Heights University Hospital

All Charges

Charge

Type

Setting

Price

OBS THORACENTESIS WO IMAGING

Facility

$1,103.00

Service Code	HCPCS 32554
Hospital Charge Code	910910
Hospital Revenue Code	361
Min. Negotiated Rate	$143.39
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$330.90
Rate for Payer: Aetna Medicare Advantage	$330.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$281.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$281.26
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	$281.26
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$143.39
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.45
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

OBS THORACENTESIS WO IMAGING

Facility

$1,103.00

Service Code	HCPCS 32554
Hospital Charge Code	910910
Hospital Revenue Code	361
Min. Negotiated Rate	$165.45
Max. Negotiated Rate	$165.45
Rate for Payer: Qualcare PPO/HMO/WC	$165.45

OBS VENIPUNCTURE

Facility

$64.00

Service Code	HCPCS 36415
Hospital Charge Code	910920
Hospital Revenue Code	300
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

OBS VENIPUNCTURE

Facility

$64.00

Service Code	HCPCS 36415
Hospital Charge Code	910920
Hospital Revenue Code	300
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.26
Rate for Payer: Aetna Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: Cigna Medicare Advantage	$4.67
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.90
Rate for Payer: Wellcare Medicare Advantage	$9.34

OBTAPE 93-4000

Facility

$4,960.00

Hospital Charge Code	270631182
Hospital Revenue Code	272
Min. Negotiated Rate	$744.00
Max. Negotiated Rate	$744.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00

OBTAPE 93-4000

Facility

$4,960.00

Hospital Charge Code	270631182
Hospital Revenue Code	272
Min. Negotiated Rate	$644.80
Max. Negotiated Rate	$2,480.00
Rate for Payer: Aetna Commercial	$1,488.00
Rate for Payer: Aetna Medicare Advantage	$1,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,264.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,264.80
Rate for Payer: Cigna Commercial	$2,480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$644.80
Rate for Payer: Oxford Commercial	$2,480.00
Rate for Payer: Qualcare PPO/HMO/WC	$744.00
Rate for Payer: UnitedHealthcare Commercial	$2,480.00

OB TRANSAB AMNIOINFUSION,US IN

Facility

$669.00

Service Code	HCPCS 59070
Hospital Charge Code	73190023
Hospital Revenue Code	361
Min. Negotiated Rate	$86.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
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	$170.59
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

OB TRANSAB AMNIOINFUSION,US IN

Facility

$669.00

Service Code	HCPCS 59070
Hospital Charge Code	73190023
Hospital Revenue Code	361
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

OBTURATOR 8MM BLDELESS LONG

Facility

$3,000.00

Hospital Charge Code	270664218
Hospital Revenue Code	270
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

OBTURATOR 8MM BLDELESS LONG

Facility

$3,000.00

Hospital Charge Code	270664218
Hospital Revenue Code	270
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00

OBTURATOR BLADELESS 8MM

Facility

$125.00

Hospital Charge Code	270663999
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

OBTURATOR BLADELESS 8MM

Facility

$125.00

Hospital Charge Code	270663999
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

OBTURATOR PENCIL 4.0MM SHARP

Facility

$814.30

Hospital Charge Code	270688983
Hospital Revenue Code	272
Min. Negotiated Rate	$122.14
Max. Negotiated Rate	$122.14
Rate for Payer: Qualcare PPO/HMO/WC	$122.14

OBTURATOR PENCIL 4.0MM SHARP

Facility

$814.30

Hospital Charge Code	270688983
Hospital Revenue Code	272
Min. Negotiated Rate	$105.86
Max. Negotiated Rate	$407.15
Rate for Payer: Aetna Commercial	$244.29
Rate for Payer: Aetna Medicare Advantage	$244.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.65
Rate for Payer: Cigna Commercial	$407.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.86
Rate for Payer: Oxford Commercial	$407.15
Rate for Payer: Qualcare PPO/HMO/WC	$122.14
Rate for Payer: UnitedHealthcare Commercial	$407.15

OBTURATOR PENCIL PKG

Facility

$587.10

Hospital Charge Code	270688258
Hospital Revenue Code	272
Min. Negotiated Rate	$88.06
Max. Negotiated Rate	$88.06
Rate for Payer: Qualcare PPO/HMO/WC	$88.06

OBTURATOR PENCIL PKG

Facility

$587.10

Hospital Charge Code	270688258
Hospital Revenue Code	272
Min. Negotiated Rate	$76.32
Max. Negotiated Rate	$293.55
Rate for Payer: Aetna Commercial	$176.13
Rate for Payer: Aetna Medicare Advantage	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.71
Rate for Payer: Cigna Commercial	$293.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.32
Rate for Payer: Oxford Commercial	$293.55
Rate for Payer: Qualcare PPO/HMO/WC	$88.06
Rate for Payer: UnitedHealthcare Commercial	$293.55

OBTURATOR VERSAPRT RT 5 179769

Facility

$159.45

Hospital Charge Code	270635090
Hospital Revenue Code	272
Min. Negotiated Rate	$20.73
Max. Negotiated Rate	$79.72
Rate for Payer: Aetna Commercial	$47.84
Rate for Payer: Aetna Medicare Advantage	$47.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.66
Rate for Payer: Cigna Commercial	$79.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: Oxford Commercial	$79.72
Rate for Payer: Qualcare PPO/HMO/WC	$23.92
Rate for Payer: UnitedHealthcare Commercial	$79.72

OBTURATOR VERSAPRT RT 5 179769

Facility

$159.45

Hospital Charge Code	270635090
Hospital Revenue Code	272
Min. Negotiated Rate	$23.92
Max. Negotiated Rate	$23.92
Rate for Payer: Qualcare PPO/HMO/WC	$23.92

OBTURATOR XI 8MM BLADELESS XLN

Facility

$150.00

Service Code	HCPCS C1776
Hospital Charge Code	270678879
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

OBTURATOR XI 8MM BLADELESS XLN

Facility

$150.00

Service Code	HCPCS C1776
Hospital Charge Code	270678879
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

OBURATOR BLUNT 12 MM STAPLER

Facility

$3,900.00

Hospital Charge Code	270691092
Hospital Revenue Code	272
Min. Negotiated Rate	$507.00
Max. Negotiated Rate	$1,950.00
Rate for Payer: Aetna Commercial	$1,170.00
Rate for Payer: Aetna Medicare Advantage	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$994.50
Rate for Payer: Cigna Commercial	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$507.00
Rate for Payer: Oxford Commercial	$1,950.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00
Rate for Payer: UnitedHealthcare Commercial	$1,950.00

OBURATOR BLUNT 12 MM STAPLER

Facility

$3,900.00

Hospital Charge Code	270691092
Hospital Revenue Code	272
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$585.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.00

OB-US<14 WEEKS, ADDL FETUS

Facility

$1,117.00

Service Code	HCPCS 76802
Hospital Charge Code	83653035
Hospital Revenue Code	402
Min. Negotiated Rate	$67.38
Max. Negotiated Rate	$1,981.00
Rate for Payer: Aetna Commercial	$335.10
Rate for Payer: Aetna Medicare Advantage	$335.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.83
Rate for Payer: Cigna Commercial	$67.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.21
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.55
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

OB-US<14 WEEKS, ADDL FETUS

Facility

$1,117.00

Service Code	HCPCS 76802
Hospital Charge Code	83653035
Hospital Revenue Code	402
Min. Negotiated Rate	$167.55
Max. Negotiated Rate	$167.55
Rate for Payer: Qualcare PPO/HMO/WC	$167.55

OB-US>14 WEEKS, ADDL FETUS

Facility

$1,408.00

Service Code	HCPCS 76810
Hospital Charge Code	83653045
Hospital Revenue Code	402
Min. Negotiated Rate	$211.20
Max. Negotiated Rate	$211.20
Rate for Payer: Qualcare PPO/HMO/WC	$211.20

Know your out-of-pocket cost for care.

All Charges