Heights University Hospital

All Charges

Charge

Type

Setting

Price

MAXFORCE PLATE PETITE RIGHT

Facility

$10,274.25

Service Code	HCPCS C1713
Hospital Charge Code	270693500
Hospital Revenue Code	278
Min. Negotiated Rate	$1,541.14
Max. Negotiated Rate	$5,137.12
Rate for Payer: Aetna Commercial	$3,082.28
Rate for Payer: Aetna Medicare Advantage	$3,082.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,619.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,619.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,054.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,619.93
Rate for Payer: Cigna Commercial	$5,137.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,486.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,541.14

MAXFRAME FULL RING 180MM ALUM

Facility

$6,930.00

Hospital Charge Code	270681262
Hospital Revenue Code	272
Min. Negotiated Rate	$900.90
Max. Negotiated Rate	$3,465.00
Rate for Payer: Aetna Commercial	$2,079.00
Rate for Payer: Aetna Medicare Advantage	$2,079.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,767.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,767.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,767.15
Rate for Payer: Cigna Commercial	$3,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.90
Rate for Payer: Oxford Commercial	$3,465.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.50
Rate for Payer: UnitedHealthcare Commercial	$3,465.00

MAXFRAME FULL RING 180MM ALUM

Facility

$6,930.00

Hospital Charge Code	270681262
Hospital Revenue Code	272
Min. Negotiated Rate	$1,039.50
Max. Negotiated Rate	$1,039.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.50

MAXFRAME SHOULDR BOLT 8MM RNG

Facility

$450.00

Hospital Charge Code	270681316
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

MAXFRAME SHOULDR BOLT 8MM RNG

Facility

$450.00

Hospital Charge Code	270681316
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

MAXFUSE DBM CRUNCH

Facility

$6,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270705464
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

MAXFUSE DBM CRUNCH

Facility

$6,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270705464
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

MAXIDE 75

Facility

$3.00

Hospital Charge Code	60634887
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MAXIDE 75

Facility

$3.00

Hospital Charge Code	60634887
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

MAXIDEX 0.1% OPHTH/5ML

Facility

$75.00

Hospital Charge Code	60633357
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

MAXIDEX 0.1% OPHTH/5ML

Facility

$75.00

Hospital Charge Code	60633357
Hospital Revenue Code	250
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

MAXIFRAME X SHORT

Facility

$6,657.00

Hospital Charge Code	270683977
Hospital Revenue Code	272
Min. Negotiated Rate	$998.55
Max. Negotiated Rate	$998.55
Rate for Payer: Qualcare PPO/HMO/WC	$998.55

MAXIFRAME X SHORT

Facility

$6,657.00

Hospital Charge Code	270683977
Hospital Revenue Code	272
Min. Negotiated Rate	$865.41
Max. Negotiated Rate	$3,328.50
Rate for Payer: Aetna Commercial	$1,997.10
Rate for Payer: Aetna Medicare Advantage	$1,997.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,697.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,697.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,697.54
Rate for Payer: Cigna Commercial	$3,328.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$865.41
Rate for Payer: Oxford Commercial	$3,328.50
Rate for Payer: Qualcare PPO/HMO/WC	$998.55
Rate for Payer: UnitedHealthcare Commercial	$3,328.50

MAXIPIME 1GM

Facility

$67.00

Hospital Charge Code	60635133
Hospital Revenue Code	636
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

MAXIPIME 1GM

Facility

$67.00

Hospital Charge Code	60635133
Hospital Revenue Code	636
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$16.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

MAXIPIME 1GM ADD/D5W

Facility

$101.00

Hospital Charge Code	60635120
Hospital Revenue Code	636
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$24.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

MAXIPIME 1GM ADD/D5W

Facility

$101.00

Hospital Charge Code	60635120
Hospital Revenue Code	636
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$30.30
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.44
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

MAXIPIME 1GM ADD/NS

Facility

$67.00

Hospital Charge Code	60635121
Hospital Revenue Code	636
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$16.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

MAXIPIME 1GM ADD/NS

Facility

$67.00

Hospital Charge Code	60635121
Hospital Revenue Code	636
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$33.50
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

MAX VPC CANN DRILL 3.2MM

Facility

$1,440.00

Hospital Charge Code	270686586
Hospital Revenue Code	272
Min. Negotiated Rate	$187.20
Max. Negotiated Rate	$720.00
Rate for Payer: Aetna Commercial	$432.00
Rate for Payer: Aetna Medicare Advantage	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$367.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$367.20
Rate for Payer: Cigna Commercial	$720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.20
Rate for Payer: Oxford Commercial	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00
Rate for Payer: UnitedHealthcare Commercial	$720.00

MAX VPC CANN DRILL 3.2MM

Facility

$1,440.00

Hospital Charge Code	270686586
Hospital Revenue Code	272
Min. Negotiated Rate	$216.00
Max. Negotiated Rate	$216.00
Rate for Payer: Qualcare PPO/HMO/WC	$216.00

MAXX-CELL ASPIRATION KIT

Facility

$11,250.00

Hospital Charge Code	270697196
Hospital Revenue Code	272
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$5,625.00
Rate for Payer: Aetna Commercial	$3,375.00
Rate for Payer: Aetna Medicare Advantage	$3,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,868.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,868.75
Rate for Payer: Cigna Commercial	$5,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,462.50
Rate for Payer: Oxford Commercial	$5,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50
Rate for Payer: UnitedHealthcare Commercial	$5,625.00

MAXX-CELL ASPIRATION KIT

Facility

$11,250.00

Hospital Charge Code	270697196
Hospital Revenue Code	272
Min. Negotiated Rate	$1,687.50
Max. Negotiated Rate	$1,687.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,687.50

MAXX FUSE DBM 5CC

Facility

$4,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270703945
Hospital Revenue Code	278
Min. Negotiated Rate	$645.00
Max. Negotiated Rate	$2,150.00
Rate for Payer: Aetna Commercial	$1,290.00
Rate for Payer: Aetna Medicare Advantage	$1,290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,096.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,096.50
Rate for Payer: Cigna Commercial	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$645.00

MAXX FUSE DBM 5CC

Facility

$4,300.00

Service Code	HCPCS C1713
Hospital Charge Code	270703945
Hospital Revenue Code	278
Min. Negotiated Rate	$645.00
Max. Negotiated Rate	$1,040.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,040.60
Rate for Payer: Qualcare PPO/HMO/WC	$645.00

Know your out-of-pocket cost for care.

All Charges