Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLASTIBELL 1.2CM****

Facility

$10.52

Hospital Charge Code	2701301580
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.58

PLASTIBELL 1.2CM****

Facility

$10.52

Hospital Charge Code	2701301580
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$5.26
Rate for Payer: Aetna Commercial	$3.16
Rate for Payer: Aetna Medicare Advantage	$3.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.37
Rate for Payer: Oxford Commercial	$5.26
Rate for Payer: Qualcare PPO/HMO/WC	$1.58
Rate for Payer: UnitedHealthcare Commercial	$5.26

PLASTIBELL 1.3CM

Facility

$19.96

Hospital Charge Code	270631614
Hospital Revenue Code	270
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$9.98
Rate for Payer: Aetna Commercial	$5.99
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.09
Rate for Payer: Cigna Commercial	$9.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$9.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.99
Rate for Payer: UnitedHealthcare Commercial	$9.98

PLASTIBELL 1.3CM

Facility

$22.45

Hospital Charge Code	270130153
Hospital Revenue Code	272
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

PLASTIBELL 1.3CM

Facility

$19.96

Hospital Charge Code	270631614
Hospital Revenue Code	270
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.99

PLASTIBELL 1.3CM

Facility

$22.45

Hospital Charge Code	270130153
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

PLASTIBELL 1.4CM

Facility

$16.73

Hospital Charge Code	270631615
Hospital Revenue Code	270
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.51

PLASTIBELL 1.4CM

Facility

$16.73

Hospital Charge Code	270631615
Hospital Revenue Code	270
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$8.37
Rate for Payer: Aetna Commercial	$5.02
Rate for Payer: Aetna Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.27
Rate for Payer: Cigna Commercial	$8.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.51
Rate for Payer: UnitedHealthcare Commercial	$8.37

PLASTIBELL 1.5CM

Facility

$16.73

Hospital Charge Code	270631616
Hospital Revenue Code	270
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.51

PLASTIBELL 1.5CM

Facility

$16.73

Hospital Charge Code	270631616
Hospital Revenue Code	270
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$8.37
Rate for Payer: Aetna Commercial	$5.02
Rate for Payer: Aetna Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.27
Rate for Payer: Cigna Commercial	$8.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.51
Rate for Payer: UnitedHealthcare Commercial	$8.37

PLASTIC REP UTERINE CERVIX VAG

Facility

$21,775.20

Service Code	HCPCS 57720
Hospital Charge Code	1600000608
Hospital Revenue Code	360
Min. Negotiated Rate	$3,266.28
Max. Negotiated Rate	$3,266.28
Rate for Payer: Qualcare PPO/HMO/WC	$3,266.28

PLASTIC REP UTERINE CERVIX VAG

Facility

$21,775.20

Service Code	HCPCS 57720
Hospital Charge Code	1600000608
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$6,532.56
Rate for Payer: Aetna Medicare Advantage	$6,532.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.68
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	$5,552.68
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,830.78
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,266.28
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

Plastic Stents

Facility

$355.00

Service Code	HCPCS C2617
Hospital Charge Code	270685516
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$85.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

Plastic Stents

Facility

$355.00

Service Code	HCPCS C2617
Hospital Charge Code	270685515
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

Plastic Stents

Facility

$355.00

Service Code	HCPCS C2617
Hospital Charge Code	270685514
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

Plastic Stents

Facility

$355.00

Service Code	HCPCS C2617
Hospital Charge Code	270685514
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$85.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

Plastic Stents

Facility

$355.00

Service Code	HCPCS C2617
Hospital Charge Code	270685516
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$106.50
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

Plastic Stents

Facility

$355.00

Service Code	HCPCS C2617
Hospital Charge Code	270685515
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$85.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

PLASTIC SURGERY OVERNIGHT STAY

Facility

$580.00

Hospital Charge Code	1600175
Hospital Revenue Code	121
Min. Negotiated Rate	$87.00
Max. Negotiated Rate	$6,764.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,086.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,764.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.00

PLATE 100DEG TUBULAR 10 HOLE

Facility

$467.50

Service Code	HCPCS C1713
Hospital Charge Code	270688923
Hospital Revenue Code	278
Min. Negotiated Rate	$70.12
Max. Negotiated Rate	$233.75
Rate for Payer: Aetna Commercial	$140.25
Rate for Payer: Aetna Medicare Advantage	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.21
Rate for Payer: Cigna Commercial	$233.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.14
Rate for Payer: Qualcare PPO/HMO/WC	$70.12

PLATE 100DEG TUBULAR 10 HOLE

Facility

$467.50

Service Code	HCPCS C1713
Hospital Charge Code	270688923
Hospital Revenue Code	278
Min. Negotiated Rate	$70.12
Max. Negotiated Rate	$113.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.14
Rate for Payer: Qualcare PPO/HMO/WC	$70.12

PLATE 100 DEG TUBULAR 7 HOLE

Facility

$440.00

Service Code	HCPCS C1713
Hospital Charge Code	270632799
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$220.00
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

PLATE 100 DEG TUBULAR 7 HOLE

Facility

$440.00

Service Code	HCPCS C1713
Hospital Charge Code	270632799
Hospital Revenue Code	278
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.48
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

PLATE 100 DEG TUBULAR 8 HOLE

Facility

$384.00

Service Code	HCPCS C1713
Hospital Charge Code	270682614
Hospital Revenue Code	278
Min. Negotiated Rate	$57.60
Max. Negotiated Rate	$192.00
Rate for Payer: Aetna Commercial	$115.20
Rate for Payer: Aetna Medicare Advantage	$115.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.92
Rate for Payer: Cigna Commercial	$192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.93
Rate for Payer: Qualcare PPO/HMO/WC	$57.60

PLATE 100 DEG TUBULAR 8 HOLE

Facility

$384.00

Service Code	HCPCS C1713
Hospital Charge Code	270682614
Hospital Revenue Code	278
Min. Negotiated Rate	$57.60
Max. Negotiated Rate	$92.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.93
Rate for Payer: Qualcare PPO/HMO/WC	$57.60

Know your out-of-pocket cost for care.

All Charges