Heights University Hospital

All Charges

Charge

Type

Setting

Price

Micro Filter (cell Saver )

Facility

$82.50

Hospital Charge Code	270661411
Hospital Revenue Code	272
Min. Negotiated Rate	$12.38
Max. Negotiated Rate	$12.38
Rate for Payer: Qualcare PPO/HMO/WC	$12.38

Micro Filter (cell Saver )

Facility

$82.50

Hospital Charge Code	270661411
Hospital Revenue Code	272
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$41.25
Rate for Payer: Aetna Commercial	$24.75
Rate for Payer: Aetna Medicare Advantage	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.04
Rate for Payer: Cigna Commercial	$41.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.72
Rate for Payer: Oxford Commercial	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$12.38
Rate for Payer: UnitedHealthcare Commercial	$41.25

MICRO HOOK MIS SHAVER SH SET

Facility

$3,775.90

Hospital Charge Code	270695989
Hospital Revenue Code	272
Min. Negotiated Rate	$490.87
Max. Negotiated Rate	$1,887.95
Rate for Payer: Aetna Commercial	$1,132.77
Rate for Payer: Aetna Medicare Advantage	$1,132.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$962.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$962.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$962.85
Rate for Payer: Cigna Commercial	$1,887.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.87
Rate for Payer: Oxford Commercial	$1,887.95
Rate for Payer: Qualcare PPO/HMO/WC	$566.38
Rate for Payer: UnitedHealthcare Commercial	$1,887.95

MICRO HOOK MIS SHAVER SH SET

Facility

$3,775.90

Hospital Charge Code	270695989
Hospital Revenue Code	272
Min. Negotiated Rate	$566.38
Max. Negotiated Rate	$566.38
Rate for Payer: Qualcare PPO/HMO/WC	$566.38

MICRO-K 10 EXTENCAPS/10ME

Facility

$4.00

Hospital Charge Code	60633424
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

MICRO-K 10 EXTENCAPS/10ME

Facility

$4.00

Hospital Charge Code	60633424
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MICRO-K/8MEQ/CAP

Facility

$4.00

Hospital Charge Code	60633423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

MICRO-K/8MEQ/CAP

Facility

$4.00

Hospital Charge Code	60633423
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MICROKNIFE MCV 3 LMN 7/5F 3281

Facility

$959.25

Hospital Charge Code	270615489
Hospital Revenue Code	272
Min. Negotiated Rate	$143.89
Max. Negotiated Rate	$143.89
Rate for Payer: Qualcare PPO/HMO/WC	$143.89

MICROKNIFE MCV 3 LMN 7/5F 3281

Facility

$959.25

Hospital Charge Code	270615489
Hospital Revenue Code	272
Min. Negotiated Rate	$124.70
Max. Negotiated Rate	$479.62
Rate for Payer: Aetna Commercial	$287.77
Rate for Payer: Aetna Medicare Advantage	$287.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.61
Rate for Payer: Cigna Commercial	$479.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.70
Rate for Payer: Oxford Commercial	$479.62
Rate for Payer: Qualcare PPO/HMO/WC	$143.89
Rate for Payer: UnitedHealthcare Commercial	$479.62

MICRO KOVER ZEISS MD 20X56

Facility

$263.00

Hospital Charge Code	270652779
Hospital Revenue Code	270
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$131.50
Rate for Payer: Aetna Commercial	$78.90
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.19
Rate for Payer: Oxford Commercial	$131.50
Rate for Payer: Qualcare PPO/HMO/WC	$39.45
Rate for Payer: UnitedHealthcare Commercial	$131.50

MICRO KOVER ZEISS MD 20X56

Facility

$263.00

Hospital Charge Code	270652779
Hospital Revenue Code	270
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

MICROMATRIX 60MG

Facility

$3,793.50

Service Code	HCPCS Q4118
Hospital Charge Code	270662132
Hospital Revenue Code	278
Min. Negotiated Rate	$569.02
Max. Negotiated Rate	$918.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.03
Rate for Payer: Qualcare PPO/HMO/WC	$569.02

MICROMATRIX 60MG

Facility

$3,793.50

Service Code	HCPCS Q4118
Hospital Charge Code	270662132
Hospital Revenue Code	278
Min. Negotiated Rate	$569.02
Max. Negotiated Rate	$1,896.75
Rate for Payer: Aetna Commercial	$1,138.05
Rate for Payer: Aetna Medicare Advantage	$1,138.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$967.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$967.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$758.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$967.34
Rate for Payer: Cigna Commercial	$1,896.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$918.03
Rate for Payer: Qualcare PPO/HMO/WC	$569.02

MICROMATRIX 60MG/1MG JW

Facility

$63.23

Hospital Charge Code	270662132W
Hospital Revenue Code	636
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$15.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

MICROMATRIX 60MG/1MG JW

Facility

$63.23

Hospital Charge Code	270662132W
Hospital Revenue Code	636
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$31.61
Rate for Payer: Aetna Commercial	$18.97
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.12
Rate for Payer: Cigna Commercial	$31.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.48

MICROMATRIX MATRISTEM (GRAFT)

Facility

$7,375.00

Service Code	HCPCS Q4118
Hospital Charge Code	270662059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$1,784.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

MICROMATRIX MATRISTEM (GRAFT)

Facility

$7,375.00

Service Code	HCPCS Q4118
Hospital Charge Code	270662059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,106.25
Max. Negotiated Rate	$3,687.50
Rate for Payer: Aetna Commercial	$2,212.50
Rate for Payer: Aetna Medicare Advantage	$2,212.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,880.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,880.62
Rate for Payer: Cigna Commercial	$3,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,784.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,106.25

MICRONASE/1.25MG/TAB

Facility

$4.00

Service Code	NDC 23155005601
Hospital Charge Code	60634880
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MICRONASE/1.25MG/TAB

Facility

$4.00

Service Code	NDC 23155005601
Hospital Charge Code	60634880
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

MICRONASE/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60633429
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MICRONASE/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60633425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MICRONASE/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60633425
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

MICRONASE/2.5MG/TAB

Facility

$3.00

Hospital Charge Code	60633429
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

MICRONASE/5MG/TAB

Facility

$4.00

Hospital Charge Code	60633426
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

Know your out-of-pocket cost for care.

All Charges