Heights University Hospital

All Charges

Charge

Type

Setting

Price

Pacific Plus 5x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683486
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$275.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Pacific Plus 5x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683486N
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Pacific Plus 5x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683486
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Pacific Plus 6x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683488N
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Pacific Plus 6x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683488
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$275.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Pacific Plus 6x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683488
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Pacific Plus 6x80x180

Facility

$1,140.00

Service Code	HCPCS C1725
Hospital Charge Code	270683488N
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$275.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

PACIFIER NUK W/HANDLE

Facility

$7.42

Hospital Charge Code	270652256
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

PACIFIER NUK W/HANDLE

Facility

$7.42

Hospital Charge Code	270652256
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$3.71
Rate for Payer: Aetna Commercial	$2.23
Rate for Payer: Aetna Medicare Advantage	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.89
Rate for Payer: Cigna Commercial	$3.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$3.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$3.71

PACIFIER SOOTHIE

Facility

$13.65

Hospital Charge Code	270600479
Hospital Revenue Code	270
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

PACIFIER SOOTHIE

Facility

$13.65

Hospital Charge Code	270600479
Hospital Revenue Code	270
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

PACING CHANDLER TRNSLM 98100H

Facility

$1,228.85

Hospital Charge Code	270110040
Hospital Revenue Code	270
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$614.42
Rate for Payer: Aetna Commercial	$368.65
Rate for Payer: Aetna Medicare Advantage	$368.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$313.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$313.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$313.36
Rate for Payer: Cigna Commercial	$614.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.75
Rate for Payer: Oxford Commercial	$614.42
Rate for Payer: Qualcare PPO/HMO/WC	$184.33
Rate for Payer: UnitedHealthcare Commercial	$614.42

PACING CHANDLER TRNSLM 98100H

Facility

$1,228.85

Hospital Charge Code	270110040
Hospital Revenue Code	270
Min. Negotiated Rate	$184.33
Max. Negotiated Rate	$184.33
Rate for Payer: Qualcare PPO/HMO/WC	$184.33

PACK 4.0MM CINCH ANCHOR

Facility

$1,342.45

Hospital Charge Code	270605121
Hospital Revenue Code	272
Min. Negotiated Rate	$174.52
Max. Negotiated Rate	$671.23
Rate for Payer: Aetna Commercial	$402.74
Rate for Payer: Aetna Medicare Advantage	$402.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.32
Rate for Payer: Cigna Commercial	$671.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.52
Rate for Payer: Oxford Commercial	$671.23
Rate for Payer: Qualcare PPO/HMO/WC	$201.37
Rate for Payer: UnitedHealthcare Commercial	$671.23

PACK 4.0MM CINCH ANCHOR

Facility

$1,342.45

Hospital Charge Code	270605121
Hospital Revenue Code	272
Min. Negotiated Rate	$201.37
Max. Negotiated Rate	$201.37
Rate for Payer: Qualcare PPO/HMO/WC	$201.37

PACK ALCON PHACO EMULS 10530F

Facility

$1,068.00

Hospital Charge Code	270614706
Hospital Revenue Code	272
Min. Negotiated Rate	$160.20
Max. Negotiated Rate	$160.20
Rate for Payer: Qualcare PPO/HMO/WC	$160.20

PACK ALCON PHACO EMULS 10530F

Facility

$1,068.00

Hospital Charge Code	270614706
Hospital Revenue Code	272
Min. Negotiated Rate	$138.84
Max. Negotiated Rate	$534.00
Rate for Payer: Aetna Commercial	$320.40
Rate for Payer: Aetna Medicare Advantage	$320.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.34
Rate for Payer: Cigna Commercial	$534.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.84
Rate for Payer: Oxford Commercial	$534.00
Rate for Payer: Qualcare PPO/HMO/WC	$160.20
Rate for Payer: UnitedHealthcare Commercial	$534.00

PACK ANTERIOR VITRECTOMY

Facility

$830.00

Hospital Charge Code	270653347
Hospital Revenue Code	270
Min. Negotiated Rate	$107.90
Max. Negotiated Rate	$415.00
Rate for Payer: Aetna Commercial	$249.00
Rate for Payer: Aetna Medicare Advantage	$249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.65
Rate for Payer: Cigna Commercial	$415.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.90
Rate for Payer: Oxford Commercial	$415.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.50
Rate for Payer: UnitedHealthcare Commercial	$415.00

PACK ANTERIOR VITRECTOMY

Facility

$830.00

Hospital Charge Code	270653347
Hospital Revenue Code	270
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$124.50
Rate for Payer: Qualcare PPO/HMO/WC	$124.50

PACK AUTOGRAFT GRAFTLINK CONV

Facility

$3,400.00

Hospital Charge Code	270676748
Hospital Revenue Code	272
Min. Negotiated Rate	$442.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Aetna Commercial	$1,020.00
Rate for Payer: Aetna Medicare Advantage	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$867.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$867.00
Rate for Payer: Cigna Commercial	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.00
Rate for Payer: Oxford Commercial	$1,700.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00
Rate for Payer: UnitedHealthcare Commercial	$1,700.00

PACK AUTOGRAFT GRAFTLINK CONV

Facility

$3,400.00

Hospital Charge Code	270676748
Hospital Revenue Code	272
Min. Negotiated Rate	$510.00
Max. Negotiated Rate	$510.00
Rate for Payer: Qualcare PPO/HMO/WC	$510.00

PACK AUTOLOGUE PLATELET CONCE

Facility

$4,005.00

Hospital Charge Code	270656948
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$969.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

PACK AUTOLOGUE PLATELET CONCE

Facility

$4,005.00

Hospital Charge Code	270656948
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$2,002.50
Rate for Payer: Aetna Commercial	$1,201.50
Rate for Payer: Aetna Medicare Advantage	$1,201.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.27
Rate for Payer: Cigna Commercial	$2,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

PACK A.V. FISTULA

Facility

$390.10

Hospital Charge Code	270653789
Hospital Revenue Code	270
Min. Negotiated Rate	$50.71
Max. Negotiated Rate	$195.05
Rate for Payer: Aetna Commercial	$117.03
Rate for Payer: Aetna Medicare Advantage	$117.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.48
Rate for Payer: Cigna Commercial	$195.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.71
Rate for Payer: Oxford Commercial	$195.05
Rate for Payer: Qualcare PPO/HMO/WC	$58.52
Rate for Payer: UnitedHealthcare Commercial	$195.05

PACK A.V. FISTULA

Facility

$390.10

Hospital Charge Code	270653789
Hospital Revenue Code	270
Min. Negotiated Rate	$58.52
Max. Negotiated Rate	$58.52
Rate for Payer: Qualcare PPO/HMO/WC	$58.52

Know your out-of-pocket cost for care.

All Charges