Heights University Hospital

All Charges

Charge

Type

Setting

Price

AUTOTOME 39

Facility

$1,069.80

Hospital Charge Code	270676503
Hospital Revenue Code	272
Min. Negotiated Rate	$139.07
Max. Negotiated Rate	$534.90
Rate for Payer: Aetna Commercial	$320.94
Rate for Payer: Aetna Medicare Advantage	$320.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.80
Rate for Payer: Cigna Commercial	$534.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.07
Rate for Payer: Oxford Commercial	$534.90
Rate for Payer: Qualcare PPO/HMO/WC	$160.47
Rate for Payer: UnitedHealthcare Commercial	$534.90

AUTOTOME RX 39

Facility

$1,072.45

Hospital Charge Code	270683532
Hospital Revenue Code	272
Min. Negotiated Rate	$160.87
Max. Negotiated Rate	$160.87
Rate for Payer: Qualcare PPO/HMO/WC	$160.87

AUTOTOME RX 39

Facility

$1,072.45

Hospital Charge Code	270683532
Hospital Revenue Code	272
Min. Negotiated Rate	$139.42
Max. Negotiated Rate	$536.23
Rate for Payer: Aetna Commercial	$321.74
Rate for Payer: Aetna Medicare Advantage	$321.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.47
Rate for Payer: Cigna Commercial	$536.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.42
Rate for Payer: Oxford Commercial	$536.23
Rate for Payer: Qualcare PPO/HMO/WC	$160.87
Rate for Payer: UnitedHealthcare Commercial	$536.23

AUTOTRANSFUSION INF.PUMP

Facility

$174.00

Hospital Charge Code	270339073
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

AUTOTRANSFUSION INF.PUMP

Facility

$174.00

Hospital Charge Code	270339073
Hospital Revenue Code	272
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$52.20
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.62
Rate for Payer: Oxford Commercial	$87.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$87.00

Auto Transfusion Procedure ( C

Facility

$2,640.00

Hospital Charge Code	270654319
Hospital Revenue Code	272
Min. Negotiated Rate	$343.20
Max. Negotiated Rate	$1,320.00
Rate for Payer: Aetna Commercial	$792.00
Rate for Payer: Aetna Medicare Advantage	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$673.20
Rate for Payer: Cigna Commercial	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.20
Rate for Payer: Oxford Commercial	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00
Rate for Payer: UnitedHealthcare Commercial	$1,320.00

Auto Transfusion Procedure ( C

Facility

$2,640.00

Hospital Charge Code	270654319
Hospital Revenue Code	272
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$396.00
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

AUTOTRANSFUSION SYSTEM ZIMMER

Facility

$186.00

Hospital Charge Code	1606375
Hospital Revenue Code	279
Min. Negotiated Rate	$24.18
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$55.80
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$93.00

AUTOTRANSFUSION SYSTEM ZIMMER

Facility

$186.00

Hospital Charge Code	1606375
Hospital Revenue Code	279
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

AUTOTRANSFUSION TUBING KIT

Facility

$3,875.00

Hospital Charge Code	270697350
Hospital Revenue Code	272
Min. Negotiated Rate	$503.75
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$503.75
Rate for Payer: Oxford Commercial	$1,937.50
Rate for Payer: Qualcare PPO/HMO/WC	$581.25
Rate for Payer: UnitedHealthcare Commercial	$1,937.50

AUTOTRANSFUSION TUBING KIT

Facility

$3,875.00

Hospital Charge Code	270697350
Hospital Revenue Code	272
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$581.25
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

AUTO TRANS PROCEDURE SCHEDULED

Facility

$3,222.45

Hospital Charge Code	270605796
Hospital Revenue Code	272
Min. Negotiated Rate	$418.92
Max. Negotiated Rate	$1,611.22
Rate for Payer: Aetna Commercial	$966.74
Rate for Payer: Aetna Medicare Advantage	$966.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$821.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$821.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$821.72
Rate for Payer: Cigna Commercial	$1,611.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.92
Rate for Payer: Oxford Commercial	$1,611.22
Rate for Payer: Qualcare PPO/HMO/WC	$483.37
Rate for Payer: UnitedHealthcare Commercial	$1,611.22

AUTO TRANS PROCEDURE SCHEDULED

Facility

$3,222.45

Hospital Charge Code	270605796
Hospital Revenue Code	272
Min. Negotiated Rate	$483.37
Max. Negotiated Rate	$483.37
Rate for Payer: Qualcare PPO/HMO/WC	$483.37

AVALON ELITE 19FR

Facility

$13,969.00

Hospital Charge Code	2703110M
Hospital Revenue Code	272
Min. Negotiated Rate	$1,815.97
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$4,190.70
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.97
Rate for Payer: Oxford Commercial	$6,984.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$6,984.50

AVALON ELITE 19FR

Facility

$13,969.00

Hospital Charge Code	2703110M
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE 23FR

Facility

$13,969.00

Hospital Charge Code	2703110N
Hospital Revenue Code	272
Min. Negotiated Rate	$1,815.97
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$4,190.70
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.97
Rate for Payer: Oxford Commercial	$6,984.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$6,984.50

AVALON ELITE 23FR

Facility

$13,969.00

Hospital Charge Code	2703110N
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE 27FR

Facility

$13,969.00

Hospital Charge Code	2703110O
Hospital Revenue Code	272
Min. Negotiated Rate	$1,815.97
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$4,190.70
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.97
Rate for Payer: Oxford Commercial	$6,984.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$6,984.50

AVALON ELITE 27FR

Facility

$13,969.00

Hospital Charge Code	2703110O
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE 31FR

Facility

$13,969.00

Hospital Charge Code	2703110P
Hospital Revenue Code	272
Min. Negotiated Rate	$1,815.97
Max. Negotiated Rate	$6,984.50
Rate for Payer: Aetna Commercial	$4,190.70
Rate for Payer: Aetna Medicare Advantage	$4,190.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,562.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,562.09
Rate for Payer: Cigna Commercial	$6,984.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,815.97
Rate for Payer: Oxford Commercial	$6,984.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35
Rate for Payer: UnitedHealthcare Commercial	$6,984.50

AVALON ELITE 31FR

Facility

$13,969.00

Hospital Charge Code	2703110P
Hospital Revenue Code	272
Min. Negotiated Rate	$2,095.35
Max. Negotiated Rate	$2,095.35
Rate for Payer: Qualcare PPO/HMO/WC	$2,095.35

AVALON ELITE VAS ACC KIT 100CM

Facility

$1,114.80

Hospital Charge Code	2703110Q
Hospital Revenue Code	272
Min. Negotiated Rate	$167.22
Max. Negotiated Rate	$167.22
Rate for Payer: Qualcare PPO/HMO/WC	$167.22

AVALON ELITE VAS ACC KIT 100CM

Facility

$1,114.80

Hospital Charge Code	2703110Q
Hospital Revenue Code	272
Min. Negotiated Rate	$144.92
Max. Negotiated Rate	$557.40
Rate for Payer: Aetna Commercial	$334.44
Rate for Payer: Aetna Medicare Advantage	$334.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.27
Rate for Payer: Cigna Commercial	$557.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.92
Rate for Payer: Oxford Commercial	$557.40
Rate for Payer: Qualcare PPO/HMO/WC	$167.22
Rate for Payer: UnitedHealthcare Commercial	$557.40

AVALON ELITE VAS ACC KIT 210CM

Facility

$4,613.75

Hospital Charge Code	2703110R
Hospital Revenue Code	272
Min. Negotiated Rate	$599.79
Max. Negotiated Rate	$2,306.88
Rate for Payer: Aetna Commercial	$1,384.12
Rate for Payer: Aetna Medicare Advantage	$1,384.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,176.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,176.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,176.51
Rate for Payer: Cigna Commercial	$2,306.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$599.79
Rate for Payer: Oxford Commercial	$2,306.88
Rate for Payer: Qualcare PPO/HMO/WC	$692.06
Rate for Payer: UnitedHealthcare Commercial	$2,306.88

AVALON ELITE VAS ACC KIT 210CM

Facility

$4,613.75

Hospital Charge Code	2703110R
Hospital Revenue Code	272
Min. Negotiated Rate	$692.06
Max. Negotiated Rate	$692.06
Rate for Payer: Qualcare PPO/HMO/WC	$692.06

Know your out-of-pocket cost for care.

All Charges