Heights University Hospital

All Charges

Charge

Type

Setting

Price

PINNACLE 8FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683727S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

PINNACLE 8FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683727N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

PINNACLE 9FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683728S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

PINNACLE 9FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683728S
Hospital Revenue Code	272
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.36
Rate for Payer: Oxford Commercial	$28.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Commercial	$28.32

PINNACLE 9FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683728N
Hospital Revenue Code	272
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.50

PINNACLE 9FR 10CM SHEATH

Facility

$56.65

Hospital Charge Code	270683728N
Hospital Revenue Code	272
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$28.32
Rate for Payer: Aetna Commercial	$17.00
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.45
Rate for Payer: Cigna Commercial	$28.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.36
Rate for Payer: Oxford Commercial	$28.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.50
Rate for Payer: UnitedHealthcare Commercial	$28.32

PINNACLE ALREX POLYETHYLENE AC

Facility

$4,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688887
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PINNACLE ALREX POLYETHYLENE AC

Facility

$4,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688887
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

PINNACLE GRIPTION ACETABULAR

Facility

$6,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688886
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

PINNACLE GRIPTION ACETABULAR

Facility

$6,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688886
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

PINNACLE SHEATH PS/5/10

Facility

$187.00

Hospital Charge Code	270330578
Hospital Revenue Code	278
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$93.50
Rate for Payer: Aetna Commercial	$56.10
Rate for Payer: Aetna Medicare Advantage	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.69
Rate for Payer: Cigna Commercial	$93.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.25
Rate for Payer: Qualcare PPO/HMO/WC	$28.05

PINNACLE SHEATH PS/5/10

Facility

$187.00

Hospital Charge Code	270330578
Hospital Revenue Code	278
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$45.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.25
Rate for Payer: Qualcare PPO/HMO/WC	$28.05

PIN NITINOL ORIENTATION 1.5MM

Facility

$1,000.00

Hospital Charge Code	270680223
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

PIN NITINOL ORIENTATION 1.5MM

Facility

$1,000.00

Hospital Charge Code	270680223
Hospital Revenue Code	272
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$500.00

PIN ORTHOSORB 1.3MM TAPERED

Facility

$1,310.00

Hospital Charge Code	270676359
Hospital Revenue Code	278
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$655.00
Rate for Payer: Aetna Commercial	$393.00
Rate for Payer: Aetna Medicare Advantage	$393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.05
Rate for Payer: Cigna Commercial	$655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.02
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

PIN ORTHOSORB 1.3MM TAPERED

Facility

$1,310.00

Hospital Charge Code	270676359
Hospital Revenue Code	278
Min. Negotiated Rate	$196.50
Max. Negotiated Rate	$317.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$262.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$317.02
Rate for Payer: Qualcare PPO/HMO/WC	$196.50

PIN ORTHOSORB KIT 2.0MM STR

Facility

$1,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270676360
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$710.00
Rate for Payer: Aetna Commercial	$426.00
Rate for Payer: Aetna Medicare Advantage	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$362.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$362.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$362.10
Rate for Payer: Cigna Commercial	$710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.64
Rate for Payer: Qualcare PPO/HMO/WC	$213.00

PIN ORTHOSORB KIT 2.0MM STR

Facility

$1,420.00

Service Code	HCPCS C1713
Hospital Charge Code	270676360
Hospital Revenue Code	278
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$343.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$284.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$343.64
Rate for Payer: Qualcare PPO/HMO/WC	$213.00

PIN ORTHOSORB TAPERED 841070**

Facility

$146.00

Hospital Charge Code	1604743
Hospital Revenue Code	274
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

PIN ORTHOSORB TAPERED 841070**

Facility

$146.00

Hospital Charge Code	1604743
Hospital Revenue Code	274
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.33
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

PIN PF 2.7MMx14MM 7117-1228

Facility

$835.00

Hospital Charge Code	270647954
Hospital Revenue Code	272
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$125.25
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

PIN PF 2.7MMx14MM 7117-1228

Facility

$835.00

Hospital Charge Code	270647954
Hospital Revenue Code	272
Min. Negotiated Rate	$108.55
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$250.50
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.55
Rate for Payer: Oxford Commercial	$417.50
Rate for Payer: Qualcare PPO/HMO/WC	$125.25
Rate for Payer: UnitedHealthcare Commercial	$417.50

PIN POSITIONING VA 5.0MM

Facility

$976.45

Service Code	HCPCS C1713
Hospital Charge Code	270693773
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$488.23
Rate for Payer: Aetna Commercial	$292.94
Rate for Payer: Aetna Medicare Advantage	$292.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.99
Rate for Payer: Cigna Commercial	$488.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

PIN POSITIONING VA 5.0MM

Facility

$976.45

Service Code	HCPCS C1713
Hospital Charge Code	270693773
Hospital Revenue Code	278
Min. Negotiated Rate	$146.47
Max. Negotiated Rate	$236.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.30
Rate for Payer: Qualcare PPO/HMO/WC	$146.47

PIN PRECISION TM 3.9X450MM

Facility

$1,395.00

Service Code	HCPCS C1713
Hospital Charge Code	270698905
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

Know your out-of-pocket cost for care.

All Charges