Heights University Hospital

All Charges

Charge

Type

Setting

Price

LINER STERRAD 10 X 17 TRAY

Facility

$10.50

Hospital Charge Code	270657523
Hospital Revenue Code	270
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

LINER STERRAD 10 X 17 TRAY

Facility

$10.50

Hospital Charge Code	270657523
Hospital Revenue Code	270
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.15
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$5.25

LINER SUCTION 1000 CC

Facility

$7.00

Hospital Charge Code	270301241
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

LINER SUCTION 1000 CC

Facility

$7.00

Hospital Charge Code	270301241
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

LINER SUCTION 1500cc 65651515

Facility

$5.88

Hospital Charge Code	270301242
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.88

LINER SUCTION 1500cc 65651515

Facility

$5.88

Hospital Charge Code	270301242
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$2.94
Rate for Payer: Aetna Commercial	$1.76
Rate for Payer: Aetna Medicare Advantage	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.50
Rate for Payer: Cigna Commercial	$2.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.76
Rate for Payer: Oxford Commercial	$2.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.88
Rate for Payer: UnitedHealthcare Commercial	$2.94

LINER TIBIA SZ11 10MM TK EMPOW

Facility

$5,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270692717
Hospital Revenue Code	278
Min. Negotiated Rate	$866.25
Max. Negotiated Rate	$2,887.50
Rate for Payer: Aetna Commercial	$1,732.50
Rate for Payer: Aetna Medicare Advantage	$1,732.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,472.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,472.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,155.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,472.62
Rate for Payer: Cigna Commercial	$2,887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,397.55
Rate for Payer: Qualcare PPO/HMO/WC	$866.25

LINER TIBIA SZ11 10MM TK EMPOW

Facility

$5,775.00

Service Code	HCPCS C1776
Hospital Charge Code	270692717
Hospital Revenue Code	278
Min. Negotiated Rate	$866.25
Max. Negotiated Rate	$1,397.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,397.55
Rate for Payer: Qualcare PPO/HMO/WC	$866.25

LINER TIB INSERT SZ4 12MM LT

Facility

$8,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697440
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

LINER TIB INSERT SZ4 12MM LT

Facility

$8,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697440
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

LINER TRAY

Facility

$283.95

Hospital Charge Code	270650926
Hospital Revenue Code	272
Min. Negotiated Rate	$42.59
Max. Negotiated Rate	$42.59
Rate for Payer: Qualcare PPO/HMO/WC	$42.59

LINER TRAY

Facility

$283.95

Hospital Charge Code	270650926
Hospital Revenue Code	272
Min. Negotiated Rate	$36.91
Max. Negotiated Rate	$141.97
Rate for Payer: Aetna Commercial	$85.19
Rate for Payer: Aetna Medicare Advantage	$85.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.41
Rate for Payer: Cigna Commercial	$141.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.91
Rate for Payer: Oxford Commercial	$141.97
Rate for Payer: Qualcare PPO/HMO/WC	$42.59
Rate for Payer: UnitedHealthcare Commercial	$141.97

LINER VERSAFITCUP CC TRIO FLAT

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681267
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

LINER VERSAFITCUP CC TRIO FLAT

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270681267
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

LINER VERSAFIT CUP HC 52/28

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270682959
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 VERSAFIT CUP HC 52/28

Facility

$6,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270682959
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 VIVACET-E BRNG 28X46MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693416
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

LINER VIVACET-E BRNG 28X46MM

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693416
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

LINER ZIM ACETB 10 28 61205028

Facility

$4,137.65

Hospital Charge Code	270612225
Hospital Revenue Code	278
Min. Negotiated Rate	$620.65
Max. Negotiated Rate	$2,068.82
Rate for Payer: Aetna Commercial	$1,241.30
Rate for Payer: Aetna Medicare Advantage	$1,241.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,055.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,055.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$827.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,055.10
Rate for Payer: Cigna Commercial	$2,068.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,001.31
Rate for Payer: Qualcare PPO/HMO/WC	$620.65

LINER ZIM ACETB 10 28 61205028

Facility

$4,137.65

Hospital Charge Code	270612225
Hospital Revenue Code	278
Min. Negotiated Rate	$620.65
Max. Negotiated Rate	$1,001.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$827.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,001.31
Rate for Payer: Qualcare PPO/HMO/WC	$620.65

LINER ZIM ACETB 10 56 61105628

Facility

$4,137.65

Hospital Charge Code	270605649
Hospital Revenue Code	278
Min. Negotiated Rate	$620.65
Max. Negotiated Rate	$2,068.82
Rate for Payer: Aetna Commercial	$1,241.30
Rate for Payer: Aetna Medicare Advantage	$1,241.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,055.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,055.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$827.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,055.10
Rate for Payer: Cigna Commercial	$2,068.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,001.31
Rate for Payer: Qualcare PPO/HMO/WC	$620.65

LINER ZIM ACETB 10 56 61105628

Facility

$4,137.65

Hospital Charge Code	270605649
Hospital Revenue Code	278
Min. Negotiated Rate	$620.65
Max. Negotiated Rate	$1,001.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$827.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,001.31
Rate for Payer: Qualcare PPO/HMO/WC	$620.65

LINER ZIM ACETB 10 58 61105828

Facility

$4,069.65

Hospital Charge Code	270606805
Hospital Revenue Code	278
Min. Negotiated Rate	$610.45
Max. Negotiated Rate	$984.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$984.86
Rate for Payer: Qualcare PPO/HMO/WC	$610.45

LINER ZIM ACETB 10 58 61105828

Facility

$4,069.65

Hospital Charge Code	270606805
Hospital Revenue Code	278
Min. Negotiated Rate	$610.45
Max. Negotiated Rate	$2,034.83
Rate for Payer: Aetna Commercial	$1,220.89
Rate for Payer: Aetna Medicare Advantage	$1,220.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,037.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,037.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,037.76
Rate for Payer: Cigna Commercial	$2,034.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$984.86
Rate for Payer: Qualcare PPO/HMO/WC	$610.45

LINER ZIM ACETB 10 60 61106028

Facility

$4,069.65

Hospital Charge Code	270605997
Hospital Revenue Code	278
Min. Negotiated Rate	$610.45
Max. Negotiated Rate	$2,034.83
Rate for Payer: Aetna Commercial	$1,220.89
Rate for Payer: Aetna Medicare Advantage	$1,220.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,037.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,037.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,037.76
Rate for Payer: Cigna Commercial	$2,034.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$984.86
Rate for Payer: Qualcare PPO/HMO/WC	$610.45

Know your out-of-pocket cost for care.

All Charges