Heights University Hospital

All Charges

Charge

Type

Setting

Price

LEFT STANDARD VDR PLATE

Facility

$5,920.00

Hospital Charge Code	270665465
Hospital Revenue Code	278
Min. Negotiated Rate	$888.00
Max. Negotiated Rate	$1,432.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: Qualcare PPO/HMO/WC	$888.00

LEFT STANDARD VDR PLATE

Facility

$5,920.00

Hospital Charge Code	270665465
Hospital Revenue Code	278
Min. Negotiated Rate	$888.00
Max. Negotiated Rate	$2,960.00
Rate for Payer: Aetna Commercial	$1,776.00
Rate for Payer: Aetna Medicare Advantage	$1,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,509.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,509.60
Rate for Payer: Cigna Commercial	$2,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,432.64
Rate for Payer: Qualcare PPO/HMO/WC	$888.00

LEGATO PROBE MONO BALL TIP

Facility

$1,310.00

Hospital Charge Code	270694697
Hospital Revenue Code	272
Min. Negotiated Rate	$170.30
Max. Negotiated Rate	$655.00
Rate for Payer: Aetna Commercial	$393.00
Rate for Payer: Aetna Medicare Advantage	$393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.05
Rate for Payer: Cigna Commercial	$655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.30
Rate for Payer: Oxford Commercial	$655.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.50
Rate for Payer: UnitedHealthcare Commercial	$655.00

LEGATO PROBE MONO BALL TIP

Facility

$1,310.00

Hospital Charge Code	270694697
Hospital Revenue Code	272
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$196.50
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

LEG CUFF SET

Facility

$1,499.70

Hospital Charge Code	270656306
Hospital Revenue Code	272
Min. Negotiated Rate	$194.96
Max. Negotiated Rate	$749.85
Rate for Payer: Aetna Commercial	$449.91
Rate for Payer: Aetna Medicare Advantage	$449.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.42
Rate for Payer: Cigna Commercial	$749.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.96
Rate for Payer: Oxford Commercial	$749.85
Rate for Payer: Qualcare PPO/HMO/WC	$224.96
Rate for Payer: UnitedHealthcare Commercial	$749.85

LEG CUFF SET

Facility

$1,499.70

Hospital Charge Code	270656306
Hospital Revenue Code	272
Min. Negotiated Rate	$224.96
Max. Negotiated Rate	$224.96
Rate for Payer: Qualcare PPO/HMO/WC	$224.96

LEGEND 14CM, 5MM BALL DIAMO

Facility

$878.85

Hospital Charge Code	270658945
Hospital Revenue Code	272
Min. Negotiated Rate	$114.25
Max. Negotiated Rate	$439.43
Rate for Payer: Aetna Commercial	$263.65
Rate for Payer: Aetna Medicare Advantage	$263.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.11
Rate for Payer: Cigna Commercial	$439.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.25
Rate for Payer: Oxford Commercial	$439.43
Rate for Payer: Qualcare PPO/HMO/WC	$131.83
Rate for Payer: UnitedHealthcare Commercial	$439.43

LEGEND 14CM, 5MM BALL DIAMO

Facility

$878.85

Hospital Charge Code	270658945
Hospital Revenue Code	272
Min. Negotiated Rate	$131.83
Max. Negotiated Rate	$131.83
Rate for Payer: Qualcare PPO/HMO/WC	$131.83

LEGGINGS DISP 89408

Facility

$22.45

Hospital Charge Code	270600163
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

LEGGINGS DISP 89408

Facility

$22.45

Hospital Charge Code	270600163
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

LEGIONELLA AB

Facility

$168.00

Service Code	HCPCS 86713
Hospital Charge Code	38476020
Hospital Revenue Code	302
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

LEGIONELLA AB

Facility

$168.00

Service Code	HCPCS 86713
Hospital Charge Code	38476020
Hospital Revenue Code	302
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.57
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.30
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	$56.06
Rate for Payer: Cigna Commercial	$15.30
Rate for Payer: Cigna Medicare Advantage	$7.65
Rate for Payer: Clover Medicare Advantage	$14.54
Rate for Payer: EmblemHealth Commercial	$45.90
Rate for Payer: Humana Medicare Advantage	$15.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.22
Rate for Payer: Wellcare Medicare Advantage	$15.30

LEGIONELLA AB PANEL IFA, I

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045A
Hospital Revenue Code	302
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

LEGIONELLA AB PANEL IFA, I

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AB PANEL IFA, II

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AB PANEL IFA, II

Facility

$390.00

Service Code	HCPCS 8671391
Hospital Charge Code	39990045B
Hospital Revenue Code	302
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	397071539
Hospital Revenue Code	306
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.54
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.16
Rate for Payer: Cigna Commercial	$15.60
Rate for Payer: Cigna Medicare Advantage	$7.80
Rate for Payer: Clover Medicare Advantage	$14.82
Rate for Payer: EmblemHealth Commercial	$46.80
Rate for Payer: Humana Medicare Advantage	$16.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.54
Rate for Payer: Wellcare Medicare Advantage	$15.60

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	401387278
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	401387278
Hospital Revenue Code	306
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.54
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.16
Rate for Payer: Cigna Commercial	$15.60
Rate for Payer: Cigna Medicare Advantage	$7.80
Rate for Payer: Clover Medicare Advantage	$14.82
Rate for Payer: EmblemHealth Commercial	$46.80
Rate for Payer: Humana Medicare Advantage	$16.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.54
Rate for Payer: Wellcare Medicare Advantage	$15.60

LEGIONELLA AG DETECT DFA STOOL

Facility

$390.00

Service Code	HCPCS 87278
Hospital Charge Code	397071539
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AG EIA

Facility

$77.95

Service Code	HCPCS 87449
Hospital Charge Code	38478080
Hospital Revenue Code	306
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$11.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.69

LEGIONELLA AG EIA

Facility

$77.95

Service Code	HCPCS 87449
Hospital Charge Code	38478080
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

LEGIONELLA AG,EIA,URINE

Facility

$390.00

Service Code	HCPCS 87449
Hospital Charge Code	39900290
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

LEGIONELLA AG,EIA,URINE

Facility

$390.00

Service Code	HCPCS 87449
Hospital Charge Code	39900290
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEGIONELLA AG,UR IMMUNO

Facility

$77.95

Service Code	HCPCS 87449
Hospital Charge Code	38479118
Hospital Revenue Code	306
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$11.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.69

Know your out-of-pocket cost for care.

All Charges