Heights University Hospital

All Charges

Charge

Type

Setting

Price

LEAD US MA 58

Facility

$5,130.00

Hospital Charge Code	270657306
Hospital Revenue Code	278
Min. Negotiated Rate	$769.50
Max. Negotiated Rate	$1,241.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,026.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,241.46
Rate for Payer: Qualcare PPO/HMO/WC	$769.50

LEAD US MARKET

Facility

$4,680.00

Hospital Charge Code	270663724
Hospital Revenue Code	278
Min. Negotiated Rate	$702.00
Max. Negotiated Rate	$2,340.00
Rate for Payer: Aetna Commercial	$1,404.00
Rate for Payer: Aetna Medicare Advantage	$1,404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,193.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,193.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,193.40
Rate for Payer: Cigna Commercial	$2,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$702.00

LEAD US MARKET

Facility

$4,680.00

Hospital Charge Code	270663724
Hospital Revenue Code	278
Min. Negotiated Rate	$702.00
Max. Negotiated Rate	$1,132.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$936.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.56
Rate for Payer: Qualcare PPO/HMO/WC	$702.00

LEAD VENTRICAL DEXTRUS 4137

Facility

$3,000.00

Hospital Charge Code	270646789
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD VENTRICAL DEXTRUS 4137

Facility

$3,000.00

Hospital Charge Code	270646789
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

LEAD VENTRICLE R53 TILDA 53CM

Facility

$4,040.00

Hospital Charge Code	270663607
Hospital Revenue Code	278
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$977.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD VENTRICLE R53 TILDA 53CM

Facility

$4,040.00

Hospital Charge Code	270663607
Hospital Revenue Code	278
Min. Negotiated Rate	$606.00
Max. Negotiated Rate	$2,020.00
Rate for Payer: Aetna Commercial	$1,212.00
Rate for Payer: Aetna Medicare Advantage	$1,212.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,030.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,030.20
Rate for Payer: Cigna Commercial	$2,020.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$977.68
Rate for Payer: Qualcare PPO/HMO/WC	$606.00

LEAD VENTRICULAR 53CM F/PACEM

Facility

$4,965.00

Hospital Charge Code	270645704
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$1,201.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD VENTRICULAR 53CM F/PACEM

Facility

$4,965.00

Hospital Charge Code	270645704
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$2,482.50
Rate for Payer: Aetna Commercial	$1,489.50
Rate for Payer: Aetna Medicare Advantage	$1,489.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,266.08
Rate for Payer: Cigna Commercial	$2,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD VENTRICULAR FOR PM 508652

Facility

$4,965.00

Hospital Charge Code	270645704C
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$1,201.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD VENTRICULAR FOR PM 508652

Facility

$4,965.00

Hospital Charge Code	270645704C
Hospital Revenue Code	275
Min. Negotiated Rate	$744.75
Max. Negotiated Rate	$2,482.50
Rate for Payer: Aetna Commercial	$1,489.50
Rate for Payer: Aetna Medicare Advantage	$1,489.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,266.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$993.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,266.08
Rate for Payer: Cigna Commercial	$2,482.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,201.53
Rate for Payer: Qualcare PPO/HMO/WC	$744.75

LEAD VENT TENDRK SDX 1488TC52

Facility

$3,720.00

Hospital Charge Code	270629428C
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$900.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD VENT TENDRK SDX 1488TC52

Facility

$3,720.00

Hospital Charge Code	270629428
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$900.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD VENT TENDRK SDX 1488TC52

Facility

$3,720.00

Hospital Charge Code	270629428C
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$1,860.00
Rate for Payer: Aetna Commercial	$1,116.00
Rate for Payer: Aetna Medicare Advantage	$1,116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$948.60
Rate for Payer: Cigna Commercial	$1,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD VENT TENDRK SDX 1488TC52

Facility

$3,720.00

Hospital Charge Code	270629428
Hospital Revenue Code	275
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$1,860.00
Rate for Payer: Aetna Commercial	$1,116.00
Rate for Payer: Aetna Medicare Advantage	$1,116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$948.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$948.60
Rate for Payer: Cigna Commercial	$1,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.24
Rate for Payer: Qualcare PPO/HMO/WC	$558.00

LEAD WIRE ECG 3-LEAD

Facility

$82.50

Hospital Charge Code	270609035
Hospital Revenue Code	271
Min. Negotiated Rate	$12.38
Max. Negotiated Rate	$12.38
Rate for Payer: Qualcare PPO/HMO/WC	$12.38

LEAD WIRE ECG 3-LEAD

Facility

$82.50

Hospital Charge Code	270609035
Hospital Revenue Code	271
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$41.25
Rate for Payer: Aetna Commercial	$24.75
Rate for Payer: Aetna Medicare Advantage	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.04
Rate for Payer: Cigna Commercial	$41.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.72
Rate for Payer: Oxford Commercial	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$12.38
Rate for Payer: UnitedHealthcare Commercial	$41.25

LEAD WIRE ECG MOBILITY 5 LEAD

Facility

$135.00

Hospital Charge Code	270644944
Hospital Revenue Code	272
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

LEAD WIRE ECG MOBILITY 5 LEAD

Facility

$135.00

Hospital Charge Code	270644944
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$40.50
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Oxford Commercial	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$67.50

LEAD WIRE PACEMAKER

Facility

$3,080.00

Hospital Charge Code	270657307
Hospital Revenue Code	278
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$1,540.00
Rate for Payer: Aetna Commercial	$924.00
Rate for Payer: Aetna Medicare Advantage	$924.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$785.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$785.40
Rate for Payer: Cigna Commercial	$1,540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: Qualcare PPO/HMO/WC	$462.00

LEAD WIRE PACEMAKER

Facility

$3,080.00

Hospital Charge Code	270657307
Hospital Revenue Code	278
Min. Negotiated Rate	$462.00
Max. Negotiated Rate	$745.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$616.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$745.36
Rate for Payer: Qualcare PPO/HMO/WC	$462.00

LEAVE OF ABSENCE

Facility

$0.01

Hospital Charge Code	10008
Hospital Revenue Code	180
Max. Negotiated Rate	$6,764.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$228.75

Service Code	HCPCS 83661
Hospital Charge Code	3002310A
Hospital Revenue Code	301
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.25
Rate for Payer: Aetna Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.57
Rate for Payer: Cigna Commercial	$21.99
Rate for Payer: Cigna Medicare Advantage	$10.99
Rate for Payer: Clover Medicare Advantage	$20.89
Rate for Payer: EmblemHealth Commercial	$65.97
Rate for Payer: Humana Medicare Advantage	$22.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.31
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.31
Rate for Payer: Wellcare Medicare Advantage	$21.99

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$137.50

Service Code	HCPCS 84081
Hospital Charge Code	3002310B
Hospital Revenue Code	301
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.52
Rate for Payer: Aetna Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$16.52
Rate for Payer: Cigna Medicare Advantage	$8.26
Rate for Payer: Clover Medicare Advantage	$15.69
Rate for Payer: EmblemHealth Commercial	$49.56
Rate for Payer: Humana Medicare Advantage	$17.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.51
Rate for Payer: Wellcare Medicare Advantage	$16.52

LECITHIN/SPHINGO RATIO,AMN FLD

Facility

$137.50

Service Code	HCPCS 84081
Hospital Charge Code	3002310B
Hospital Revenue Code	301
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

Know your out-of-pocket cost for care.

All Charges