Heights University Hospital

All Charges

Charge

Type

Setting

Price

PATCH PERCARDIAL 6X10 555-610

Facility

$2,667.25

Hospital Charge Code	270615779
Hospital Revenue Code	272
Min. Negotiated Rate	$346.74
Max. Negotiated Rate	$1,333.62
Rate for Payer: Aetna Commercial	$800.17
Rate for Payer: Aetna Medicare Advantage	$800.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.15
Rate for Payer: Cigna Commercial	$1,333.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$346.74
Rate for Payer: Oxford Commercial	$1,333.62
Rate for Payer: Qualcare PPO/HMO/WC	$400.09
Rate for Payer: UnitedHealthcare Commercial	$1,333.62

PATCH PERCARDIAL 6X10 555-610

Facility

$2,667.25

Hospital Charge Code	270615779
Hospital Revenue Code	272
Min. Negotiated Rate	$400.09
Max. Negotiated Rate	$400.09
Rate for Payer: Qualcare PPO/HMO/WC	$400.09

PATCH PERICARD 12 CIRC 555-12C

Facility

$3,448.00

Hospital Charge Code	270619075
Hospital Revenue Code	272
Min. Negotiated Rate	$517.20
Max. Negotiated Rate	$517.20
Rate for Payer: Qualcare PPO/HMO/WC	$517.20

PATCH PERICARD 12 CIRC 555-12C

Facility

$3,448.00

Hospital Charge Code	270619075
Hospital Revenue Code	272
Min. Negotiated Rate	$448.24
Max. Negotiated Rate	$1,724.00
Rate for Payer: Aetna Commercial	$1,034.40
Rate for Payer: Aetna Medicare Advantage	$1,034.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.24
Rate for Payer: Cigna Commercial	$1,724.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.24
Rate for Payer: Oxford Commercial	$1,724.00
Rate for Payer: Qualcare PPO/HMO/WC	$517.20
Rate for Payer: UnitedHealthcare Commercial	$1,724.00

PATCH PLUG MARLEX BARD

Facility

$1,362.50

Service Code	HCPCS C1781
Hospital Charge Code	270601199
Hospital Revenue Code	278
Min. Negotiated Rate	$204.38
Max. Negotiated Rate	$329.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.73
Rate for Payer: Qualcare PPO/HMO/WC	$204.38

PATCH PLUG MARLEX BARD

Facility

$1,362.50

Service Code	HCPCS C1781
Hospital Charge Code	270601199
Hospital Revenue Code	278
Min. Negotiated Rate	$204.38
Max. Negotiated Rate	$681.25
Rate for Payer: Aetna Commercial	$408.75
Rate for Payer: Aetna Medicare Advantage	$408.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.44
Rate for Payer: Cigna Commercial	$681.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.73
Rate for Payer: Qualcare PPO/HMO/WC	$204.38

PATCH PLUG MARLEX MEDIUM

Facility

$1,213.50

Hospital Charge Code	270621075
Hospital Revenue Code	272
Min. Negotiated Rate	$157.75
Max. Negotiated Rate	$606.75
Rate for Payer: Aetna Commercial	$364.05
Rate for Payer: Aetna Medicare Advantage	$364.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.44
Rate for Payer: Cigna Commercial	$606.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.75
Rate for Payer: Oxford Commercial	$606.75
Rate for Payer: Qualcare PPO/HMO/WC	$182.03
Rate for Payer: UnitedHealthcare Commercial	$606.75

PATCH PLUG MARLEX MEDIUM

Facility

$1,213.50

Hospital Charge Code	270621075
Hospital Revenue Code	272
Min. Negotiated Rate	$182.03
Max. Negotiated Rate	$182.03
Rate for Payer: Qualcare PPO/HMO/WC	$182.03

PATCH TISSUE 10.CM X 15.0CM

Facility

$2,060.00

Hospital Charge Code	270650766
Hospital Revenue Code	272
Min. Negotiated Rate	$309.00
Max. Negotiated Rate	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00

PATCH TISSUE 10.CM X 15.0CM

Facility

$2,060.00

Hospital Charge Code	270650766
Hospital Revenue Code	272
Min. Negotiated Rate	$267.80
Max. Negotiated Rate	$1,030.00
Rate for Payer: Aetna Commercial	$618.00
Rate for Payer: Aetna Medicare Advantage	$618.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$525.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$525.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$525.30
Rate for Payer: Cigna Commercial	$1,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$267.80
Rate for Payer: Oxford Commercial	$1,030.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00
Rate for Payer: UnitedHealthcare Commercial	$1,030.00

PATCH VASC COLLAGN 8x75 CP0875

Facility

$615.10

Hospital Charge Code	270634353
Hospital Revenue Code	272
Min. Negotiated Rate	$79.96
Max. Negotiated Rate	$307.55
Rate for Payer: Aetna Commercial	$184.53
Rate for Payer: Aetna Medicare Advantage	$184.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.85
Rate for Payer: Cigna Commercial	$307.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.96
Rate for Payer: Oxford Commercial	$307.55
Rate for Payer: Qualcare PPO/HMO/WC	$92.27
Rate for Payer: UnitedHealthcare Commercial	$307.55

PATCH VASC COLLAGN 8x75 CP0875

Facility

$615.10

Hospital Charge Code	270634353
Hospital Revenue Code	272
Min. Negotiated Rate	$92.27
Max. Negotiated Rate	$92.27
Rate for Payer: Qualcare PPO/HMO/WC	$92.27

PATCH VASCGARD 0.8 8CM VG0108N

Facility

$915.65

Service Code	HCPCS C1768
Hospital Charge Code	270619788
Hospital Revenue Code	278
Min. Negotiated Rate	$137.35
Max. Negotiated Rate	$457.82
Rate for Payer: Aetna Commercial	$274.69
Rate for Payer: Aetna Medicare Advantage	$274.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$233.49
Rate for Payer: Cigna Commercial	$457.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.59
Rate for Payer: Qualcare PPO/HMO/WC	$137.35

PATCH VASCGARD 0.8 8CM VG0108N

Facility

$915.65

Service Code	HCPCS C1768
Hospital Charge Code	270619788
Hospital Revenue Code	278
Min. Negotiated Rate	$137.35
Max. Negotiated Rate	$221.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.59
Rate for Payer: Qualcare PPO/HMO/WC	$137.35

PATCH VASCU 2X9 NR-555-CRT29

Facility

$971.25

Hospital Charge Code	270615141
Hospital Revenue Code	278
Min. Negotiated Rate	$145.69
Max. Negotiated Rate	$485.62
Rate for Payer: Aetna Commercial	$291.38
Rate for Payer: Aetna Medicare Advantage	$291.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.67
Rate for Payer: Cigna Commercial	$485.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.04
Rate for Payer: Qualcare PPO/HMO/WC	$145.69

PATCH VASCU 2X9 NR-555-CRT29

Facility

$971.25

Hospital Charge Code	270615141
Hospital Revenue Code	278
Min. Negotiated Rate	$145.69
Max. Negotiated Rate	$235.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.04
Rate for Payer: Qualcare PPO/HMO/WC	$145.69

PATCH VASCUGUARD 1x10cm

Facility

$855.00

Hospital Charge Code	270642471
Hospital Revenue Code	272
Min. Negotiated Rate	$128.25
Max. Negotiated Rate	$128.25
Rate for Payer: Qualcare PPO/HMO/WC	$128.25

PATCH VASCUGUARD 1x10cm

Facility

$855.00

Hospital Charge Code	270642471
Hospital Revenue Code	272
Min. Negotiated Rate	$111.15
Max. Negotiated Rate	$427.50
Rate for Payer: Aetna Commercial	$256.50
Rate for Payer: Aetna Medicare Advantage	$256.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.03
Rate for Payer: Cigna Commercial	$427.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.15
Rate for Payer: Oxford Commercial	$427.50
Rate for Payer: Qualcare PPO/HMO/WC	$128.25
Rate for Payer: UnitedHealthcare Commercial	$427.50

PATCH VASCULAR 0.4MM 2x9CM

Facility

$1,255.00

Service Code	HCPCS C1768
Hospital Charge Code	270601201
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$627.50
Rate for Payer: Aetna Commercial	$376.50
Rate for Payer: Aetna Medicare Advantage	$376.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.02
Rate for Payer: Cigna Commercial	$627.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

PATCH VASCULAR 0.4MM 2x9CM

Facility

$1,255.00

Service Code	HCPCS C1768
Hospital Charge Code	270601201
Hospital Revenue Code	278
Min. Negotiated Rate	$188.25
Max. Negotiated Rate	$303.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.25

PATCH VASCULAR 0.6MM 2.5x15CM

Facility

$1,530.00

Service Code	HCPCS C1768
Hospital Charge Code	270650847
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

PATCH VASCULAR 0.6MM 2.5x15CM

Facility

$1,530.00

Service Code	HCPCS C1768
Hospital Charge Code	270650847
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$459.00
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

PATCH VASCULAR 0.6MM 5x7.5CM

Facility

$1,580.00

Service Code	HCPCS C1768
Hospital Charge Code	270655457
Hospital Revenue Code	278
Min. Negotiated Rate	$237.00
Max. Negotiated Rate	$790.00
Rate for Payer: Aetna Commercial	$474.00
Rate for Payer: Aetna Medicare Advantage	$474.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$402.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$402.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$316.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$402.90
Rate for Payer: Cigna Commercial	$790.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$382.36
Rate for Payer: Qualcare PPO/HMO/WC	$237.00

PATCH VASCULAR 0.6MM 5x7.5CM

Facility

$1,580.00

Service Code	HCPCS C1768
Hospital Charge Code	270655457
Hospital Revenue Code	278
Min. Negotiated Rate	$237.00
Max. Negotiated Rate	$382.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$316.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$382.36
Rate for Payer: Qualcare PPO/HMO/WC	$237.00

PATCH VENTRALEX W/STRAP LG

Facility

$3,455.00

Hospital Charge Code	270642380
Hospital Revenue Code	278
Min. Negotiated Rate	$518.25
Max. Negotiated Rate	$1,727.50
Rate for Payer: Aetna Commercial	$1,036.50
Rate for Payer: Aetna Medicare Advantage	$1,036.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$881.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$881.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$691.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$881.02
Rate for Payer: Cigna Commercial	$1,727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$836.11
Rate for Payer: Qualcare PPO/HMO/WC	$518.25

Know your out-of-pocket cost for care.

All Charges