Heights University Hospital

All Charges

Charge

Type

Setting

Price

MAXX FUSE DBM CRUNCH 2.5CC

Facility

$2,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270703875
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

MAXX FUSE DBM CRUNCH 2.5CC

Facility

$2,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270703875
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

MAXX FUSE SURE CHIP CANC 4-10M

Facility

$2,890.00

Service Code	HCPCS C1765
Hospital Charge Code	270705743
Hospital Revenue Code	278
Min. Negotiated Rate	$433.50
Max. Negotiated Rate	$699.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$578.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.38
Rate for Payer: Qualcare PPO/HMO/WC	$433.50

MAXX FUSE SURE CHIP CANC 4-10M

Facility

$2,890.00

Service Code	HCPCS C1765
Hospital Charge Code	270705743
Hospital Revenue Code	278
Min. Negotiated Rate	$433.50
Max. Negotiated Rate	$1,445.00
Rate for Payer: Aetna Commercial	$867.00
Rate for Payer: Aetna Medicare Advantage	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$736.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$736.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$736.95
Rate for Payer: Cigna Commercial	$1,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$699.38
Rate for Payer: Qualcare PPO/HMO/WC	$433.50

MAXZIDE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633359
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

MAXZIDE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633358
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

MAXZIDE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633359
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MAXZIDE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633358
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MAYO CATGUT NEEDLE

Facility

$11.00

Hospital Charge Code	270657334
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

MAYO CATGUT NEEDLE

Facility

$11.00

Hospital Charge Code	270657334
Hospital Revenue Code	270
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

MAZICON .1MG/INJ/10ML

Facility

$272.00

Hospital Charge Code	60634733
Hospital Revenue Code	250
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

MAZICON .1MG/INJ/10ML

Facility

$272.00

Hospital Charge Code	60634733
Hospital Revenue Code	250
Min. Negotiated Rate	$35.36
Max. Negotiated Rate	$136.00
Rate for Payer: Aetna Commercial	$81.60
Rate for Payer: Aetna Medicare Advantage	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.36
Rate for Payer: Oxford Commercial	$136.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$136.00

MB&J HIP POSITIONER CLAMPS

Facility

$3,260.00

Hospital Charge Code	270678486
Hospital Revenue Code	272
Min. Negotiated Rate	$423.80
Max. Negotiated Rate	$1,630.00
Rate for Payer: Aetna Commercial	$978.00
Rate for Payer: Aetna Medicare Advantage	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$831.30
Rate for Payer: Cigna Commercial	$1,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.80
Rate for Payer: Oxford Commercial	$1,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$489.00
Rate for Payer: UnitedHealthcare Commercial	$1,630.00

MB&J HIP POSITIONER CLAMPS

Facility

$3,260.00

Hospital Charge Code	270678486
Hospital Revenue Code	272
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$489.00
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

M CIRCULAR REAMER

Facility

$2,250.00

Hospital Charge Code	270683494
Hospital Revenue Code	272
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$1,125.00

M CIRCULAR REAMER

Facility

$2,250.00

Hospital Charge Code	270683494
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

MCP ARTHROPL W IMPL EACH

Facility

$39,644.20

Service Code	HCPCS 26531
Hospital Charge Code	16000853
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$11,893.26
Rate for Payer: Aetna Medicare Advantage	$11,893.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,109.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,109.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,109.27
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,153.75
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,946.63
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

MCP ARTHROPL W IMPL EACH

Facility

$39,644.20

Service Code	HCPCS 26531
Hospital Charge Code	16000853
Hospital Revenue Code	360
Min. Negotiated Rate	$5,946.63
Max. Negotiated Rate	$5,946.63
Rate for Payer: Qualcare PPO/HMO/WC	$5,946.63

MCROPUNCTRE SET 5FR SS ECHOGEN

Facility

$24.50

Hospital Charge Code	270650009
Hospital Revenue Code	272
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$3.67
Rate for Payer: Qualcare PPO/HMO/WC	$3.67

MCROPUNCTRE SET 5FR SS ECHOGEN

Facility

$24.50

Hospital Charge Code	270650009
Hospital Revenue Code	272
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$12.25
Rate for Payer: Aetna Commercial	$7.35
Rate for Payer: Aetna Medicare Advantage	$7.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.25
Rate for Payer: Cigna Commercial	$12.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.19
Rate for Payer: Oxford Commercial	$12.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.67
Rate for Payer: UnitedHealthcare Commercial	$12.25

MCV TOPNOTCH CORE 510-110****

Facility

$76.00

Hospital Charge Code	1810084
Hospital Revenue Code	272
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

MCV TOPNOTCH CORE 510-110****

Facility

$76.00

Hospital Charge Code	1810084
Hospital Revenue Code	272
Min. Negotiated Rate	$9.88
Max. Negotiated Rate	$38.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.38
Rate for Payer: Cigna Commercial	$38.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.88
Rate for Payer: Oxford Commercial	$38.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$38.00

MCYTOGEN CHROM IN SITU HYBRID

Facility

$204.95

Service Code	HCPCS 88273
Hospital Charge Code	38477180
Hospital Revenue Code	311
Min. Negotiated Rate	$30.74
Max. Negotiated Rate	$30.74
Rate for Payer: Qualcare PPO/HMO/WC	$30.74

MCYTOGEN CHROM IN SITU HYBRID

Facility

$204.95

Service Code	HCPCS 88273
Hospital Charge Code	38477180
Hospital Revenue Code	311
Min. Negotiated Rate	$17.41
Max. Negotiated Rate	$127.54
Rate for Payer: Aetna Commercial	$112.78
Rate for Payer: Aetna Medicare Advantage	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.54
Rate for Payer: Cigna Commercial	$34.81
Rate for Payer: Cigna Medicare Advantage	$17.41
Rate for Payer: Clover Medicare Advantage	$33.07
Rate for Payer: EmblemHealth Commercial	$104.43
Rate for Payer: Humana Medicare Advantage	$35.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.74
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$36.90
Rate for Payer: Wellcare Medicare Advantage	$34.81

M CYTOGEN CHROMO IN SITU HYBRI

Facility

$153.75

Service Code	HCPCS 88272
Hospital Charge Code	38477169
Hospital Revenue Code	311
Min. Negotiated Rate	$19.99
Max. Negotiated Rate	$149.12
Rate for Payer: Aetna Commercial	$131.87
Rate for Payer: Aetna Medicare Advantage	$40.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.12
Rate for Payer: Cigna Commercial	$40.70
Rate for Payer: Cigna Medicare Advantage	$20.35
Rate for Payer: Clover Medicare Advantage	$38.66
Rate for Payer: EmblemHealth Commercial	$122.10
Rate for Payer: Humana Medicare Advantage	$41.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.06
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$43.14
Rate for Payer: Wellcare Medicare Advantage	$40.70

Know your out-of-pocket cost for care.

All Charges