Heights University Hospital

All Charges

Charge

Type

Setting

Price

PACK CUSTOM EYE SEY11EYBYA

Facility

$248.00

Hospital Charge Code	270622793
Hospital Revenue Code	272
Min. Negotiated Rate	$32.24
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$74.40
Rate for Payer: Aetna Medicare Advantage	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.24
Rate for Payer: Cigna Commercial	$124.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.24
Rate for Payer: Oxford Commercial	$124.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.20
Rate for Payer: UnitedHealthcare Commercial	$124.00

PACK CUSTOM KIT LAP SMA11GLBYA

Facility

$285.85

Hospital Charge Code	270632133
Hospital Revenue Code	272
Min. Negotiated Rate	$37.16
Max. Negotiated Rate	$142.93
Rate for Payer: Aetna Commercial	$85.75
Rate for Payer: Aetna Medicare Advantage	$85.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.89
Rate for Payer: Cigna Commercial	$142.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.16
Rate for Payer: Oxford Commercial	$142.93
Rate for Payer: Qualcare PPO/HMO/WC	$42.88
Rate for Payer: UnitedHealthcare Commercial	$142.93

PACK CUSTOM KIT LAP SMA11GLBYA

Facility

$285.85

Hospital Charge Code	270632133
Hospital Revenue Code	272
Min. Negotiated Rate	$42.88
Max. Negotiated Rate	$42.88
Rate for Payer: Qualcare PPO/HMO/WC	$42.88

PACK CUSTOM LAPAROSCOPY LPBYB

Facility

$309.65

Hospital Charge Code	270619914
Hospital Revenue Code	272
Min. Negotiated Rate	$46.45
Max. Negotiated Rate	$46.45
Rate for Payer: Qualcare PPO/HMO/WC	$46.45

PACK CUSTOM LAPAROSCOPY LPBYB

Facility

$309.65

Hospital Charge Code	270619914
Hospital Revenue Code	272
Min. Negotiated Rate	$40.25
Max. Negotiated Rate	$154.82
Rate for Payer: Aetna Commercial	$92.89
Rate for Payer: Aetna Medicare Advantage	$92.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.96
Rate for Payer: Cigna Commercial	$154.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.25
Rate for Payer: Oxford Commercial	$154.82
Rate for Payer: Qualcare PPO/HMO/WC	$46.45
Rate for Payer: UnitedHealthcare Commercial	$154.82

PACK CUSTOM LAP CHOLE

Facility

$259.05

Hospital Charge Code	270642270
Hospital Revenue Code	272
Min. Negotiated Rate	$38.86
Max. Negotiated Rate	$38.86
Rate for Payer: Qualcare PPO/HMO/WC	$38.86

PACK CUSTOM LAP CHOLE

Facility

$259.05

Hospital Charge Code	270642270
Hospital Revenue Code	272
Min. Negotiated Rate	$33.68
Max. Negotiated Rate	$129.53
Rate for Payer: Aetna Commercial	$77.72
Rate for Payer: Aetna Medicare Advantage	$77.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.06
Rate for Payer: Cigna Commercial	$129.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.68
Rate for Payer: Oxford Commercial	$129.53
Rate for Payer: Qualcare PPO/HMO/WC	$38.86
Rate for Payer: UnitedHealthcare Commercial	$129.53

PACK CUSTOM MAJOR

Facility

$720.00

Hospital Charge Code	270619913
Hospital Revenue Code	272
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

PACK CUSTOM MAJOR

Facility

$720.00

Hospital Charge Code	270619913
Hospital Revenue Code	272
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$216.00
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.60
Rate for Payer: Oxford Commercial	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.00
Rate for Payer: UnitedHealthcare Commercial	$360.00

PACK CUSTOM MAJR AVIBMBM005-10

Facility

$242.30

Hospital Charge Code	270642264
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$121.15
Rate for Payer: Aetna Commercial	$72.69
Rate for Payer: Aetna Medicare Advantage	$72.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.79
Rate for Payer: Cigna Commercial	$121.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$121.15
Rate for Payer: Qualcare PPO/HMO/WC	$36.34
Rate for Payer: UnitedHealthcare Commercial	$121.15

PACK CUSTOM MAJR AVIBMBM005-10

Facility

$242.30

Hospital Charge Code	270642264
Hospital Revenue Code	272
Min. Negotiated Rate	$36.34
Max. Negotiated Rate	$36.34
Rate for Payer: Qualcare PPO/HMO/WC	$36.34

PACK CUSTOM MINOR AVIBMBM00408

Facility

$139.75

Hospital Charge Code	270642263
Hospital Revenue Code	272
Min. Negotiated Rate	$18.17
Max. Negotiated Rate	$69.88
Rate for Payer: Qualcare PPO/HMO/WC	$20.96
Rate for Payer: Aetna Commercial	$41.92
Rate for Payer: Aetna Medicare Advantage	$41.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.64
Rate for Payer: Cigna Commercial	$69.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.17
Rate for Payer: Oxford Commercial	$69.88
Rate for Payer: UnitedHealthcare Commercial	$69.88

PACK CUSTOM MINOR AVIBMBM00408

Facility

$139.75

Hospital Charge Code	270642263
Hospital Revenue Code	272
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$20.96
Rate for Payer: Qualcare PPO/HMO/WC	$20.96

PACK CUSTOM MINOR SBA11MIBYA

Facility

$415.00

Hospital Charge Code	270619912
Hospital Revenue Code	272
Min. Negotiated Rate	$53.95
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$124.50
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.95
Rate for Payer: Oxford Commercial	$207.50
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Commercial	$207.50

PACK CUSTOM MINOR SBA11MIBYA

Facility

$415.00

Hospital Charge Code	270619912
Hospital Revenue Code	272
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$62.25
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

PACK CUSTOM NONVASC SBA11ANBYA

Facility

$254.45

Hospital Charge Code	270626894
Hospital Revenue Code	272
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$38.17
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

PACK CUSTOM NONVASC SBA11ANBYA

Facility

$254.45

Hospital Charge Code	270626894
Hospital Revenue Code	272
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$76.33
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.08
Rate for Payer: Oxford Commercial	$127.22
Rate for Payer: Qualcare PPO/HMO/WC	$38.17
Rate for Payer: UnitedHealthcare Commercial	$127.22

PACK CUSTOM TOTAL JOINT

Facility

$898.15

Hospital Charge Code	270653777
Hospital Revenue Code	272
Min. Negotiated Rate	$134.72
Max. Negotiated Rate	$134.72
Rate for Payer: Qualcare PPO/HMO/WC	$134.72

PACK CUSTOM TOTAL JOINT

Facility

$739.25

Hospital Charge Code	270619915
Hospital Revenue Code	272
Min. Negotiated Rate	$110.89
Max. Negotiated Rate	$110.89
Rate for Payer: Qualcare PPO/HMO/WC	$110.89

PACK CUSTOM TOTAL JOINT

Facility

$739.25

Hospital Charge Code	270619915
Hospital Revenue Code	272
Min. Negotiated Rate	$96.10
Max. Negotiated Rate	$369.62
Rate for Payer: Aetna Commercial	$221.78
Rate for Payer: Aetna Medicare Advantage	$221.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.51
Rate for Payer: Cigna Commercial	$369.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.10
Rate for Payer: Oxford Commercial	$369.62
Rate for Payer: Qualcare PPO/HMO/WC	$110.89
Rate for Payer: UnitedHealthcare Commercial	$369.62

PACK CUSTOM TOTAL JOINT

Facility

$898.15

Hospital Charge Code	270653777
Hospital Revenue Code	272
Min. Negotiated Rate	$116.76
Max. Negotiated Rate	$449.07
Rate for Payer: Aetna Commercial	$269.44
Rate for Payer: Aetna Medicare Advantage	$269.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.03
Rate for Payer: Cigna Commercial	$449.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.76
Rate for Payer: Oxford Commercial	$449.07
Rate for Payer: Qualcare PPO/HMO/WC	$134.72
Rate for Payer: UnitedHealthcare Commercial	$449.07

PACK CUSTOM VASC AVIBMBM014-09

Facility

$292.10

Hospital Charge Code	270642271
Hospital Revenue Code	272
Min. Negotiated Rate	$43.81
Max. Negotiated Rate	$43.81
Rate for Payer: Qualcare PPO/HMO/WC	$43.81

PACK CUSTOM VASC AVIBMBM014-09

Facility

$292.10

Hospital Charge Code	270642271
Hospital Revenue Code	272
Min. Negotiated Rate	$37.97
Max. Negotiated Rate	$146.05
Rate for Payer: Aetna Commercial	$87.63
Rate for Payer: Aetna Medicare Advantage	$87.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.49
Rate for Payer: Cigna Commercial	$146.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.97
Rate for Payer: Oxford Commercial	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$43.81
Rate for Payer: UnitedHealthcare Commercial	$146.05

PACK CUSTOM VASCULAR

Facility

$292.10

Hospital Charge Code	270642271C
Hospital Revenue Code	272
Min. Negotiated Rate	$37.97
Max. Negotiated Rate	$146.05
Rate for Payer: Aetna Commercial	$87.63
Rate for Payer: Aetna Medicare Advantage	$87.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.49
Rate for Payer: Cigna Commercial	$146.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.97
Rate for Payer: Oxford Commercial	$146.05
Rate for Payer: Qualcare PPO/HMO/WC	$43.81
Rate for Payer: UnitedHealthcare Commercial	$146.05

PACK CUSTOM VASCULAR

Facility

$292.10

Hospital Charge Code	270642271C
Hospital Revenue Code	272
Min. Negotiated Rate	$43.81
Max. Negotiated Rate	$43.81
Rate for Payer: Qualcare PPO/HMO/WC	$43.81

Know your out-of-pocket cost for care.

All Charges