534
Hospital Charge Code	1600000881
Hospital Revenue Code	360
Min. Negotiated Rate	$350.65
Max. Negotiated Rate	$2,826.01
Rate for Payer: Aetna Commercial	$2,826.01
Rate for Payer: Aetna Medicare Advantage	$2,826.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,402.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,402.11
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	$2,402.11
Rate for Payer: Cigna Commercial	$350.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.61
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.01
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

LAT THOR/LUMB ADDL SEG

Facility

$9,420.05

Service Code	HCPCS 22534
Hospital Charge Code	1600000881
Hospital Revenue Code	360
Min. Negotiated Rate	$1,413.01
Max. Negotiated Rate	$1,413.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,413.01

LAYER 1.5 X 10

Facility

$117.50

Hospital Charge Code	270690217
Hospital Revenue Code	272
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$17.62
Rate for Payer: Qualcare PPO/HMO/WC	$17.62

LAYER 1.5 X 10

Facility

$117.50

Hospital Charge Code	270690217
Hospital Revenue Code	272
Min. Negotiated Rate	$15.28
Max. Negotiated Rate	$58.75
Rate for Payer: Aetna Commercial	$35.25
Rate for Payer: Aetna Medicare Advantage	$35.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.96
Rate for Payer: Cigna Commercial	$58.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.28
Rate for Payer: Oxford Commercial	$58.75
Rate for Payer: Qualcare PPO/HMO/WC	$17.62
Rate for Payer: UnitedHealthcare Commercial	$58.75

Know your out-of-pocket cost for care.

All Charges