Heights University Hospital

All Charges

Charge

Type

Setting

Price

LOAD UNIT 55 2.5 WH TVR55

Facility

$266.90

Hospital Charge Code	270608734
Hospital Revenue Code	272
Min. Negotiated Rate	$34.70
Max. Negotiated Rate	$133.45
Rate for Payer: Aetna Commercial	$80.07
Rate for Payer: Aetna Medicare Advantage	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.06
Rate for Payer: Cigna Commercial	$133.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.70
Rate for Payer: Oxford Commercial	$133.45
Rate for Payer: Qualcare PPO/HMO/WC	$40.03
Rate for Payer: UnitedHealthcare Commercial	$133.45

LOAD UNIT ENDO GIA 30-2.5R

Facility

$683.60

Hospital Charge Code	270651833
Hospital Revenue Code	272
Min. Negotiated Rate	$88.87
Max. Negotiated Rate	$341.80
Rate for Payer: Aetna Commercial	$205.08
Rate for Payer: Aetna Medicare Advantage	$205.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.32
Rate for Payer: Cigna Commercial	$341.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.87
Rate for Payer: Oxford Commercial	$341.80
Rate for Payer: Qualcare PPO/HMO/WC	$102.54
Rate for Payer: UnitedHealthcare Commercial	$341.80

LOAD UNIT ENDO GIA 30-2.5R

Facility

$683.60

Hospital Charge Code	270651833
Hospital Revenue Code	272
Min. Negotiated Rate	$102.54
Max. Negotiated Rate	$102.54
Rate for Payer: Qualcare PPO/HMO/WC	$102.54

LOAD UNIT ENDO GIA 30MMVAS/MED

Facility

$1,512.03

Hospital Charge Code	270655977
Hospital Revenue Code	272
Min. Negotiated Rate	$226.80
Max. Negotiated Rate	$226.80
Rate for Payer: Qualcare PPO/HMO/WC	$226.80

LOAD UNIT ENDO GIA 30MMVAS/MED

Facility

$1,512.03

Hospital Charge Code	270655977
Hospital Revenue Code	272
Min. Negotiated Rate	$196.56
Max. Negotiated Rate	$756.01
Rate for Payer: Aetna Commercial	$453.61
Rate for Payer: Aetna Medicare Advantage	$453.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$385.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$385.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$385.57
Rate for Payer: Cigna Commercial	$756.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.56
Rate for Payer: Oxford Commercial	$756.01
Rate for Payer: Qualcare PPO/HMO/WC	$226.80
Rate for Payer: UnitedHealthcare Commercial	$756.01

LOAD UNIT ENDO GIA 45 2.5R

Facility

$781.22

Hospital Charge Code	270619587
Hospital Revenue Code	272
Min. Negotiated Rate	$101.56
Max. Negotiated Rate	$390.61
Rate for Payer: Aetna Commercial	$234.37
Rate for Payer: Aetna Medicare Advantage	$234.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.21
Rate for Payer: Cigna Commercial	$390.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.56
Rate for Payer: Oxford Commercial	$390.61
Rate for Payer: Qualcare PPO/HMO/WC	$117.18
Rate for Payer: UnitedHealthcare Commercial	$390.61

LOAD UNIT ENDO GIA 45 2.5R

Facility

$781.22

Hospital Charge Code	270619587
Hospital Revenue Code	272
Min. Negotiated Rate	$117.18
Max. Negotiated Rate	$117.18
Rate for Payer: Qualcare PPO/HMO/WC	$117.18

LOAD UNIT ENDO GIA 45 3.5R

Facility

$781.22

Hospital Charge Code	270619588
Hospital Revenue Code	272
Min. Negotiated Rate	$101.56
Max. Negotiated Rate	$390.61
Rate for Payer: Aetna Commercial	$234.37
Rate for Payer: Aetna Medicare Advantage	$234.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.21
Rate for Payer: Cigna Commercial	$390.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.56
Rate for Payer: Oxford Commercial	$390.61
Rate for Payer: Qualcare PPO/HMO/WC	$117.18
Rate for Payer: UnitedHealthcare Commercial	$390.61

LOAD UNIT ENDO GIA 45 3.5R

Facility

$781.22

Hospital Charge Code	270619588
Hospital Revenue Code	272
Min. Negotiated Rate	$117.18
Max. Negotiated Rate	$117.18
Rate for Payer: Qualcare PPO/HMO/WC	$117.18

LOAD UNIT ENDO GIA 45 4.8R

Facility

$820.33

Hospital Charge Code	270640220
Hospital Revenue Code	272
Min. Negotiated Rate	$123.05
Max. Negotiated Rate	$123.05
Rate for Payer: Qualcare PPO/HMO/WC	$123.05

LOAD UNIT ENDO GIA 45 4.8R

Facility

$820.33

Hospital Charge Code	270640220
Hospital Revenue Code	272
Min. Negotiated Rate	$106.64
Max. Negotiated Rate	$410.17
Rate for Payer: Aetna Commercial	$246.10
Rate for Payer: Aetna Medicare Advantage	$246.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.18
Rate for Payer: Cigna Commercial	$410.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.64
Rate for Payer: Oxford Commercial	$410.17
Rate for Payer: Qualcare PPO/HMO/WC	$123.05
Rate for Payer: UnitedHealthcare Commercial	$410.17

LOAD UNIT ENDO GIA 60-3.5R

Facility

$1,777.35

Hospital Charge Code	270660575
Hospital Revenue Code	272
Min. Negotiated Rate	$266.60
Max. Negotiated Rate	$266.60
Rate for Payer: Qualcare PPO/HMO/WC	$266.60

LOAD UNIT ENDO GIA 60-3.5R

Facility

$1,777.35

Hospital Charge Code	270660575
Hospital Revenue Code	272
Min. Negotiated Rate	$231.06
Max. Negotiated Rate	$888.67
Rate for Payer: Aetna Commercial	$533.21
Rate for Payer: Aetna Medicare Advantage	$533.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.22
Rate for Payer: Cigna Commercial	$888.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.06
Rate for Payer: Oxford Commercial	$888.67
Rate for Payer: Qualcare PPO/HMO/WC	$266.60
Rate for Payer: UnitedHealthcare Commercial	$888.67

LOAD UNIT ENDO GIA II 30-3.5

Facility

$439.47

Hospital Charge Code	270621874
Hospital Revenue Code	272
Min. Negotiated Rate	$57.13
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$131.84
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$219.74
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$219.74

LOAD UNIT ENDO GIA II 30-3.5

Facility

$439.47

Hospital Charge Code	270621874
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

LOAD UNIT ENDO GIA II 45-3.5

Facility

$439.47

Hospital Charge Code	270608866
Hospital Revenue Code	272
Min. Negotiated Rate	$65.92
Max. Negotiated Rate	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$65.92

LOAD UNIT ENDO GIA II 45-3.5

Facility

$439.47

Hospital Charge Code	270608866
Hospital Revenue Code	272
Min. Negotiated Rate	$57.13
Max. Negotiated Rate	$219.74
Rate for Payer: Aetna Commercial	$131.84
Rate for Payer: Aetna Medicare Advantage	$131.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.06
Rate for Payer: Cigna Commercial	$219.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$219.74
Rate for Payer: Qualcare PPO/HMO/WC	$65.92
Rate for Payer: UnitedHealthcare Commercial	$219.74

LOAD UNIT ENDOWRIST 30MM BLUE

Facility

$854.15

Hospital Charge Code	270677822
Hospital Revenue Code	272
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Qualcare PPO/HMO/WC	$128.12

LOAD UNIT ENDOWRIST 30MM BLUE

Facility

$854.15

Hospital Charge Code	270677822
Hospital Revenue Code	272
Min. Negotiated Rate	$111.04
Max. Negotiated Rate	$427.07
Rate for Payer: Aetna Commercial	$256.25
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.04
Rate for Payer: Oxford Commercial	$427.07
Rate for Payer: Qualcare PPO/HMO/WC	$128.12
Rate for Payer: UnitedHealthcare Commercial	$427.07

LOAD UNIT ENDOWRIST 30MM GRAY

Facility

$10,250.00

Hospital Charge Code	270677911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,332.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,332.50
Rate for Payer: Oxford Commercial	$5,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50
Rate for Payer: UnitedHealthcare Commercial	$5,125.00

LOAD UNIT ENDOWRIST 30MM GRAY

Facility

$10,250.00

Hospital Charge Code	270677911
Hospital Revenue Code	272
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$1,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

LOAD UNIT ENDOWRIST 30MM GREEN

Facility

$854.17

Hospital Charge Code	270677824
Hospital Revenue Code	272
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$128.13

LOAD UNIT ENDOWRIST 30MM GREEN

Facility

$854.17

Hospital Charge Code	270677824
Hospital Revenue Code	272
Min. Negotiated Rate	$111.04
Max. Negotiated Rate	$427.08
Rate for Payer: Aetna Commercial	$256.25
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.04
Rate for Payer: Oxford Commercial	$427.08
Rate for Payer: Qualcare PPO/HMO/WC	$128.13
Rate for Payer: UnitedHealthcare Commercial	$427.08

LOAD UNIT ENDOWRIST 30MM WHITE

Facility

$854.17

Hospital Charge Code	270677823
Hospital Revenue Code	272
Min. Negotiated Rate	$111.04
Max. Negotiated Rate	$427.08
Rate for Payer: Aetna Commercial	$256.25
Rate for Payer: Aetna Medicare Advantage	$256.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.81
Rate for Payer: Cigna Commercial	$427.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.04
Rate for Payer: Oxford Commercial	$427.08
Rate for Payer: Qualcare PPO/HMO/WC	$128.13
Rate for Payer: UnitedHealthcare Commercial	$427.08

LOAD UNIT ENDOWRIST 30MM WHITE

Facility

$854.17

Hospital Charge Code	270677823
Hospital Revenue Code	272
Min. Negotiated Rate	$128.13
Max. Negotiated Rate	$128.13
Rate for Payer: Qualcare PPO/HMO/WC	$128.13

Know your out-of-pocket cost for care.

All Charges