Heights University Hospital

All Charges

Charge

Type

Setting

Price

LINER CONSTRAINED GROUP 3 36MM

Facility

$7,848.00

Hospital Charge Code	270670931
Hospital Revenue Code	278
Min. Negotiated Rate	$1,177.20
Max. Negotiated Rate	$3,924.00
Rate for Payer: Aetna Commercial	$2,354.40
Rate for Payer: Aetna Medicare Advantage	$2,354.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,001.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,001.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,001.24
Rate for Payer: Cigna Commercial	$3,924.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.20

LINER CONSTRAINED GROUP 3 36MM

Facility

$7,848.00

Hospital Charge Code	270670931
Hospital Revenue Code	278
Min. Negotiated Rate	$1,177.20
Max. Negotiated Rate	$1,899.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,899.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,177.20

LINER CONSTRAINED NEUTRAL 36MM

Facility

$26,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270706022
Hospital Revenue Code	278
Min. Negotiated Rate	$4,011.75
Max. Negotiated Rate	$13,372.50
Rate for Payer: Aetna Commercial	$8,023.50
Rate for Payer: Aetna Medicare Advantage	$8,023.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,819.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,819.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,349.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,819.98
Rate for Payer: Cigna Commercial	$13,372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,472.29
Rate for Payer: Qualcare PPO/HMO/WC	$4,011.75

LINER CONSTRAINED NEUTRAL 36MM

Facility

$26,745.00

Service Code	HCPCS C1713
Hospital Charge Code	270706022
Hospital Revenue Code	278
Min. Negotiated Rate	$4,011.75
Max. Negotiated Rate	$6,472.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,349.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,472.29
Rate for Payer: Qualcare PPO/HMO/WC	$4,011.75

LINER CONSTRAINED TRI 64x36MM

Facility

$17,943.50

Hospital Charge Code	270675768
Hospital Revenue Code	278
Min. Negotiated Rate	$2,691.53
Max. Negotiated Rate	$4,342.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,588.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,342.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,691.53

LINER CONSTRAINED TRI 64x36MM

Facility

$17,943.50

Hospital Charge Code	270675768
Hospital Revenue Code	278
Min. Negotiated Rate	$2,691.53
Max. Negotiated Rate	$8,971.75
Rate for Payer: Aetna Commercial	$5,383.05
Rate for Payer: Aetna Medicare Advantage	$5,383.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,575.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,575.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,588.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,575.59
Rate for Payer: Cigna Commercial	$8,971.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,342.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,691.53

LINER DM

Facility

$9,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270670740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

LINER DM

Facility

$9,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270670740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$2,947.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

LINER DME HEAD 26MM

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270676062
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

LINER DME HEAD 26MM

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270676062
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

LINER DM HEAD 28MM

Facility

$9,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270668030
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$2,377.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

LINER DM HEAD 28MM

Facility

$9,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270668030
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.75
Max. Negotiated Rate	$4,912.50
Rate for Payer: Aetna Commercial	$2,947.50
Rate for Payer: Aetna Medicare Advantage	$2,947.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.38
Rate for Payer: Cigna Commercial	$4,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.75

LINER F/INSPIREASE DRUG DELI-

Facility

$29.93

Hospital Charge Code	270639105
Hospital Revenue Code	270
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$14.96
Rate for Payer: Aetna Commercial	$8.98
Rate for Payer: Aetna Medicare Advantage	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.63
Rate for Payer: Cigna Commercial	$14.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.89
Rate for Payer: Oxford Commercial	$14.96
Rate for Payer: Qualcare PPO/HMO/WC	$4.49
Rate for Payer: UnitedHealthcare Commercial	$14.96

LINER F/INSPIREASE DRUG DELI-

Facility

$29.93

Hospital Charge Code	270639105
Hospital Revenue Code	270
Min. Negotiated Rate	$4.49
Max. Negotiated Rate	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$4.49

LINER FLAT HC 40 J MPACT

Facility

$10,465.00

Service Code	HCPCS C1776
Hospital Charge Code	270684311
Hospital Revenue Code	278
Min. Negotiated Rate	$1,569.75
Max. Negotiated Rate	$5,232.50
Rate for Payer: Aetna Commercial	$3,139.50
Rate for Payer: Aetna Medicare Advantage	$3,139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,668.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,668.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,093.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,668.57
Rate for Payer: Cigna Commercial	$5,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,532.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,569.75

LINER FLAT HC 40 J MPACT

Facility

$10,465.00

Service Code	HCPCS C1776
Hospital Charge Code	270684311
Hospital Revenue Code	278
Min. Negotiated Rate	$1,569.75
Max. Negotiated Rate	$2,532.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,093.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,532.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,569.75

LINER FLAT PE HC 36G

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270694024
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

LINER FLAT PE HC 36G

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270694024
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

LINER FREEDOM CONS HD 36MM T1

Facility

$7,920.00

Service Code	HCPCS C1776
Hospital Charge Code	270697521
Hospital Revenue Code	278
Min. Negotiated Rate	$1,188.00
Max. Negotiated Rate	$1,916.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,584.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.00

LINER FREEDOM CONS HD 36MM T1

Facility

$7,920.00

Service Code	HCPCS C1776
Hospital Charge Code	270697521
Hospital Revenue Code	278
Min. Negotiated Rate	$1,188.00
Max. Negotiated Rate	$3,960.00
Rate for Payer: Aetna Commercial	$2,376.00
Rate for Payer: Aetna Medicare Advantage	$2,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,584.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,019.60
Rate for Payer: Cigna Commercial	$3,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,916.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,188.00

LINER FREEDOM CONST 32MM T1

Facility

$7,530.00

Service Code	HCPCS C1776
Hospital Charge Code	270698812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,129.50
Max. Negotiated Rate	$3,765.00
Rate for Payer: Aetna Commercial	$2,259.00
Rate for Payer: Aetna Medicare Advantage	$2,259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,920.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,920.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,920.15
Rate for Payer: Cigna Commercial	$3,765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,822.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,129.50

LINER FREEDOM CONST 32MM T1

Facility

$7,530.00

Service Code	HCPCS C1776
Hospital Charge Code	270698812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,129.50
Max. Negotiated Rate	$1,822.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,506.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,822.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,129.50

LINER FREEDOM CONST 36 MM

Facility

$17,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270692332
Hospital Revenue Code	278
Min. Negotiated Rate	$2,632.50
Max. Negotiated Rate	$4,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,247.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,632.50

LINER FREEDOM CONST 36 MM

Facility

$17,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270692332
Hospital Revenue Code	278
Min. Negotiated Rate	$2,632.50
Max. Negotiated Rate	$8,775.00
Rate for Payer: Aetna Commercial	$5,265.00
Rate for Payer: Aetna Medicare Advantage	$5,265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,475.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,475.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,475.25
Rate for Payer: Cigna Commercial	$8,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,247.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,632.50

LINER FREEDOM E1 SZ D G7 36MM

Facility

$17,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270697841
Hospital Revenue Code	278
Min. Negotiated Rate	$2,632.50
Max. Negotiated Rate	$4,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,247.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,632.50

Know your out-of-pocket cost for care.

All Charges